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BDNF 和 GDNF 血浆水平与首发 MDD 的诊断、治疗反应的关系。

Association between plasma levels of BDNF and GDNF and the diagnosis, treatment response in first-episode MDD.

机构信息

Unit of Bipolar Disorder, Tianjin Anding Hospital, Tianjin, China.

Tianjin Medical University, Tianjin, China.

出版信息

J Affect Disord. 2022 Oct 15;315:190-197. doi: 10.1016/j.jad.2022.07.041. Epub 2022 Jul 28.

Abstract

INTRODUCTION

The aims of our study are: i) to explore whether plasma levels of BDNF/GDNF are valuable in the diagnosis of first-episode depression; ii) to discuss whether there is an association between peripheral plasma levels of BDNF/GDNF and patients' depression severity and cognitive dysfunction; iii) to explore the association between plasma levels of BDNF/GDNF and the effectiveness of antidepressant treatment.

METHODS

Ninety patients with first-episode unmedicated MDD and healthy controls were recruited. MDD patients were treated with antidepressant medication for 8 weeks. Patients were assessed for clinical symptoms using HDRS-17 and HAMA-14. Social and neurocognitive functioning of all subjects was assessed at baseline using the Functional Assessment Test Short Form (FAST) and the MATRICS Consensus Cognitive Battery (MCCB). At the same time, peripheral venous blood was drawn from all subjects for BDNF/GDNF peripheral plasma level analysis at baseline and after 8 weeks of treatment.

RESULTS

The baseline BDNF/GDNF levels in MDD patients were significantly lower than that in healthy controls. The area under ROC curve (AUC) of baseline plasma BDNF and GDNF levels predicting MDD was 0.776 (95 % CI: 0.705-0.846, p < 0.001) and 0.864 (95 % CI: 0.808-0.920, p < 0.001), respectively. The baseline GDNF level (beta = 0.425, p = 0.001), the autonomy score of FAST (beta = -0.247, p = 0.037) and BACS-SC score of MCCB (beta = 0.323, p = 0.039) were predictors of HDRS-17 reduction rate after 8 weeks' antidepressant treatment.

LIMITATIONS

A longer follow-up period than 8 weeks may make the results more convincing, and the sample size of this study is still insufficient.

CONCLUSION

The decreased plasma levels of BDNF and GDNF are strong indicators for predicting the occurrence of MDD. This preliminary finding highlighted the value of GDNF plasma concentrations in the diagnosis of MDD and the prognosis of antidepressant treatment.

摘要

简介

我们的研究目的是:i)探讨脑源性神经营养因子/胶质细胞源性神经营养因子(BDNF/GDNF)的血浆水平在首发抑郁症诊断中的价值;ii)讨论外周血 BDNF/GDNF 水平与患者抑郁严重程度和认知功能障碍之间的关系;iii)探讨 BDNF/GDNF 水平与抗抑郁治疗效果的关系。

方法

共招募了 90 例未经药物治疗的首发未用药 MDD 患者和健康对照组。MDD 患者接受抗抑郁药物治疗 8 周。采用 HDRS-17 和 HAMA-14 评估患者的临床症状。所有受试者在基线时使用功能评估测试简表(FAST)和 MATRICS 共识认知电池(MCCB)评估社会和神经认知功能。同时,从所有受试者中抽取外周静脉血,在基线和 8 周治疗后进行 BDNF/GDNF 外周血浆水平分析。

结果

MDD 患者的 BDNF/GDNF 基线水平明显低于健康对照组。BDNF 和 GDNF 基线血浆水平预测 MDD 的 ROC 曲线下面积(AUC)分别为 0.776(95%CI:0.705-0.846,p<0.001)和 0.864(95%CI:0.808-0.920,p<0.001)。基线 GDNF 水平(β=0.425,p=0.001)、FAST 自主性评分(β=-0.247,p=0.037)和 MCCB BACS-SC 评分(β=0.323,p=0.039)是 8 周抗抑郁治疗后 HDRS-17 减分率的预测因子。

局限性

8 周以上的随访期可能会使结果更有说服力,而且本研究的样本量仍然不足。

结论

BDNF 和 GDNF 血浆水平降低是预测 MDD 发生的有力指标。这一初步发现突出了 GDNF 血浆浓度在 MDD 诊断和抗抑郁治疗预后中的价值。

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