Neurobiology Research Unit, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark; Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
Translational Neuropsychiatry Unit, Department of Clinical Medicine, Aarhus University, Denmark.
Eur Neuropsychopharmacol. 2024 Oct;87:35-55. doi: 10.1016/j.euroneuro.2024.06.008. Epub 2024 Jul 29.
Major depressive disorder (MDD) is a highly prevalent psychiatric disorder and a leading cause of disability worldwide. Brain-derived neurotrophic factor (BDNF), a signaling protein responsible for promoting neuroplasticity, is highly expressed in the central nervous system but can also be found in the blood. Since impaired brain plasticity is considered a cornerstone in the pathophysiology of MDD, measurement of BDNF in blood has been proposed as a potential biomarker in MDD. The aim of our study is to systematically review the literature for the effects of antidepressant treatments on blood BDNF levels in MDD and the suitability of blood BDNF as a biomarker for depression severity and antidepressant response. We searched Pubmed® and Cochrane library up to March 2024 in a systematic manner using Medical Subject Headings (MeSH). The search resulted in a total of 42 papers, of which 30 were included in this systematic review. Generally, we found that patients with untreated MDD have a lower blood BDNF level than healthy controls. Antidepressant treatments increase blood BDNF levels, and more evidently after pharmacological than non-pharmacological treatment. Neither baseline nor change in the blood BDNF level correlates with depression severity or treatment outcome, which undermines its use as a biomarker in MDD. Our review also highlights the importance of considering factors influencing the accuracy and reproducibility of BDNF measurements. We summarize considerations to help obtain more robust blood BDNF values and compile a list of recommendations to help streamline assessment of blood BDNF levels in future studies.
重度抑郁症（MDD）是一种高发的精神疾病，也是全球致残的主要原因。脑源性神经营养因子（BDNF）是一种负责促进神经可塑性的信号蛋白，在中枢神经系统中高度表达，但也可以在血液中找到。由于受损的大脑可塑性被认为是 MDD 病理生理学的基石，因此血液中 BDNF 的测量被提出作为 MDD 的潜在生物标志物。我们的研究旨在系统地综述文献，以了解抗抑郁治疗对 MDD 患者血液 BDNF 水平的影响，以及血液 BDNF 作为抑郁严重程度和抗抑郁反应的生物标志物的适用性。我们系统地使用医学主题词（MeSH）在 Pubmed®和 Cochrane 图书馆中进行了搜索，截至 2024 年 3 月。搜索共产生了 42 篇论文，其中 30 篇被纳入本系统综述。一般来说，我们发现未经治疗的 MDD 患者的血液 BDNF 水平低于健康对照组。抗抑郁治疗会增加血液 BDNF 水平，且药物治疗比非药物治疗更明显。无论是基线还是血液 BDNF 水平的变化都与抑郁严重程度或治疗结果无关，这削弱了其作为 MDD 生物标志物的用途。我们的综述还强调了考虑影响 BDNF 测量准确性和重现性的因素的重要性。我们总结了一些注意事项，以帮助获得更可靠的血液 BDNF 值，并列出了一些建议，以帮助简化未来研究中血液 BDNF 水平的评估。
