Mater Hospital, Brisbane and Faculty of Medicine, University of Queensland, Australia; APHM, Timone Hospital, Epileptology and Cerebral Rhythmology, Marseille, France; Aix Marseille Univ, INSERM, INS, Inst Neurosci Syst, Marseille, France.
Université Paris Cité, INSERM, U1124, Paris, France.
Epilepsy Res. 2023 Sep;195:107200. doi: 10.1016/j.eplepsyres.2023.107200. Epub 2023 Aug 2.
Several studies implicate brain-derived neurotrophic factor (BDNF) in the pathophysiology of epilepsy. In particular, preclinical data suggest that lower serum BDNF is a biomarker of epilepsy severity and psychiatric comorbidities. We tested this prediction in clinical epilepsy cohorts.
Patients with epilepsy were recruited from 4 epilepsy centers in France and serum BDNF was quantified. Clinical characteristics including epilepsy duration, classification, localization, etiology, seizure frequency and drug resistance were documented. Presence of individual anti-seizure medications (ASM) was noted. Screening for depression and anxiety symptoms was carried out in all patients using the NDDI-E and the GAD-7 scales. In patients with positive screening for anxiety and/or depression, detailed psychiatric testing was performed including the Mini International Neuropsychiatric Interview (MINI), STAI-Y, Holmes Rahe Stressful Events Scale and Beck Depression Interview. Descriptive analysis was applied. Spearman's test and Pearson's co-efficient were used to assess the association between BDNF level and continuous variables. For discrete variables, comparison of means (Student's t-test, Mann-Whitney u-test) was used to compare mean BDNF serum level between groups. Multivariate analysis was performed using a regression model.
No significant correlation was found between serum BDNF level and clinical features of epilepsy or measures of depression. The main group-level finding was that presence of any ASM at was associated with increased BDNF; this effect was particularly significant for valproate and perampanel.
Presence of ASM affects serum BDNF levels in patients with epilepsy. Future studies exploring BDNF as a possible biomarker of epilepsy severity and/or psychiatric comorbidity must control for ASM effects.
多项研究表明脑源性神经营养因子（BDNF）与癫痫的病理生理学有关。特别是，临床前数据表明，血清 BDNF 水平降低是癫痫严重程度和精神共病的生物标志物。我们在临床癫痫队列中验证了这一预测。
从法国的 4 个癫痫中心招募癫痫患者，并定量测定血清 BDNF。记录了包括癫痫持续时间、分类、定位、病因、发作频率和药物耐药性在内的临床特征。注意到个体抗癫痫药物（ASM）的存在。所有患者均使用 NDDI-E 和 GAD-7 量表进行抑郁和焦虑症状筛查。在焦虑和/或抑郁筛查阳性的患者中，进行详细的精神病学测试，包括 Mini 国际神经精神病学访谈（MINI）、STAI-Y、Holmes Rahe 应激事件量表和贝克抑郁问卷。进行描述性分析。使用 Spearman 检验和 Pearson 相关系数评估 BDNF 水平与连续变量之间的相关性。对于离散变量，使用学生 t 检验、Mann-Whitney u 检验比较组间平均 BDNF 血清水平。使用回归模型进行多变量分析。
血清 BDNF 水平与癫痫的临床特征或抑郁测量值之间没有显著相关性。主要的组水平发现是任何 ASM 的存在与 BDNF 水平升高相关；这种影响在丙戊酸钠和吡仑帕奈中尤为显著。
ASM 的存在会影响癫痫患者的血清 BDNF 水平。未来探索 BDNF 作为癫痫严重程度和/或精神共病的可能生物标志物的研究必须控制 ASM 效应。
