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继继续电抽搐治疗后血清 BDNF 的重复增强。

Repetitive enhancement of serum BDNF subsequent to continuation ECT.

机构信息

Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria.

Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong.

出版信息

Acta Psychiatr Scand. 2019 Nov;140(5):426-434. doi: 10.1111/acps.13080. Epub 2019 Sep 11.

Abstract

INTRODUCTION

Continuation electroconvulsive therapy (c-ECT) is highly effective for the prevention of depressive symptom relapse. There is a lack of understanding, about how c-ECT works in humans, particularly with regard to its effects on brain derived neurotrophic factor (BDNF) concentrations. Here, we aimed to close a gap in the literature by evaluating BDNF levels in patients receiving c-ECT.

METHODS

We included 13 patients with either unipolar or bipolar depression (mean age ± SD: 55.5 ± 17.1; f/m: 10/3; unipolar/bipolar: 10/3) who received between one and four c-ECT (average per patient: 2.8). Serum BDNF (sBDNF) levels were assessed before and after each c-ECT sessions. Clinical assessments were also administered both before and after treatment.

RESULTS

Our analysis revealed a significant increase in sBDNF after each treatment (c-ECT 1-3: P < 0.001, c-ECT 4: P = 0.018). The application of multiple c-ECT treatments was not, however, associated with further sBDNF enhancements. Psychometric scores were not significantly altered following c-ECT.

DISCUSSION

An increase in sBDNF concentrations subsequent to c-ECT parallel data from the animal literature, which has linked regularly applied electrical stimulation to neuroplastic processes. This finding suggests a relationship between ECT-induced sBDNF concentrations and (sustained) remission status, considering a stable clinical condition across c-ECT.

摘要

简介

继续电抽搐治疗(c-ECT)在预防抑郁症状复发方面非常有效。目前对于 c-ECT 如何在人体中发挥作用,特别是其对脑源性神经营养因子(BDNF)浓度的影响,人们的理解还很有限。在这里,我们旨在通过评估接受 c-ECT 的患者的 BDNF 水平来填补文献中的空白。

方法

我们纳入了 13 名患有单相或双相抑郁症的患者(平均年龄 ± 标准差:55.5 ± 17.1;f/m:10/3;单相/双相:10/3),他们接受了 1 到 4 次 c-ECT(每位患者平均:2.8 次)。在每次 c-ECT 前后评估血清 BDNF(sBDNF)水平。在治疗前后还进行了临床评估。

结果

我们的分析显示,每次治疗后 sBDNF 水平均显著升高(c-ECT 1-3:P<0.001,c-ECT 4:P=0.018)。然而,多次 c-ECT 治疗并不会进一步增加 sBDNF。c-ECT 后心理测量评分没有显著改变。

讨论

c-ECT 后 sBDNF 浓度的增加与动物文献中的数据相平行,该文献将定期应用电刺激与神经可塑性过程联系起来。考虑到 c-ECT 期间的稳定临床状况,这一发现表明 ECT 诱导的 sBDNF 浓度与(持续)缓解状态之间存在关系。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a200/6856812/140f7f8cd843/ACPS-140-426-g001.jpg

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