Unité de Recherche Clinique Intersectorielle en Psychiatrie, Centre Hospitalier Henri Laborit, Poitiers, France.
INSERM U1084 - Laboratoire de Neurosciences Expérimentales et Cliniques, Université de Poitiers, Poitiers, France.
CNS Spectr. 2022 Oct;27(5):645-651. doi: 10.1017/S1092852921000687. Epub 2021 Jul 27.
Obsessive-compulsive disorder (OCD) is a severe psychiatric disorder characterized by its heterogeneous nature and by different dimensions of obsessive-compulsive (OC) symptoms. Serotonin reuptake inhibitors (SRIs) are used to treat OCD, but up to 40% to 60% of patients do not show a significant improvement with these medications. In this study, we aimed to test the impact of brain-derived neurotrophic factor (BDNF) Val66Met polymorphism on the efficacy of antidepressants in OCD overall, and in relation to the different OC dimensions.
In a 6-month prospective treatment study, 69 Caucasian OCD patients were treated with escitalopram for 24 weeks or with escitalopram for 12 weeks followed by paroxetine for an additional 12-week period. Patients were genotyped and assessed for treatment response. The main clinical outcomes were improvement of the Yale-Brown Obsessive-Compulsive Scale score and in different OC symptom dimension scores.
The Val/Val group comprised 43 (62%) patients, the Val/Met and Met/Met group comprised 26 (38%) patients. Forty-two patients were classified as responders at 12 weeks and 38 at 24 weeks; no significant association was found between BDNF Val66Met and SRIs response at 12 and 24 weeks. In analyses of the different OC symptom dimensions, the Met allele was associated with a slightly reduced score in the aggressive/checking dimension at 6 months ( = .048).
Our findings do not support the usefulness of BDNF Val66Met genotyping to predict overall response to treatment with SRIs in OCD; they did however suggest a better outcome at 6 months for the aggressive/checking symptom dimension for patients carrying the Met allele.
强迫症（OCD）是一种严重的精神疾病，其特征为异质性和强迫观念强迫行为的不同维度。选择性 5-羟色胺再摄取抑制剂（SSRIs）被用于治疗 OCD，但多达 40%至 60%的患者对这些药物的治疗效果并不显著。在这项研究中，我们旨在检验脑源性神经营养因子（BDNF）Val66Met 多态性对 OCD 患者总体抗抑郁治疗效果的影响，以及与不同 OC 维度的关系。
在一项为期 6 个月的前瞻性治疗研究中，69 名高加索 OCD 患者接受依地普仑治疗 24 周或依地普仑治疗 12 周后加用帕罗西汀治疗 12 周。患者进行基因分型并评估治疗反应。主要临床结局为耶鲁-布朗强迫症量表评分和不同 OC 症状维度评分的改善。
Val/Val 组包括 43 名（62%）患者，Val/Met 和 Met/Met 组包括 26 名（38%）患者。42 名患者在 12 周时被归类为应答者，38 名在 24 周时被归类为应答者；BDNF Val66Met 与 12 周和 24 周时 SRIs 反应之间无显著关联。在对不同 OC 症状维度的分析中，Met 等位基因与 6 个月时的攻击性/检查性维度评分略低相关（=0.048）。
我们的研究结果不支持 BDNF Val66Met 基因分型可用于预测 OCD 患者对 SSRIs 治疗的总体反应；然而，携带 Met 等位基因的患者在 6 个月时的攻击性/检查性症状维度有更好的预后。
