Li Ru, Li Jiaxin, Ji Shiyi Suzy, Li Dazhi, Chu Lijun, Zhang Jian, Sun Xia, Luo Xingguang, Zhang Yong
Unit of Bipolar Disorder, Tianjin Anding Hospital, Tianjin, People's Republic of China.
Department of Counseling and Clinical Psychology, Teachers College, Columbia University, NY, New York, USA.
Neuropsychiatr Dis Treat. 2025 Jan 25;21:115-128. doi: 10.2147/NDT.S502176. eCollection 2025.
We aimed to verify the impact of functional remediation (FR) on serum brain-derived neurotrophic factor (BDNF) and tyrosine kinase receptor B (TrkB) levels, to explore the biomechanism of FR intervention in patients with euthymic bipolar disorder (BD).
This is a randomized controlled, 12-week intervention study with participants randomized into the FR group (n=39) and the treatment as usual group (TAU, n=42) at the 1∶1 ratio. 17-Hamilton Depression Rating Scale-17 (HDRS-17), Young Mania Rating Scale (YMRS), and Measurement and Treatment Research to Improve Cognition in Schizophrenia (MATRICS) Consensus Cognitive Battery (MCCB) were used to assess affective symptoms and cognitive functioning both at baseline and week 12, respectively. Meanwhile, we collected blood samples (10 milliliters) from all participants for determination of serum BDNF/ TrkB levels both at baseline and week 12. After baseline assessment, all participants received FR or TAU treatments, respectively.
Our results showed significant decreasing in HDRS-17 and YMRS scores, increasing in serum BDNF and TrkB levels in both groups over 12 weeks (all s<0.05). There were no group differences in the HDRS-17 and YMRS scores (all s>0.05), but the FR group showed greater increasing in serum BDNF and TrkB levels than those in the TAU group (all s<0.05). In terms of cognition, the change in serum BDNF levels was negatively correlated with changes in Mazes test, and the improved TrKB levels were associated with improved Mayer-Salovey-Caruso Emotional Intelligence Test (MSCEIT) in the FR group (all s<0.05).
The changes in serum BDNF and TrkB levels may be implicated in the mechanisms underlying FR intervention in euthymic patients with BD.
A longer follow-up period than 12 weeks and set up healthy controls may make the results more convincing, and the sample size of this study is still insufficient.
我们旨在验证功能康复（FR）对血清脑源性神经营养因子（BDNF）和酪氨酸激酶受体B（TrkB）水平的影响，以探究FR干预对心境正常的双相情感障碍（BD）患者的生物力学机制。
这是一项随机对照的12周干预研究，参与者按1∶1比例随机分为FR组（n = 39）和常规治疗组（TAU，n = 42）。分别使用17项汉密尔顿抑郁量表（HDRS - 17）、杨氏躁狂量表（YMRS）以及改善精神分裂症认知的测量与治疗研究（MATRICS）共识认知成套测验（MCCB）在基线和第12周时评估情感症状和认知功能。同时，我们在基线和第12周时从所有参与者采集血样（10毫升）以测定血清BDNF/TrkB水平。在基线评估后，所有参与者分别接受FR或TAU治疗。
我们的结果显示，两组在12周内HDRS - 17和YMRS评分均显著降低，血清BDNF和TrkB水平均升高（所有P<0.05）。HDRS - 17和YMRS评分在两组间无差异（所有P>0.05），但FR组血清BDNF和TrkB水平的升高幅度大于TAU组（所有P<0.05）。在认知方面，FR组血清BDNF水平的变化与迷宫测试的变化呈负相关，TrKB水平的改善与梅耶 - 萨洛维 - 卡鲁索情商测试（MSCEIT）的改善相关（所有P<0.05）。
血清BDNF和TrkB水平的变化可能与FR干预心境正常的BD患者的潜在机制有关。
随访期超过12周并设立健康对照组可能会使结果更具说服力，且本研究的样本量仍不足。
