Serum Brain-Derived Neurotrophic Factors in Taiwanese Patients with Drug-Naïve First-Episode Major Depressive Disorder: Effects of Antidepressants.
Serum Brain-Derived Neurotrophic Factors in Taiwanese Patients with Drug-Naïve First-Episode Major Depressive Disorder: Effects of Antidepressants.
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DOI：
10.1093/ijnp/pyw096
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发表时间：
2017-03-01
期刊：
影响因子：
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通讯作者：
Huang TL
中科院分区：
文献类型：
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作者：
Chiou YJ;Huang TL
已知脑源性神经营养因子与严重抑郁障碍的精神病理学有关。然而，专注于药物幼稚的首发患者的研究仍然很少。在6年的时间里，我们检测了fi首发药物幼稚重度抑郁障碍患者的血清脑源性神经营养因子水平，并将其与性别匹配的健康对照组进行比较。我们还调查了抗抑郁药物治疗前后血清脑源性神经营养因子水平、自杀行为和汉密尔顿抑郁量表评分之间的关系。71例患者基线血清脑源性神经营养因子水平显著低于对照组(P=0.017)，且71例患者的汉密尔顿抑郁量表评分与脑源性神经营养因子水平无相关性。13例有自杀倾向的重度抑郁障碍患者的脑源性神经营养因子水平显著低于58例非自杀性重度抑郁障碍患者(P=0.038)。在41例随访患者中，抗抑郁药物治疗后血清脑源性神经营养因子水平没有变化(P=.126)。在受试者工作特征曲线分析中，使用预处理脑源性神经营养因子来估计治疗反应，曲线下面积为0.684。以6.1 ng/m L为临界值，灵敏度为78.6%，特异度为53.8%。我们的数据支持药物未治疗的首发抑郁症患者的血清脑源性神经营养因子水平低于健康对照组，且治疗前脑源性神经营养因子水平为6.1 ng/mL的患者更有可能成为应答者。尽管我们的结果与抑郁症的药物作用机制和病理生理学之间的关系尚不清楚，但该方法可能会作为治疗反应的预测指标。未来，还需要一个大样本来证明这些结果。
Brain-derived neurotrophic factors are known to be related to the psychopathology of major depressive disorder. However, studies focusing on drug-naïve first-episode patients are still rare. Over a 6-year period, we examined the serum brain-derived neurotrophic factors levels in patients with first-episode drug-naïve major depressive disorder and compared them with sex-matched healthy controls. We also investigated the relationships between serum brain-derived neurotrophic factors levels, suicidal behavior, and Hamilton Depression Rating Scale scores before and after a 4-week antidepressant treatment. The baseline serum brain-derived neurotrophic factors levels of 71 patients were significantly lower than those of the controls (P=.017), and the Hamilton Depression Rating Scale scores in 71 patients did not correlate with brain-derived neurotrophic factor levels. Brain-derived neurotrophic factor levels were significantly lower in 13 suicidal major depressive disorder patients than in 58 nonsuicidal major depressive disorder patients (P=.038). Among 41 followed-up patients, there was no alteration in serum brain-derived neurotrophic factors levels after treatment with antidepressants (P=.126). In receiver operating characteristic curve analysis of using pretreatment brain-derived neurotrophic factors to estimate the response to treatment, the area under the curve was 0.684. The most suitable cut-off point was 6.1 ng/mL (sensitivity=78.6%, specificity = 53.8%). Our data support the serum brain-derived neurotrophic factor levels in patients with drug-naïve first-episode major depressive disorder were lower than those in the healthy controls, and patients with pretreatment brain-derived neurotrophic factors >6.1 ng/mL were more likely to be responders. Although the relationship of our results to the mechanism of drug action and pathophysiology of depression remains unclear, the measure may have potential use as a predictor of response to treatment. In the future, it needs a large sample to prove these results.