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双相情感障碍老年患者脑源性神经营养因子水平降低。

Decreased Brain-Derived Neurotrophic Factor in Older Adults with Bipolar Disorder.

作者信息

Soares Aline T, Andreazza Ana C, Rej Soham, Rajji Tarek K, Gildengers Ariel G, Lafer Beny, Young L Trevor, Mulsant Benoit H

机构信息

Department of Internal Medicine, Geriatrics Discipline, University of Sao Paulo, Brazil.

Department of Psychiatry, University of Toronto, Canada; Department of Pharmacology, University of Toronto, Canada; Department of Psychiatry, Centre for Addiction and Mental Health, Toronto, Canada.

出版信息

Am J Geriatr Psychiatry. 2016 Aug;24(8):596-601. doi: 10.1016/j.jagp.2016.02.052. Epub 2016 Mar 15.

Abstract

OBJECTIVES

Decreased levels of brain derived neurotrophic factor (BDNF) have been found in adult patients with bipolar disorder (BD) compared with a comparison group, yet there are no data specifically examining this in geriatric patients. The objective of this study was to examine whether euthymic late-life BD patients have lower BDNF levels than healthy comparators.

DESIGN

Cross-sectional study.

SETTING

Clinics at the University of Pittsburgh and the Centre for Addiction and Mental Health (Toronto).

PARTICIPANTS

Older patients with BD (age ≥50 years, N = 118) and similarly aged healthy comparators (N = 76). There were both BD type I (N = 91) and type II (N = 27) patients.

MEASUREMENTS

Serum BDNF levels were assessed in BD patients and healthy comparators.

RESULTS

We found lower levels of BDNF in patients with BD than in healthy comparators (9.0 ± 6.2 versus 12.3 ± 8.9 pg/µg, t(192) = -3.01, p = 0.002), which remained even after controlling for age, sex, lithium use, and site (F(1,176) = 4.32, p = 0.039). This decrease was found specifically in patients with BD type I (8.0 ± 5.5 versus 12.3 ± 8.9 pg/µg, t(165) = 3.7, Bonferroni p < 0.001), but not type II (12.0 ± 7.5 versus 12.3 ± 8.9 pg/µg, t(101) = 0.14, Bonferroni p = 1.0).

CONCLUSIONS

Older patients with BD have lower serum levels of BDNF compared with similarly aged comparators. These effects appear to be specific to patients with BD type I. Future studies are needed to investigate the impact of reduced BDNF levels on cognition, mood, and other aspects of BD throughout the life course.

摘要

目的

与对照组相比,已发现双相情感障碍(BD)成年患者脑源性神经营养因子(BDNF)水平降低,但尚无专门针对老年患者的相关数据。本研究的目的是检验处于心境正常期的老年BD患者的BDNF水平是否低于健康对照者。

设计

横断面研究。

地点

匹兹堡大学诊所及成瘾与心理健康中心(多伦多)。

参与者

老年BD患者(年龄≥50岁,N = 118)及年龄相仿的健康对照者(N = 76)。其中既有I型BD患者(N = 91),也有II型BD患者(N = 27)。

测量指标

对BD患者和健康对照者的血清BDNF水平进行评估。

结果

我们发现BD患者的BDNF水平低于健康对照者(9.0±6.2对12.3±8.9 pg/μg,t(192)= -3.01,p = 0.002),即便在控制了年龄、性别、锂盐使用情况及研究地点后,这一差异依然存在(F(1,176)= 4.32,p = 0.039)。这种降低在I型BD患者中尤为明显(8.0±5.5对12.3±8.9 pg/μg,t(165)= 3.7,Bonferroni校正p < 0.001),但在II型BD患者中未出现(12.0±7.5对12.3±8.9 pg/μg,t(101)= 0.14,Bonferroni校正p = 1.0)。

结论

与年龄相仿的对照者相比,老年BD患者的血清BDNF水平较低。这些影响似乎在I型BD患者中更为显著。未来需要开展研究,以调查BDNF水平降低对BD患者一生认知、情绪及其他方面的影响。

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