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强迫症患儿治疗前的皮质醇和脑源性神经营养因子水平

Cortisol and Brain-Derived Neurotrophic Factor Levels Prior to Treatment in Children With Obsessive-Compulsive Disorder.

作者信息

Şimşek Şeref, Gençoğlan Salih, Yüksel Tuğba, Kaplan İbrahim, Alaca Rümeysa

机构信息

Dicle University, Medical School, Department of Child Psychiatry, Sur, Diyarbakır, Turkey 21280.

Dicle University, Medical School, Department of Child Psychiatry, Diyarbakır, Turkey.

出版信息

J Clin Psychiatry. 2016 Jul;77(7):e855-9. doi: 10.4088/JCP.15m10146.

Abstract

OBJECTIVE

In this study, we investigated serum brain-derived neurotrophic factor (BDNF), adrenocorticotropic hormone (ACTH), and cortisol levels between children with obsessive-compulsive disorder (OCD) prior to treatment and healthy controls. In addition, the study aimed to assess any correlations between OCD symptom severity and BDNF, ACTH, and cortisol levels.

METHODS

Twenty-nine children, aged from 7 to 17 years (male/female: 21/8) and diagnosed with OCD according to DSM-IV prior to treatment, were compared with 25 healthy control subjects (male/female: 16/9). The study was conducted between December 2012 and December 2013. The Kiddie Schedule for Affective Disorders and Schizophrenia, Present and Lifetime Version (K-SADS-PL), Children's Yale-Brown Obsessive Compulsive Scale, and Children's Depression Inventory (CDI) were administered to the children. BDNF, ACTH, and cortisol levels were detected using a prepared kit with the enzyme-linked immunosorbent assay method.

RESULTS

BDNF, ACTH, and cortisol levels in the OCD group were significantly higher when compared with the control group (P = .02, P = .03, and P = .046, respectively). No association was detected between the severity and duration of OCD symptoms and BDNF, ACTH, and cortisol levels. CDI scores in both groups were similar. The mean (SD) duration of OCD symptoms was 17.9 (18.5) months.

CONCLUSIONS

Our findings suggest that BDNF levels adaptively increase as a result of the damaging effects of the hypothalamic-pituitary-adrenal (HPA) axis hyperactivity on brain tissue in the early stages of OCD. HPA axis abnormalities and BDNF may play a role in the pathogenesis of the disease.

摘要

目的

在本研究中,我们调查了强迫症(OCD)患儿治疗前血清脑源性神经营养因子(BDNF)、促肾上腺皮质激素(ACTH)和皮质醇水平,并与健康对照进行比较。此外,本研究旨在评估OCD症状严重程度与BDNF、ACTH和皮质醇水平之间的相关性。

方法

选取29名7至17岁的儿童(男/女:21/8),这些儿童在治疗前根据《精神疾病诊断与统计手册》第四版(DSM-IV)被诊断为OCD,并与25名健康对照受试者(男/女:16/9)进行比较。研究于2012年12月至2013年12月进行。对儿童进行了《儿童情感障碍和精神分裂症量表》(K-SADS-PL)、《儿童耶鲁-布朗强迫症量表》和《儿童抑郁量表》(CDI)的评估。采用酶联免疫吸附测定法,使用预制试剂盒检测BDNF、ACTH和皮质醇水平。

结果

与对照组相比,OCD组的BDNF、ACTH和皮质醇水平显著更高(分别为P = .02、P = .03和P = .046)。未发现OCD症状的严重程度和持续时间与BDNF、ACTH和皮质醇水平之间存在关联。两组的CDI评分相似。OCD症状的平均(标准差)持续时间为17.9(18.5)个月。

结论

我们的研究结果表明,在OCD早期,下丘脑-垂体-肾上腺(HPA)轴功能亢进对脑组织的损害作用导致BDNF水平适应性升高。HPA轴异常和BDNF可能在该疾病的发病机制中起作用。

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