Karamustafalioglu Nesrin, Genc Abdullah, Kalelioglu Tevfik, Tasdemir Akif, Umut Gokhan, Incir Said, Akkuş Mustafa, Emul Murat
Department of Psychiatry, Bakırkoy Mental Health Research and Training State Hospital, Istanbul, Turkey.
Department of Psychiatry, Bakırkoy Mental Health Research and Training State Hospital, Istanbul, Turkey
J Psychopharmacol. 2015 Aug;29(8):898-902. doi: 10.1177/0269881115578161. Epub 2015 Mar 31.
Inconsistent findings concerning brain-derived neurotrophic factor (BDNF) levels across different episodes in bipolar disorder have been reported, which is also in line with the treatment effects on BDNF levels in acute mania. We aimed to compare plasma BDNF level alterations after pure antipsychotic drug or ECT plus antipsychotic drug treatment in acute mania.
Sixty-eight patients with mania were divided into two treatment arms: the antipsychotic treatment arm (AP) and electroconvulsive therapy (ECT)+AP arm. In addition, 30 healthy controls were included in the study.
There was no significant statistical difference according to mean age, education level, marital and working status between patients and healthy controls. The initial serum BDNF level in patients with acute mania was significantly lower than healthy controls. The initial BDNF level between the ECT arm and AP arm was not significant. The BDNF level decreased significantly after reaching remission in patients with acute mania. The change in BDNF level in the AP arm was not significant while in the ECT arm it was significant after treatment.
In this study, for the first time we revealed a significant decrease in BDNF levels after ECT sessions in acute manic patients. Besides clinical remission after treatment in acute mania, the decrement in BDNF levels does not seem to be related to clinical response. Thus cumulative effects of mood episodes for the ongoing decrease in BDNF levels might be borne in mind despite the achievement of remission and/or more time being required for an increase in BDNF levels after treatment.
关于双相情感障碍不同发作期脑源性神经营养因子（BDNF）水平的研究结果并不一致，这也与急性躁狂发作时BDNF水平的治疗效果相符。我们旨在比较单纯抗精神病药物治疗或电休克治疗（ECT）联合抗精神病药物治疗急性躁狂发作后血浆BDNF水平的变化。
68例躁狂患者被分为两个治疗组：抗精神病药物治疗组（AP）和ECT联合抗精神病药物治疗组（ECT+AP）。此外，30名健康对照者纳入研究。
患者与健康对照者在平均年龄、教育水平、婚姻和工作状况方面无显著统计学差异。急性躁狂患者的初始血清BDNF水平显著低于健康对照者。ECT组和AP组的初始BDNF水平无显著差异。急性躁狂患者达到缓解后BDNF水平显著下降。AP组BDNF水平变化不显著，而ECT组治疗后变化显著。
在本研究中，我们首次揭示急性躁狂患者接受ECT治疗后BDNF水平显著下降。除了急性躁狂发作治疗后的临床缓解外，BDNF水平的下降似乎与临床反应无关。因此，尽管实现了缓解和/或治疗后BDNF水平升高需要更多时间，但仍应考虑情绪发作对BDNF水平持续下降的累积影响。
