Brain-derived neurotrophic factor levels in schizophrenia: a systematic review with meta-analysis
Brain-derived neurotrophic factor levels in schizophrenia: a systematic review with meta-analysis
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DOI：
10.1038/mp.2010.88
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发表时间：
2011-09-01
影响因子：
11
通讯作者：
Carr, V. J.
中科院分区：
文献类型：
--
作者：
Green, M. J.;Matheson, S. L.;Carr, V. J.
脑源性神经营养因子（BDNF）调节神经元的存活和生长，并影响突触的效率和可塑性。几项研究报道了精神分裂症患者外周血BDNF水平降低，但结果不一致。我们对精神分裂症患者与健康对照者血液BDNF水平的研究进行了第一次系统性综述和荟萃分析，并研究了年龄，性别和药物的潜在影响。包括精神分裂症（包括情感性精神障碍或首发精神病）与年龄匹配的健康对照组的BDNF血液（血清或血浆）水平的个体研究，通过电子Medline和Embase搜索和手动搜索获得。纳入或排除研究、数据提取和质量评估的决定由两名独立评审员完成。最初的检索发现了378条记录，其中342条在阅读摘要时被排除在外，因为他们没有检查精神分裂症患者与健康对照组相比的BDNF血液水平。在全面筛选的36篇论文中，有17篇符合纳入条件，但随后有一篇作为离群值被删除。其余16项研究提供了精神分裂症患者血液BDNF水平降低的中等质量证据（Hedges g =-0.458，95%置信区间= -0.770 to-0.146，P < 0.004，随机效应模型）。亚组分析显示，在药物初治和药物治疗的患者中，以及男性和女性精神分裂症患者中，BDNF减少。荟萃回归分析显示，精神分裂症患者BDNF减少与年龄增加有关，但药物剂量无影响。总体而言，药物治疗和药物初治的精神分裂症患者的BDNF血液水平降低;这一证据是中等质量的，也就是说，精确，但在研究结果中存在相当大的，无法解释的异质性。Molecular Psychiatry（2011）16，960-972; doi：10.1038/mp.2010.88; 2010年8月24日在线发表
Brain-derived neurotrophic factor (BDNF) regulates the survival and growth of neurons, and influences synaptic efficiency and plasticity. Several studies report reduced peripheral (blood) levels of BDNF in schizophrenia, but findings are inconsistent. We undertook the first systematic review with meta-analysis of studies examining blood BDNF levels in schizophrenia compared with healthy controls, and examined potential effects of age, gender and medication. Included are individual studies of BDNF blood (serum or plasma) levels in schizophrenia (including schizoaffective disorder, or first episode psychosis), compared with age-matched healthy controls, obtained by electronic Medline and Embase searches, and hand searching. The decision to include or exclude studies, data extraction and quality assessment were completed by two independent reviewers. The initial search revealed 378 records, of which 342 were excluded on reading the Abstract, because they did not examine BDNF blood levels in schizophrenia compared with healthy controls. Of 36 papers screened in full, 17 were eligible for inclusion, but one was subsequently removed as an outlier. The remaining 16 studies provided moderate quality evidence of reduced blood BDNF levels in schizophrenia (Hedges g = -0.458, 95% confidence interval = -0.770 to -0.146, P < 0.004, random effects model). Subgroup analyses reveal reduced BDNF in both drug-naive and medicated patients, and in males and females with schizophrenia. Meta-regressions showed an association between reduced BDNF in schizophrenia and increasing age, but no effects of medication dosage. Overall, blood levels of BDNF are reduced in medicated and drug-naive patients with schizophrenia; this evidence is of moderate quality, that is, precise but with considerable, unexplained heterogeneity across study results. Molecular Psychiatry (2011) 16, 960-972; doi:10.1038/mp.2010.88; published online 24 August 2010