Williams John, Finn Karen, Melvin Vincent, Meagher David, McCarthy Geraldine, Adamis Dimitrios
Pathology Department, Sligo University Hospital Sligo, Sligo, Ireland.
School of Biological Science, Cork Institute of Technology, Cork, Ireland.
Biomed Res Int. 2017;2017:5271395. doi: 10.1155/2017/5271395. Epub 2017 Feb 9.
Limited studies of the association between BDNF levels and delirium have given inconclusive results. This prospective, longitudinal study examined the relationship between BDNF levels and the occurrence of and recovery from delirium. Participants were assessed twice weekly using MoCA, DRS-R98, and APACHE II scales. BDNF levels were estimated using an ELISA method. Delirium was defined with DRS-R98 (score > 16) and recovery from delirium as ≥2 consecutive assessments without delirium prior to discharge. We identified no difference in BDNF levels between those with and without delirium. Excluding those who never developed delirium ( = 140), we examined the association of BDNF levels and other variables with delirium recovery. Of 58 who experienced delirium, 39 remained delirious while 19 recovered. Using Generalized Estimating Equations models we found that BDNF levels (Wald = 7.155; df: 1, = 0.007) and MoCA (Wald = 4.933; df: 1, = 0.026) were associated with recovery. No significant association was found for APACHE II, dementia, age, or gender. BDNF levels do not appear to be directly linked to the occurrence of delirium but recovery was less likely in those with continuously lower levels. No previous study has investigated the role of BDNF in delirium recovery and these findings warrant replication in other populations.
关于脑源性神经营养因子（BDNF）水平与谵妄之间关联的研究有限，结果尚无定论。这项前瞻性纵向研究考察了BDNF水平与谵妄的发生及恢复之间的关系。参与者每周使用蒙特利尔认知评估量表（MoCA）、98版谵妄评定量表（DRS-R98）和急性生理与慢性健康状况评分系统II（APACHE II）进行两次评估。BDNF水平采用酶联免疫吸附测定（ELISA）法进行测定。谵妄由DRS-R98定义（得分>16），谵妄恢复定义为出院前连续≥2次评估无谵妄。我们发现有谵妄和无谵妄者的BDNF水平无差异。排除那些从未发生谵妄的人（n = 140），我们考察了BDNF水平及其他变量与谵妄恢复的关联。在58名经历过谵妄的患者中，39人仍处于谵妄状态，19人恢复。使用广义估计方程模型，我们发现BDNF水平（Wald = 7.155；自由度：1，P = 0.007）和MoCA（Wald = 4.933；自由度：1，P = 0.026）与恢复有关。未发现APACHE II、痴呆、年龄或性别有显著关联。BDNF水平似乎与谵妄的发生没有直接联系，但水平持续较低者恢复的可能性较小。此前尚无研究调查BDNF在谵妄恢复中的作用，这些发现有待在其他人群中重复验证。
