Focus on ECT seizure quality: serum BDNF as a peripheral biomarker in depressed patients
Focus on ECT seizure quality: serum BDNF as a peripheral biomarker in depressed patients
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DOI：
10.1007/s00406-014-0543-3
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发表时间：
2015-04-01
影响因子：
4.7
通讯作者：
Sartorius, Alexander
中科院分区：
文献类型：
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作者：
Bumb, Jan Malte;Aksay, Suna Su;Sartorius, Alexander
电痉挛疗法（ECT）是一种公认的、安全有效的治疗严重或耐药情感障碍的方法。任何外周生物标志物与癫痫发作质量之间的潜在关系，作为治疗效果的替代品，迄今尚未研究。我们前瞻性地检测了20例重度抑郁症患者在电休克治疗前后的血清脑源性神经营养因子（BDNF）水平。根据癫痫发作持续时间、癫痫发作幅度、中枢抑制、半球间一致性和交感神经激活，对每次ECT治疗的癫痫发作质量进行综合评分。ECT后血清BDNF水平显著升高（P = 0.036）。在线性回归分析中，血清BDNF水平与最后一次电休克与抽血时间有显著相关性（P = 0.01）。方差分析显示，最后一次ECT与抽血之间的间隔时间（P = 0.0017）以及癫痫发作质量（P = 0.038）对血清BDNF水平的方差有显著影响。我们的数据证实了神经营养因子假说，表明ect诱导的中枢BDNF升高导致外周BDNF的延迟（大约6天）和平衡增加。癫痫发作充分性与BDNF升高的关联可能强调了在日常实践中监测癫痫发作质量标记物的重要性。
Electroconvulsive therapy (ECT) is a well-established, safe and effective treatment in severest or drug-resistant affective disorders. The potential relation between any peripheral biological marker and the seizure quality as a surrogate for treatment efficacy has not been investigated so far. We prospectively examined serum brain-derived neurotrophic factor (BDNF) levels in 20 patients with major depression before and after electroconvulsive therapy. A seizure quality sum score for every ECT session was build up on the basis of the seizure duration, seizure amplitude, central inhibition, interhemispheric coherence and sympathetic activation. Serum BDNF levels were significantly higher after ECT (P = 0.036). In the linear regression analysis, a significant correlation of the serum BDNF levels and the time between the last ECT and the blood withdrawal (P = 0.01) was observed. The ANOVA revealed a significant influence of the interval between the last ECT and the blood withdrawal (P = 0.0017) as well as the seizure quality (P = 0.038) on the variance of BDNF serum levels. Our data corroborate the neurotrophin hypothesis suggesting an ECT-induced central BDNF rise leading to a delayed (> 6 days) and increased equilibrium of the peripheral BDNF. The association of seizure adequacy with a BDNF rise might underline the importance of monitoring seizure quality markers in daily practice.