Santoro M, Nociti V, De Fino C, Caprara A, Giordano R, Palomba N, Losavio F, Marra C, Patanella A K, Mirabella M, Gainotti G, Quaranta D
Fondazione Don Gnocchi - ONLUS, Milan, Italy.
Institute of Neurology, Catholic University, Rome, Italy.
Eur J Neurol. 2016 Mar;23(3):630-40. doi: 10.1111/ene.12913. Epub 2016 Jan 12.
Depression is common amongst subjects with multiple sclerosis (MS), and several investigations have explored different determinants of this condition, including physical disability, psychological and psychosocial factors. The brain derived neurotrophic factor (BDNF) Val66Met polymorphism has been associated with depression. The aim of this study was to analyze the influence of disease-related factors, BDNF Val66Met polymorphism and perception of disease on the severity of depression in MS.
In total, 136 MS patients (88 women) were recruited and genotyped for BDNF rs6265 polymorphism at nucleotide 196 (G/A) using 'high resolution melting'. Depressive symptoms were assessed by the Multiple Sclerosis Depression Rating Scale. Perception of health status was assessed using the SF-36 questionnaire.
A multivariable linear regression model showed that the best predictors of depression were the SF-36 General health (β = -0.209; P = 0.013), Mental health (β = -0.410; P < 0.001) and Social activity (β = -0.195; P = 0.035) scores; physical disability (assessed by the Extended Disability Status Scale score) was directly correlated to depression severity on univariate analysis, but it was not a relevant predictor of depression on multivariate analysis; other variables directly related to the disease (treatment, annual relapsing rate) and the BDNF Val66Met polymorphism were not significantly associated with depression.
Perception of the health status is the principal predictor of depressive symptoms in our sample. This result supports the hypothesis that the subjective interpretation of the disease's consequences is one of the main factors in determining depression in MS.
抑郁症在多发性硬化症(MS)患者中很常见,多项研究探讨了这种情况的不同决定因素,包括身体残疾、心理和社会心理因素。脑源性神经营养因子(BDNF)Val66Met多态性与抑郁症有关。本研究的目的是分析疾病相关因素、BDNF Val66Met多态性和疾病认知对MS患者抑郁严重程度的影响。
共招募了136例MS患者(88名女性),并使用“高分辨率熔解”技术对BDNF rs6265多态性在核苷酸196(G/A)处进行基因分型。通过多发性硬化症抑郁评定量表评估抑郁症状。使用SF-36问卷评估健康状况认知。
多变量线性回归模型显示,抑郁的最佳预测因素是SF-36总体健康(β = -0.209;P = 0.013)、心理健康(β = -0.410;P < 0.001)和社会活动(β = -0.195;P = 0.035)得分;身体残疾(通过扩展残疾状态量表评分评估)在单变量分析中与抑郁严重程度直接相关,但在多变量分析中不是抑郁的相关预测因素;其他与疾病直接相关的变量(治疗、年复发率)和BDNF Val66Met多态性与抑郁症无显著关联。
在我们的样本中,健康状况认知是抑郁症状的主要预测因素。这一结果支持了以下假设,即对疾病后果的主观解释是决定MS患者抑郁的主要因素之一。