Piotrkowicz Michal, Janoska-Jazdzik Marlena, Koweszko Tytus, Szulc Agata
Department of Psychiatry, Faculty of Health Sciences, Medical University of Warsaw, Partyzantow 2/4, 05-802 Pruszkow, Poland.
J Clin Med. 2021 Sep 27;10(19):4424. doi: 10.3390/jcm10194424.
Psychotherapy is a well-established method of treating many mental disorders. It has been proven that psychotherapy leads to structural and functional changes in the brain; however, knowledge about the molecular and cellular mechanisms of these changes is limited. Neuroplasticity and one of its mediators, brain-derived neurotrophic factor (BDNF), are potential research targets in this field. To define the role of BDNF concentration in serum, or in plasma, and BDNF promoter gene methylation in saliva or leucocytes, in psychotherapy, an extensive literature search was conducted in the PubMed and Web of Science databases. The literature review was conducted based on papers published up until May 2021 that included pre and post psychotherapy measurements of either BDNF concentration levels or promoter gene methylation status. Ten studies were indicated as eligible for analysis: eight studies that investigated peripheral BDNF concentration levels, one study that investigated methylation status, and one study that included an evaluation of both subject matters. Patients underwent cognitive behavioral therapy or interpersonal psychotherapy. Patients were diagnosed with borderline personality disorder, major depressive disorder, anorexia nervosa, bulimia nervosa, or post-traumatic stress disorder. There were only three of the nine studies that showed statistically significant increases in BDNF concentration levels after psychotherapy. The two studies that involved BDNF gene methylation status showed a decrease in methylation after dialectical behavioral therapy of borderline patients.
心理治疗是一种治疗多种精神障碍的成熟方法。业已证明，心理治疗会导致大脑发生结构和功能变化；然而，关于这些变化的分子和细胞机制的知识有限。神经可塑性及其介质之一脑源性神经营养因子（BDNF）是该领域潜在的研究靶点。为了确定血清或血浆中BDNF浓度以及唾液或白细胞中BDNF启动子基因甲基化在心理治疗中的作用，我们在PubMed和Web of Science数据库中进行了广泛的文献检索。文献综述基于截至2021年5月发表的论文，这些论文包括心理治疗前后BDNF浓度水平或启动子基因甲基化状态的测量。有十项研究被确定为符合分析条件：八项研究调查了外周BDNF浓度水平，一项研究调查了甲基化状态，一项研究同时评估了这两个主题。患者接受了认知行为疗法或人际心理治疗。患者被诊断为边缘型人格障碍、重度抑郁症、神经性厌食症、神经性贪食症或创伤后应激障碍。九项研究中只有三项显示心理治疗后BDNF浓度水平有统计学显著升高。两项涉及BDNF基因甲基化状态的研究表明，边缘型患者接受辩证行为疗法后甲基化水平降低。
