创伤后应激障碍(PTSD)患者外周血脑源性神经营养因子水平:系统评价和荟萃分析。
Peripheral blood levels of brain-derived neurotrophic factor in patients with post-traumatic stress disorder (PTSD): A systematic review and meta-analysis.
机构信息
School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
Systematic Review and Meta-Analysis Expert Group (SRMEG), Universal Scientific Education and Research Network (USERN), Tehran, Iran.
出版信息
PLoS One. 2020 Nov 5;15(11):e0241928. doi: 10.1371/journal.pone.0241928. eCollection 2020.
BACKGROUND
Brain-derived neurotrophic factor (BDNF) plays a crucial role in the survival, differentiation, growth, and plasticity of the central nervous system (CNS). Post-traumatic stress disorder (PTSD) is a complex syndrome that affects CNS function. Evidence indicates that changes in peripheral levels of BDNF may interfere with stress. However, the results are mixed. This study investigates whether blood levels of BDNF in patients with post-traumatic stress disorder (PTSD) are different.
METHODS
We conducted a systematic search in the major electronic medical databases from inception through September 2019 and identified Observational studies that measured serum levels of BDNF in patients with PTSD compared to controls without PTSD.
RESULTS
20 studies were eligible to be included in the present meta-analysis. Subjects with PTSD (n = 909) showed lower BDNF levels compared to Non-PTSD controls (n = 1679) (SMD = 0.52; 95% confidence interval: 0.18 to 0.85). Subgroup meta-analyses confirmed higher levels of BDNF in patients with PTSD compared to non-PTSD controls in plasma, not serum, and in studies that used sandwich ELISA, not ELISA, for BDNF measurement. Meta-regressions showed no significant effect of age, gender, NOS, and sample size.
CONCLUSIONS
PTSD patients had increased serum BDNF levels compared to healthy controls. Our finding of higher BDNF levels in patients with PTSD supports the notion that PTSD is a neuroplastic disorder.
背景
脑源性神经营养因子(BDNF)在中枢神经系统(CNS)的存活、分化、生长和可塑性中起着至关重要的作用。创伤后应激障碍(PTSD)是一种影响 CNS 功能的复杂综合征。有证据表明,BDNF 外周水平的变化可能会干扰应激。然而,结果喜忧参半。本研究旨在探讨 PTSD 患者血液中 BDNF 水平是否存在差异。
方法
我们在主要的电子医学数据库中进行了系统检索,检索时间从建库开始到 2019 年 9 月,并确定了观察性研究,这些研究比较了 PTSD 患者与无 PTSD 对照组的血清 BDNF 水平。
结果
共有 20 项研究符合纳入本 meta 分析的标准。与非 PTSD 对照组(n = 1679)相比,PTSD 患者(n = 909)的 BDNF 水平较低(SMD = 0.52;95%置信区间:0.18 至 0.85)。亚组 meta 分析证实,与非 PTSD 对照组相比,PTSD 患者的血浆而非血清 BDNF 水平更高,且使用夹心 ELISA 而非 ELISA 测量 BDNF 的研究中,BDNF 水平更高。Meta 回归显示,年龄、性别、NOS 和样本量均无显著影响。
结论
与健康对照组相比,PTSD 患者的血清 BDNF 水平升高。我们发现 PTSD 患者的 BDNF 水平较高,这支持了 PTSD 是一种神经可塑性障碍的观点。