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接受度洛西汀治疗的重度抑郁症患者血浆脑源性神经营养因子水平的变化

BDNF plasma levels variations in major depressed patients receiving duloxetine.

作者信息

Fornaro Michele, Escelsior Andrea, Rocchi Giulio, Conio Benedetta, Magioncalda Paola, Marozzi Valentina, Presta Andrea, Sterlini Bruno, Contini Paola, Amore Mario, Fornaro Pantaleo, Martino Matteo

机构信息

Section of Psychiatry, Department of Neuroscience, IRCCS AOU San Martino-IST, Ospedale San Martino, Largo Rosanna Benzi n.16, 16100, Genoa, Italy,

出版信息

Neurol Sci. 2015 May;36(5):729-34. doi: 10.1007/s10072-014-2027-7. Epub 2014 Dec 11.

Abstract

It has been frequently reported that brain-derived neurotrophic factor (BDNF) plays an important role in the pathophysiology of major depressive disorder (MDD). Objective of the study was to investigate BDNF levels variations in MDD patients during antidepressant treatment with duloxetine. 30 MDD patients and 32 healthy controls were assessed using Hamilton Depression Scale (HAM-D) and monitored for BDNF plasma levels at baseline, week 6 and week 12 of duloxetine treatment (60 mg/day) and at baseline, respectively. According to early clinical response to duloxetine (defined at week 6 by reduction >50 % of baseline HAM-D score), MDD patients were distinguished in early responders (ER) and early non-responders (ENR), who reached clinical response at week 12. Laboratory analysis showed significant lower baseline BDNF levels among patients compared to controls. During duloxetine treatment, in ENR BDNF levels increased, reaching values not significantly different compared to controls, while in ER BDNF levels remained nearly unchanged. Lower baseline BDNF levels observed in patients possibly confirm an impairment of the NEI stress-adaptation system and neuroplasticity in depression, while BDNF increase and normalization observed only in ENR might suggest differential neurobiological backgrounds in ER vs. ENR within the depressive syndrome.

摘要

经常有报道称,脑源性神经营养因子(BDNF)在重度抑郁症(MDD)的病理生理学中起重要作用。本研究的目的是调查度洛西汀抗抑郁治疗期间MDD患者的BDNF水平变化。使用汉密尔顿抑郁量表(HAM-D)对30例MDD患者和32名健康对照者进行评估,并分别在基线、度洛西汀治疗(60毫克/天)的第6周和第12周以及基线时监测血浆BDNF水平。根据度洛西汀的早期临床反应(在第6周时定义为HAM-D基线评分降低>50%),将MDD患者分为早期反应者(ER)和早期无反应者(ENR),后者在第12周达到临床反应。实验室分析显示,与对照组相比,患者的基线BDNF水平显著较低。在度洛西汀治疗期间,ENR的BDNF水平升高,达到与对照组无显著差异的值,而ER的BDNF水平几乎保持不变。患者中观察到的较低基线BDNF水平可能证实了抑郁症中NEI应激适应系统和神经可塑性的损害,而仅在ENR中观察到的BDNF升高和正常化可能表明抑郁综合征中ER与ENR的神经生物学背景不同。

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