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治疗初治注意缺陷多动障碍男孩的血清脑源性神经营养因子水平:一项为期 8 周的观察性治疗前后研究。

Serum brain-derived neurotrophic factor levels in treatment-naïve boys with attention-deficit/hyperactivity disorder treated with methylphenidate: an 8-week, observational pretest-posttest study.

机构信息

Department of Child and Adolescent Psychiatry, Dokuz Eylul University Medical Faculty, Izmir, Turkey.

Department of Biochemistry, Dokuz Eylul University Medical Faculty, Izmir, Turkey.

出版信息

Eur Child Adolesc Psychiatry. 2018 Jan;27(1):127-135. doi: 10.1007/s00787-017-1022-y. Epub 2017 Jul 14.

Abstract

Brain-derived neurotrophic factor (BDNF) is an important neurotrophin in the brain that modulates dopaminergic neurons. In this study, we aimed to investigate the changes in serum BDNF levels of children with attention-deficit/hyperactivity disorder (ADHD) in response to OROS methylphenidate treatment. We also aimed to determine whether there were any pre-post-differences between ADHD subtypes and comorbid psychiatric disorders in serum BDNF levels. Fifty male children with ADHD and 50 male healthy controls within the age range of 6-12 years were recruited to the study. The psychiatric diagnoses were determined by applying a structured interview with Kiddie schedule for affective disorders and schizophrenia for school-age children-present and lifetime version. The symptom severity of ADHD was measured using the Clinical Global Impression ADHD Severity Scale (CGI-S). Physicians completed Du Paul ADHD questionnaires. The levels of serum BDNF were assessed before and after 8 weeks of treatment with effective dosages of OROS methylphenidate. In the present study, the mean serum BDNF levels of boys with ADHD and of the healthy controls were 2626.33 ± 1528.05 and 2989.11 ± 1420.08 pg/mL, respectively. Although there were no statistically significant difference between the ADHD group and healthy controls at baseline (p = 0.22), the increase of serum BDNF was statistically significant from baseline to endpoint in the ADHD group (p = 0.04). The mean serum BDNF levels at baseline and endpoint of the ADHD group were 2626.33 ± 1528.05 and 3255.80 ± 1908.79 pg/mL, respectively. The serum BDNF levels of ADHD-inattentive subtype were significantly lower at baseline (p = 0.02), whereas BDNF levels post-treatment showed no significant difference. The increase of serum BDNF levels with methylphenidate treatment after 8 weeks was significantly higher in the inattentive group (p = 0.005). The increase of serum BDNF levels with methylphenidate treatment after 8 weeks in boys with ADHD may support the potential role of BDNF in the pathophysiology of ADHD. The role of BDNF in ADHD subtypes in particular should be evaluated with further, larger studies.

摘要

脑源性神经营养因子(BDNF)是大脑中一种重要的神经营养因子,可调节多巴胺能神经元。本研究旨在探讨奥洛他定治疗注意力缺陷多动障碍(ADHD)儿童时血清 BDNF 水平的变化。我们还旨在确定 ADHD 亚型和合并精神疾病之间的血清 BDNF 水平是否存在治疗前后差异。研究纳入了 50 名年龄在 6-12 岁之间的 ADHD 男性儿童和 50 名健康男性对照。使用儿童情感障碍和精神分裂症的 Kiddie 时间表进行结构化访谈来确定精神科诊断。使用 ADHD 严重程度临床总体印象量表(CGI-S)来衡量 ADHD 的症状严重程度。医生完成了 Du Paul ADHD 问卷。在奥洛他定有效剂量治疗 8 周前后评估血清 BDNF 水平。在本研究中,ADHD 男孩和健康对照的平均血清 BDNF 水平分别为 2626.33±1528.05 和 2989.11±1420.08 pg/mL。虽然 ADHD 组和健康对照组在基线时无统计学差异(p=0.22),但 ADHD 组从基线到终点时血清 BDNF 水平升高有统计学意义(p=0.04)。ADHD 组的平均血清 BDNF 水平在基线和终点分别为 2626.33±1528.05 和 3255.80±1908.79 pg/mL。ADHD 不注意亚型的血清 BDNF 水平在基线时显著降低(p=0.02),而治疗后的 BDNF 水平无显著差异。奥洛他定治疗 8 周后血清 BDNF 水平升高与注意力不集中组显著相关(p=0.005)。奥洛他定治疗 8 周后 ADHD 男孩血清 BDNF 水平升高可能支持 BDNF 在 ADHD 发病机制中的潜在作用。BDNF 在 ADHD 亚型中的作用需要进一步的、更大的研究来评估。

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