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注意力缺陷多动障碍中外周脑源性神经营养因子:一项全面的系统评价和荟萃分析。

Peripheral brain-derived neurotrophic factor in attention-deficit/hyperactivity disorder: A comprehensive systematic review and meta-analysis.

机构信息

Division of Obstetrics and Gynecology, Nanfang Hospital, Southern Medical University, Guangzhou 510515, Guangdong, China; Department of Medical Genetics, School of Basic Medical Sciences, Southern Medical University, Guangzhou 510515, Guangdong, China.

The Second School of Clinical Medicine, Southern Medical University, Guangzhou 510515, Guangdong, China.

出版信息

J Affect Disord. 2018 Feb;227:298-304. doi: 10.1016/j.jad.2017.11.012. Epub 2017 Nov 6.

Abstract

BACKGROUND

Studies suggest that dysfunction of BDNF is a possible contributor to the pathology and symptoms of attention-deficit/hyperactivity disorder (ADHD). Several studies have found changes of peripheral BDNF levels in ADHD, but findings are not always consistent. The aim of our study was to assess the association between peripheral BDNF levels and ADHD by using a meta-analysis.

METHODS

A systematic search of Pubmed, Web of Science and China National Knowledge Infrastructure identified 10 articles encompassing a sample of 1183 individuals for the meta-analysis. Meta-analysis was performed in a fixed/random effect model by using the software Review Manager 5.2.

RESULTS

Our meta-analysis suggests that peripheral BDNF levels did not differ significantly between ADHD and controls with the standardized mean difference (SMD) of 0.62 (95% CI -0.12 to 1.35, p = 0.10). However, it is intriguing that BDNF levels were significantly higher in males with ADHD compared with controls (SMD = 0.49, 95% CI = 0.14-0.84, p = 0.006), whereas there was no difference in BDNF levels between ADHD female patients and control groups (SMD = 0.21,95% CI = -0.44 to 0.86, p = 0.53).

LIMITATIONS

High heterogeneity was noted across sampled studies, which may be a function of sample size, participants sampled, variations in study design, or other factors.

CONCLUSIONS

We found that though there was no significantly difference in peripheral BDNF levels between ADHD patients and control groups overall, BDNF levels were significantly higher in males with ADHD compared with controls. Our results suggested a sex-specific association between peripheral blood BDNF levels and ADHD male patients.

摘要

背景

研究表明,BDNF 功能障碍可能是导致注意力缺陷多动障碍(ADHD)病理和症状的原因之一。几项研究发现 ADHD 患者外周血 BDNF 水平发生变化,但研究结果并不总是一致。我们的研究旨在通过荟萃分析评估外周血 BDNF 水平与 ADHD 之间的相关性。

方法

通过系统检索 Pubmed、Web of Science 和中国国家知识基础设施,共纳入了 10 项研究,这些研究共包含了 1183 名参与者的样本,用于荟萃分析。荟萃分析采用 Review Manager 5.2 软件在固定/随机效应模型中进行。

结果

我们的荟萃分析表明,ADHD 患者与对照组之间外周血 BDNF 水平无显著差异,标准化均数差(SMD)为 0.62(95%CI -0.12 至 1.35,p = 0.10)。然而,有趣的是,ADHD 男性患者的 BDNF 水平明显高于对照组(SMD = 0.49,95%CI = 0.14-0.84,p = 0.006),而 ADHD 女性患者与对照组之间的 BDNF 水平无差异(SMD = 0.21,95%CI = -0.44 至 0.86,p = 0.53)。

局限性

纳入的研究存在高度异质性,这可能是由于样本量、抽样参与者、研究设计的变化或其他因素所致。

结论

我们发现,虽然总体上 ADHD 患者与对照组之间外周血 BDNF 水平无显著差异,但 ADHD 男性患者的 BDNF 水平明显高于对照组。我们的研究结果提示,外周血 BDNF 水平与 ADHD 男性患者之间存在性别特异性关联。

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