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首发精神病患者外周血脑源性神经营养因子水平:一项系统评价和荟萃分析

Peripheral Blood Levels of Brain-Derived Neurotrophic Factor in Patients with First Episode Psychosis: A Systematic Review and Meta-Analysis.

作者信息

Singh Sukhbir, Roy Dipta, Marzouk Taylor, Zhang Jian-Ping

机构信息

Division of Psychiatry Research, Zucker Hillside Hospital, Northwell Health, Glen Oaks, NY 11004, USA.

Advarra Inc., Institutional Review Board, Columbia, MD 21044, USA.

出版信息

Brain Sci. 2022 Mar 22;12(4):414. doi: 10.3390/brainsci12040414.

Abstract

Background: Peripheral blood level of brain-derived neurotrophic factor (BDNF) may be used as a diagnostic and/or prognostic marker for schizophrenia. Previous studies were inconsistent. A systematic review was conducted to examine whether BDNF level is different in patients with first episode psychosis (FEP) compared to health controls (HC) and whether it changes after treatment. Methods: Literature search was done in PubMed, Web of Science, and Google Scholar following standard procedures. Hedges’ g was used as the measure of effect size (ES), which was pooled with random effects model. Publication bias and moderator effects were examined. Results: Search yielded 29 studies with a total sample size of 2912. First meta-analysis included 27 studies with FEP vs. HC comparison. Pooled ES was −0.63, p < 0.001, indicating that BDNF level was lower in FEP than in HC. Studies were heterogeneous, and moderator analysis showed that studies of younger patient, higher symptom severity, and more drug naïve had larger ES. Second meta-analysis examined change in BDNF levels before and after antipsychotic treatment in eight studies. A pooled ES of −0.003 (p = 0.96) showed no change in peripheral BDNF level after treatment. Conclusion: Peripheral BDNF level was decreased in FEP compared to HC, but it did not change after treatment.

摘要

背景

脑源性神经营养因子(BDNF)的外周血水平可用作精神分裂症的诊断和/或预后标志物。以往的研究结果并不一致。本研究进行了一项系统综述,以检验首发精神病(FEP)患者与健康对照(HC)相比,BDNF水平是否存在差异,以及治疗后其水平是否发生变化。方法:按照标准程序在PubMed、Web of Science和谷歌学术上进行文献检索。采用Hedges' g作为效应量(ES)的度量指标,并使用随机效应模型进行汇总。对发表偏倚和调节效应进行了检验。结果:检索得到29项研究,总样本量为2912。首次荟萃分析纳入了27项比较FEP与HC的研究。汇总效应量为−0.63,p < 0.001,表明FEP患者的BDNF水平低于HC。研究存在异质性,调节分析显示,针对年轻患者、症状严重程度较高以及药物初治患者的研究效应量更大。第二次荟萃分析在八项研究中检验了抗精神病药物治疗前后BDNF水平的变化。汇总效应量为−0.003(p = 0.96),表明治疗后外周BDNF水平无变化。结论:与HC相比,FEP患者外周BDNF水平降低,但治疗后未发生变化。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5baa/9027267/37c953b2d809/brainsci-12-00414-g001.jpg

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