Cavaleri Daniele, Moretti Federico, Bartoccetti Alessandra, Mauro Stefano, Crocamo Cristina, Carrà Giuseppe, Bartoli Francesco
Department of Medicine and Surgery, University of Milano-Bicocca, via Cadore 48, 20900 Monza, Italy.
Department of Medicine and Surgery, University of Milano-Bicocca, via Cadore 48, 20900 Monza, Italy; Division of Psychiatry, University College London, Maple House 149, London W1T 7BN, United Kingdom.
Neurosci Biobehav Rev. 2023 Jun;149:105159. doi: 10.1016/j.neubiorev.2023.105159. Epub 2023 Apr 3.
The brain-derived neurotrophic factor (BDNF) has received considerable attention as a potential biomarker of major depressive disorder (MDD) and antidepressant response. We conducted an overview of meta-analyses investigating the relationship of BDNF with MDD, related clinical features, and antidepressant treatment. Based on a systematic screening on main electronic databases, 11 systematic reviews with meta-analyses were included. Available evidence suggests that people with MDD have peripheral and central BDNF levels lower than non-depressed individuals. A negative correlation between blood BDNF and symptom severity emerged, while no association with suicidality was detected. Moreover, an increase in blood BDNF levels after antidepressant treatment, proportional to symptom improvement, was reported. BDNF levels seem to be increased in both treatment responders and remitters, remaining stable in non-responders. Conversely, no variations of BDNF concentrations after non-pharmacological interventions (electroconvulsive therapy, repetitive transcranial magnetic stimulation, and physical activity) were found. The findings of this overview appear consistent with the neurotrophic hypothesis of depression, suggesting that BDNF may play a role in both MDD pathophysiology and pharmacological treatment response.
脑源性神经营养因子（BDNF）作为重度抑郁症（MDD）及抗抑郁反应的潜在生物标志物已受到广泛关注。我们对探讨BDNF与MDD、相关临床特征及抗抑郁治疗之间关系的荟萃分析进行了综述。通过对主要电子数据库的系统筛选，纳入了11项带有荟萃分析的系统评价。现有证据表明，MDD患者的外周和中枢BDNF水平低于非抑郁个体。血液BDNF与症状严重程度之间呈现负相关，而未检测到与自杀倾向的关联。此外，有报告称抗抑郁治疗后血液BDNF水平升高，且与症状改善成比例。治疗有反应者和病情缓解者的BDNF水平似乎均升高，无反应者的BDNF水平保持稳定。相反，未发现非药物干预（电休克疗法、重复经颅磁刺激和体育活动）后BDNF浓度有变化。该综述结果似乎与抑郁症的神经营养假说一致，表明BDNF可能在MDD病理生理学和药物治疗反应中均起作用。
