Zhao Xinling, Jie Huijin, Wang Jun, Liu Yu, Liu Yilin, Qin Fuyi, Long Qing, Hou Xi, Zhang Xin-Wen, Wu Wenzhi, Wu Xiaoqin, Li Jing, Zeng Yong
Department of Clinical Psychology, People's Hospital of Chongqing Liang Jiang New Area, Chongqing, People's Republic of China.
Department of Psychiatry, the Second Affiliated Hospital of Kunming Medical University, Kunming, People's Republic of China.
Neuropsychiatr Dis Treat. 2024 Aug 2;20:1513-1522. doi: 10.2147/NDT.S454370. eCollection 2024.
Adolescents with major depressive (MDD) episodes associated with childhood trauma have a poorer response to treatment and a higher risk of suicide. The underlying etiology is unclear. Brain-derived neurotrophic factor (BDNF) could improve depressive symptoms by down-regulating mammalian target of rapamycin (mTOR) signaling pathways, which was involved in adverse environmental stimuli during neurodevelopment. BDNF and mTOR have not been reported simultaneously in adolescents with major depressive episodes associated with childhood trauma.
Childhood Trauma Questionnaire-Short Form (CTQ-SF), Children's Depression Inventory (CDI) and Children's Depression Rating Scale-Revised (CDRS-R) were used to evaluate the recruited adolescents with major depression episodes. Serum BDNF and p-mTOR levels were measured by ELISA in 31 adolescents with major depression episodes with childhood trauma and 18 matched healthy control.
The serum levels of BDNF were significantly lower (p<0.001); and the serum levels of p-mTOR were high (p=0.003) in the adolescents with the first episode of major depressive episode accompanied by childhood trauma. Of the 31 adolescents with major depressive episodes, 17 had suicide or self-injury. Compared with the healthy control group, the serum levels of BDNF in patients with suicide or self-injury were lower than those without suicide or self-injury(p<0.001); the serum levels of p-mTOR were higher than those without suicide or self-injury (p=0.01). While in patients without suicide or self-injury, only serum p-mTOR was significantly higher than that in healthy group (p=0.028). BDNF was negatively correlated with CDRS-R (r=-0.427, p=0.006), p-mTOR was positively correlated with CDI (r=0.364, p=0.048). According to Receiver Operating Characteristic Curve (ROC), the combination of serum BDNF and p-mTOR levels have better diagnostic value.
Neurotrophic and signaling pathways, involving BDNF and p-mTOR, may play a role in adolescent MDD with a history of childhood trauma, especially patients with suicide and self-injury tendencies.
患有与童年创伤相关的重度抑郁（MDD）发作的青少年对治疗反应较差，自杀风险较高。其潜在病因尚不清楚。脑源性神经营养因子（BDNF）可通过下调雷帕霉素哺乳动物靶点（mTOR）信号通路来改善抑郁症状，该信号通路参与神经发育过程中的不良环境刺激。在患有与童年创伤相关的重度抑郁发作的青少年中，尚未同时报道BDNF和mTOR。
使用儿童创伤问卷简表（CTQ-SF）、儿童抑郁量表（CDI）和儿童抑郁评定量表修订版（CDRS-R）对招募的患有重度抑郁发作的青少年进行评估。通过酶联免疫吸附测定法（ELISA）测量31名患有童年创伤的重度抑郁发作青少年和18名匹配的健康对照者的血清BDNF和p-mTOR水平。
首次发作伴有童年创伤的重度抑郁发作青少年的血清BDNF水平显著降低（p<0.001）；血清p-mTOR水平较高（p=0.003）。在31名患有重度抑郁发作的青少年中，17人有自杀或自我伤害行为。与健康对照组相比，有自杀或自我伤害行为的患者血清BDNF水平低于无自杀或自我伤害行为的患者（p<0.001）；血清p-mTOR水平高于无自杀或自我伤害行为的患者（p=0.01）。而在无自杀或自我伤害行为的患者中，仅血清p-mTOR显著高于健康组（p=0.028）。BDNF与CDRS-R呈负相关（r=-0.427，p=0.006），p-mTOR与CDI呈正相关（r=0.364，p=0.048）。根据受试者工作特征曲线（ROC），血清BDNF和p-mTOR水平的组合具有更好的诊断价值。
涉及BDNF和p-mTOR的神经营养和信号通路可能在有童年创伤史的青少年MDD中起作用，尤其是有自杀和自我伤害倾向的患者。
