Zheng Wei, Cen Qiaomei, Nie Sha, Li Minyi, Zeng Rong, Zhou Sumiao, Cai Dongbin, Jiang Miaoling, Huang Xiong
The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China.
Shenzhen Traditional Chinese Medicine Hospital, Shenzhen, China.
PeerJ. 2021 Feb 5;9:e10699. doi: 10.7717/peerj.10699. eCollection 2021.
To firstly examine the relationship between serum brain-derived neurotrophic factor (BDNF) levels and antidepressant response to ketamine as an anaesthesia in electroconvulsive therapy (ECT) in Chinese patients with treatment-refractory depression (TRD).
Thirty patients with TRD were enrolled and underwent eight ECT sessions with ketamine anaesthesia (0.8 mg/kg) alone. Depression severity, response and remission were evaluated using the 17-item Hamilton Depression Rating Scale (HAMD-17). Enzyme-linked immunosorbent assay (ELISA) was applied to examine serum BDNF levels in patients with TRD at baseline and after the second, fourth and eighth ECT sessions. Baseline serum samples were also collected for 30 healthy controls.
No significant differences were observed in serum BDNF levels between patients with TRD and healthy controls at baseline ( > 0.05). The remission rate was 76.7% (23/30) after the last ECT treatment, although all patients with TRD obtained antidepressant response criteria. Serum BDNF levels were not altered compared to baseline, even between remitters and nonremitters (all > 0.05), despite the significant reduction in HAMD-17 and Brief Psychiatric Rating Scale (BPRS) scores after ECT with ketamine anaesthesia (all < 0.05). The antidepressant effects of ECT with ketamine anaesthesia were not correlated with changes in serum BDNF levels (all > 0.05).
This preliminary study indicated that serum BDNF levels do not appear to be a reliable biomarker to determine the antidepressant effects of ketamine as an anaesthesia in ECT for patients with TRD. Further studies with larger sample sizes are warranted to confirm these findings.
首先在中国难治性抑郁症（TRD）患者中，研究血清脑源性神经营养因子（BDNF）水平与氯胺酮作为电休克治疗（ECT）麻醉剂时的抗抑郁反应之间的关系。
招募30例TRD患者，仅接受8次氯胺酮麻醉（0.8mg/kg）的ECT治疗。使用17项汉密尔顿抑郁量表（HAMD-17）评估抑郁严重程度、反应和缓解情况。采用酶联免疫吸附测定（ELISA）法检测TRD患者在基线时以及第2、4和8次ECT治疗后的血清BDNF水平。还收集了30名健康对照者的基线血清样本。
TRD患者与健康对照者在基线时血清BDNF水平无显著差异（>0.05）。尽管所有TRD患者均达到抗抑郁反应标准，但最后一次ECT治疗后的缓解率为76.7%（23/30）。与基线相比，血清BDNF水平未发生改变，无论是缓解者还是未缓解者（均>0.05），尽管氯胺酮麻醉的ECT治疗后HAMD-17和简明精神病评定量表（BPRS）评分显著降低（均<0.05）。氯胺酮麻醉的ECT治疗的抗抑郁效果与血清BDNF水平的变化无关（均>0.05）。
这项初步研究表明，血清BDNF水平似乎不是确定氯胺酮作为ECT麻醉剂对TRD患者抗抑郁效果的可靠生物标志物。需要进一步进行更大样本量的研究来证实这些发现。
