Department of Mental Health, The First Hospital of Jilin University, Changchun, 130021, China.
Department of Surgery, Jilin University Hospital, Changchun, 130012, China.
Asian J Psychiatr. 2020 Jun;51:101983. doi: 10.1016/j.ajp.2020.101983. Epub 2020 Feb 26.
Some evidence pointed out that Electro-Convulsive Treatment (ECT) could increase the level of brain-derived neurotrophic factor (BDNF) in depressive patients. However, there are some disagreements. The purpose of the study is through a systematic review and meta-analysis to evaluate BDNF levels after ECT in patients with Major depressive disorder. Two independent researchers searched of published articles in the databases of Cochrane Library, PubMed, MEDLINE, EMBASE and WanFang Data, from January 1990 to March 2019. The following key words were used: "depression" or "depressive disorder", "major depressive disorder", "unipolar depression", "brain-derived neurotrophic factor" or "BDNF", and "electroconvulsive" or "ECT". A total of 22 studies met the inclusion criteria of the meta-analysis and included into our analysis. BDNF levels were increased among patients with MDD after ECT (P = 0.000) in plasma samples. The standardized mean difference (SMD) was 0.695 (95 % CI: 0.402-0.988). We also found BDNF levels increased on one week and one month after finishing ECT (SMD = 0.491, 95 %CI: 0.150,0.833, P = 0.005; and SMD = 0.812, 95 %CI: 0.326,1.298, P = 0.001, respectively). Our findings suggest that BDNF levels may increase after ECT and may possibly be used as an indicator of treatment response after one or more weeks of ECT in patients with depression. However, additional investigation of BDNF levels with different ECT durations are needed in responders and non-responders.
一些证据表明，电休克治疗（ECT）可以增加抑郁患者的脑源性神经营养因子（BDNF）水平。然而，存在一些分歧。本研究的目的是通过系统评价和荟萃分析来评估ECT 后伴有重度抑郁症患者的 BDNF 水平。两位独立研究员在 Cochrane 图书馆、PubMed、MEDLINE、EMBASE 和万方数据库中检索了 1990 年 1 月至 2019 年 3 月发表的文章。使用了以下关键词：“抑郁”或“抑郁障碍”，“重度抑郁症”，“单相抑郁症”，“脑源性神经营养因子”或“BDNF”和“电抽搐”或“ECT”。共有 22 项研究符合荟萃分析的纳入标准，并纳入我们的分析。ECT 后 MDD 患者的 BDNF 水平升高（P=0.000），血浆样本中的标准化均数差（SMD）为 0.695（95%CI：0.402-0.988）。我们还发现 ECT 结束后一周和一个月时 BDNF 水平升高（SMD=0.491，95%CI：0.150,0.833，P=0.005；SMD=0.812，95%CI：0.326,1.298，P=0.001）。我们的研究结果表明，ECT 后 BDNF 水平可能会升高，并且在 ECT 后一周或更长时间内，BDNF 水平可能可作为抑郁患者治疗反应的指标。然而，需要在有反应者和无反应者中进一步研究不同 ECT 持续时间的 BDNF 水平。
