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非侵入性脑刺激对自闭症患者行为及血清脑源性神经营养因子和胰岛素样生长因子-1 水平的影响。

Effect of non-invasive brain stimulation on behavior and serum brain-derived neurotrophic factor and insulin-like growth factor-1 levels in autistic patients.

机构信息

Neuroimmunology Department, International Center for Neurological Restoration, Havana, Cuba.

Department of Psychiatry and Behavioral Neurosciences, McMaster University, Hamilton, Ontario, Canada.

出版信息

Drug Dev Res. 2021 Aug;82(5):716-723. doi: 10.1002/ddr.21808. Epub 2021 Mar 18.

DOI:10.1002/ddr.21808
PMID:33734467
Abstract

Aberrant neural connectivity and intra-cortical inhibitory dysfunction are key features of autism. Non-invasive brain stimulation (NIBS) protocols have been proposed that modulate this aberrant plasticity. However, additional investigations are needed to evaluate the impact of this intervention on biological biomarkers of the disease. We recently demonstrated alterations in serum insulin-like growth factor-1 (IGF-1) and brain-derived neurotrophic factor (BDNF) immunoreactivity in subjects with autism compared to controls. The aim of this pilot study was to explore the change in serum levels of the neurotrophic factors BDNF and IGF-1 in patients undergoing NIBS therapy. Sixteen subjects with autism spectrum disorder (ASD) were tested 1 week before and 1 week after NIBS to determine the short-term outcome on behavior using the total score on the autism behavior checklist, autism treatment evaluation checklist, clinical global impression severity and the autism diagnostic interview. ASD subjects younger than 11 years old (n = 11) were treated with transcranial direct current stimulation (tDCS), and those 11 years and older (n = 5) were treated with repetitive transcranial magnetic stimulation (rTMS). Serum levels of BDNF and IGF-1 were evaluated by Enzyme-Linked Immuno-Sorbent Assay before and after the intervention with NIBS. A significant reduction in scores on the clinical behavioral scales was observed in patients treated with NIBS (ABC-T p = .002, CGI-S p = .008, ADI-T and ATEC-T p < .0001). There was a trend towards reduced serum BDNF levels after NIBS (p = .061), while there was no change in IGF-1 levels. These data support further studies on the potential of BDNF as a biomarker to measure the effectiveness of NIBS in autism.

摘要

异常的神经连接和皮质内抑制功能障碍是自闭症的关键特征。已经提出了非侵入性脑刺激(NIBS)方案,以调节这种异常的可塑性。然而,需要进一步的研究来评估这种干预对疾病的生物标志物的影响。我们最近发现在自闭症患者的血清胰岛素样生长因子-1(IGF-1)和脑源性神经营养因子(BDNF)免疫反应性与对照组相比发生了改变。本研究的目的是探索接受 NIBS 治疗的患者血清神经营养因子 BDNF 和 IGF-1 水平的变化。16 名自闭症谱系障碍(ASD)患者在接受 NIBS 治疗前 1 周和治疗后 1 周进行测试,以使用自闭症行为检查表、自闭症治疗评估检查表、临床总体印象严重程度和自闭症诊断访谈的总分来确定行为的短期结果。年龄小于 11 岁的 ASD 患者(n=11)接受经颅直流电刺激(tDCS)治疗,年龄为 11 岁及以上的患者(n=5)接受重复经颅磁刺激(rTMS)治疗。在接受 NIBS 干预前后,通过酶联免疫吸附试验评估血清 BDNF 和 IGF-1 水平。接受 NIBS 治疗的患者临床行为量表评分显著降低(ABC-T p=0.002,CGI-S p=0.008,ADI-T 和 ATEC-T p<0.0001)。NIBS 后 BDNF 水平呈下降趋势(p=0.061),而 IGF-1 水平无变化。这些数据支持进一步研究 BDNF 作为生物标志物的潜力,以衡量 NIBS 在自闭症中的有效性。

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