Wu Gwyneth W Y, Wolkowitz Owen M, Reus Victor I, Kang Jee In, Elnar Mathea, Sarwal Reuben, Flory Janine D, Abu-Amara Duna, Hammamieh Rasha, Gautam Aarti, Doyle Francis J, Yehuda Rachel, Marmar Charles R, Jett Marti, Mellon Synthia H
Department of Psychiatry and Behavioral Sciences, University of California San Francisco (UCSF) School of Medicine, San Francisco, CA, USA.
Department of Psychiatry and Behavioral Sciences, University of California San Francisco (UCSF) School of Medicine, San Francisco, CA, USA.
Psychoneuroendocrinology. 2021 Jul 22;134:105360. doi: 10.1016/j.psyneuen.2021.105360.
Attempts to correlate blood levels of brain-derived neurotrophic factor (BDNF) with post-traumatic stress disorder (PTSD) have provided conflicting results. Some studies found a positive association between BDNF and PTSD diagnosis and symptom severity, while others found the association to be negative. The present study investigated whether serum levels of BDNF are different cross-sectionally between combat trauma-exposed veterans with and without PTSD, as well as whether longitudinal changes in serum BDNF differ as a function of PTSD diagnosis over time. We analyzed data of 270 combat trauma-exposed veterans (230 males, 40 females, average age: 33.29 ± 8.28 years) and found that, at the initial cross-sectional assessment (T0), which averaged 6 years after the initial exposure to combat trauma (SD=2.83 years), the PTSD positive group had significantly higher serum BDNF levels than the PTSD negative controls [31.03 vs. 26.95 ng/mL, t(268) = 3.921, p < 0.001]. This difference remained significant after excluding individuals with comorbid major depressive disorder, antidepressant users and controlling for age, gender, race, BMI, and time since trauma. Fifty-nine of the male veterans who participated at the first timepoint (T0) were re-assessed at follow-up evaluation (T1), approximately 3 years (SD=0.88 years) after T0. A one-way ANOVA comparing PTSD positive, "subthreshold PTSD" and control groups revealed that serum BDNF remained significantly higher in the PTSD positive group than the control group at T1 [30.05 vs 24.66 ng/mL, F(2, 56)= 3.420, p = 0.040]. Serum BDNF levels did not correlate with PTSD symptom severity at either time point within the PTSD group [r(128) = 0.062, p = 0.481 and r(28) = 0.157, p = 0.407]. Serum BDNF did not significantly change over time within subjects [t(56) = 1.269, p = 0.210] nor did the change of serum BDNF from T0 to T1 correlate with change in PTSD symptom severity within those who were diagnosed with PTSD at T0 [r(27) = -0.250, p = 0.192]. Our longitudinal data are the first to be reported in combat PTSD and suggest that higher serum BDNF levels may be a stable biological characteristic of chronic combat PTSD independent of symptom severity.
试图将脑源性神经营养因子（BDNF）的血液水平与创伤后应激障碍（PTSD）相关联的研究得出了相互矛盾的结果。一些研究发现BDNF与PTSD诊断及症状严重程度之间存在正相关，而另一些研究则发现这种关联是负相关。本研究调查了有PTSD和无PTSD的经历过战斗创伤的退伍军人之间，血清BDNF水平在横断面是否存在差异，以及血清BDNF的纵向变化是否会随着时间因PTSD诊断而有所不同。我们分析了270名经历过战斗创伤的退伍军人（230名男性，40名女性，平均年龄：33.29±8.28岁）的数据，发现在初次接触战斗创伤平均6年后（标准差=2.83年）的初始横断面评估（T0）时，PTSD阳性组的血清BDNF水平显著高于PTSD阴性对照组[31.03对26.95 ng/mL，t(268)=3.921，p<0.001]。在排除患有共病重度抑郁症的个体、使用抗抑郁药的个体，并对年龄、性别、种族、BMI和创伤后的时间进行控制后，这种差异仍然显著。59名首次参与（T0）的男性退伍军人在随访评估（T1）时再次接受评估，T1大约在T0后3年（标准差=0.88年）。一项比较PTSD阳性组、“亚阈值PTSD”组和对照组的单因素方差分析显示，在T1时，PTSD阳性组的血清BDNF水平仍然显著高于对照组[30.05对24.66 ng/mL，F(2, 56)=3.420，p=0.040]。在PTSD组内的两个时间点，血清BDNF水平均与PTSD症状严重程度无相关性[r(128)=0.062，p=0.481和r(28)=0.157，p=0.407]。在受试者内部，血清BDNF水平随时间没有显著变化[t(56)=1.269，p=0.210]，从T0到T1的血清BDNF变化也与在T0时被诊断为PTSD的患者的PTSD症状严重程度变化无相关性[r(27)=-0.250，p=0.192]。我们的纵向数据是首次在战斗PTSD中报告的，表明较高的血清BDNF水平可能是慢性战斗PTSD的一个稳定生物学特征，与症状严重程度无关。
