Schmidt Frank Martin, Mergl Roland, Stach Barbara, Jahn Ina, Schönknecht Peter
Department of Psychiatry and Psychotherapy, University Hospital Leipzig , Leipzig , Germany.
World J Biol Psychiatry. 2015 Feb;16(2):106-13. doi: 10.3109/15622975.2014.952776. Epub 2014 Sep 29.
Alterations in neuronal and glial integrity are considered to be of pathogenic impact on major depressive disorder (MDD). For MDD, data on cerebrospinal fluid (CSF) levels of neuron-specific enolase (NSE) are lacking and scarce for glial protein S100B.
We measured CSF levels of NSE and S100B in 31 patients with MDD and 32 mentally healthy controls using electrochemiluminescence immunoassays (ECLIA).
Adjusted means of NSE were significantly elevated in the MDD patients (11.73 ng/ml (9.95-13.52 95% CI) compared to the controls (6.17 ng/ml (4.55-7.78), F = 9.037, P = 0.004. Effect size for adjusted mean group difference of 5.57 ng/ml was found invariably high (Cohen's d = 1.23). Differentiating MDD from controls, a NSE cut-off of 7.94 ng/ml showed sensitivity of 81% (95% CI 63.7-90.8) and specificity of 75% (95% CI 57.9-86.7). Adjusted levels of S100B did not differ significantly between the two groups (1.12 ng/ml (0.77-1.48) in MDD, 0.97 ng/ml (0.64-1.30) in controls).
Our results of elevated CSF-NSE levels support neuronal pathology in MDD and the potential use of CSF-NSE as marker in clinical diagnostics. Missing group differences in S100B do not promote a specific glial pathology in depressive disorders.
神经元和神经胶质完整性的改变被认为对重度抑郁症(MDD)具有致病影响。对于MDD,关于脑脊液(CSF)中神经元特异性烯醇化酶(NSE)水平的数据缺乏,而关于神经胶质蛋白S100B的数据也很稀少。
我们使用电化学发光免疫分析法(ECLIA)测量了31例MDD患者和32名心理健康对照者脑脊液中NSE和S100B的水平。
与对照组(6.17 ng/ml(4.55 - 7.78))相比,MDD患者中NSE的校正均值显著升高(11.73 ng/ml(9.95 - 13.52 95%CI),F = 9.037,P = 0.004)。发现校正均值组间差异5.57 ng/ml的效应大小始终很高(科恩d值 = 1.23)。将MDD与对照组区分开来,NSE临界值为7.94 ng/ml时,敏感性为81%(95%CI 63.7 - 90.8),特异性为75%(95%CI 57.9 - 86.7)。两组间S100B的校正水平无显著差异(MDD组为1.12 ng/ml(0.77 - 1.48),对照组为0.97 ng/ml(0.64 - 1.30))。
我们关于脑脊液NSE水平升高的结果支持MDD中的神经元病理学以及脑脊液NSE作为临床诊断标志物的潜在用途。S100B组间差异缺失并不支持抑郁症中存在特定的神经胶质病理学。