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Brain-derived neurotrophic factor as a possible predictor of electroconvulsive therapy outcome.

ABSTRACT: While brain-derived neurotrophic factor (BDNF) has been shown to predict response to pharmacotherapy in depression, studies in electroconvulsive therapy (ECT) are small and report conflicting results. This study assesses the association between pre-treatment BDNF levels and ECT outcome in severe late-life unipolar depression (LLD). The potential of BDNF as a clinical predictor of ECT outcome was subsequently evaluated. Characteristics associated with low and high BDNF subgroups were determined as well. Ninety-four patients diagnosed with LDD referred for ECT were included. Fasting serum BDNF levels were determined before ECT. Remission and response, measured with the Montgomery-Åsberg Depression Rating Scale, were the outcomes. The association between BDNF and ECT outcome was analysed with logistic regression and Cox regression. The clinical usefulness of BDNF was evaluated using the receiver operating characteristic (ROC) curve. Associations between clinical characteristics and low versus high BDNF levels were examined with T tests, chi-squared tests and Mann-Whitney tests. The odds of remission decreased with 33% for every five units increase of BDNF levels (OR 0.67, 95% confidence interval 0.47-0.96; p?=?0.03); however, neither the association with time to remission nor the associations with response nor the adjusted models were significant. The area under the ROC (0.66) implied a poor accuracy of BDNF as a clinical test. Clinical characteristics associated with BDNF were inclusion site, physical comorbidities and duration of the index episode. To conclude, although there is an association between pre-treatment BDNF levels and ECT outcome, BDNF cannot be considered an eligible biomarker for ECT outcome in clinical practice.

SUBMITTER: van Zutphen EM

PROVIDER: S-EPMC6534549 | biostudies-literature | 2019 May

REPOSITORIES: biostudies-literature

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Brain-derived neurotrophic factor as a possible predictor of electroconvulsive therapy outcome.

van Zutphen Elisabeth Maria EM Rhebergen Didi D van Exel Eric E Oudega Mardien Leoniek ML Bouckaert Filip F Sienaert Pascal P Vandenbulcke Matthieu M Stek Max M Dols Annemieke A

Translational psychiatry 20190524 1

While brain-derived neurotrophic factor (BDNF) has been shown to predict response to pharmacotherapy in depression, studies in electroconvulsive therapy (ECT) are small and report conflicting results. This study assesses the association between pre-treatment BDNF levels and ECT outcome in severe late-life unipolar depression (LLD). The potential of BDNF as a clinical predictor of ECT outcome was subsequently evaluated. Characteristics associated with low and high BDNF subgroups were determined a ...[more]

PMID: 31127089

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Project description:OBJECTIVE:Brain-derived neurotrophic factor (BDNF) levels are decreased in individuals with depression and increase following antidepressant treatment. The objective of this study is to compare pre- and post-treatment serum BDNF levels in patients with drug-resistant major depressive disorder (MDD) who received either electroconvulsive therapy (ECT) or repetitive transcranial magnetic stimulation (rTMS). It is hypothesized that non-pharmacological treatments also increase serum BDNF levels. METHODS:This was a prospective, single-blind study comparing pre- and post-treatment serum BDNF levels of 29 patients with drug-resistant MDD who received ECT or rTMS treatment. Serum BDNF levels were measured 1?week prior to and 1?week after treatment using the sandwich ELISA technique. Depression severity was measured 1?week before and 1?week after treatment using the Hamilton Depression Rating Scale. Two-sided normal distribution paired t-test analysis was used to compare pre- and post-treatment BDNF concentration and illness severity. Bivariate correlations using Pearson's coefficient assessed the relationship between post-treatment BDNF levels and post-treatment depression severity. RESULTS:There was no significant difference in serum BDNF levels before and after ECT, although concentrations tended to increase from a baseline mean of 9.95-12.29?ng/ml after treatment (p?=?0.137). Treatment with rTMS did not significantly alter BDNF concentrations (p?=?0.282). Depression severity significantly decreased following both ECT (p?=?0.003) and rTMS (p?<?0.001). Post-treatment BDNF concentration was not significantly correlated with post-treatment depression severity in patients who received either ECT (r?=?-0.133, p?=?0.697) or rTMS (r?=?0.374, p?=?0.126). It is important to note that these results are based on the small number of patients included in this study. CONCLUSION:This study suggests that ECT and rTMS may not exert their clinical effects by altering serum BDNF levels in patients with drug-resistant MDD. Serum BDNF concentration may not be a biomarker of ECT or rTMS treatment response.

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Brain-derived neurotrophic factor as a possible predictor of electroconvulsive therapy outcome.

Publications

Brain-derived neurotrophic factor as a possible predictor of electroconvulsive therapy outcome.

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