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Crawford CA, Williams MK, Shell AL, MacDonald KL, Considine RV, Wu W, Rand KL, Stewart JC. Effect of modernized collaborative care for depression on brain-derived neurotrophic factor (BDNF) and depressive symptom clusters: Data from the eIMPACT trial. Psychiatry Res 2023; 330:115581. [PMID: 37931480 PMCID: PMC10842310 DOI: 10.1016/j.psychres.2023.115581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 10/20/2023] [Accepted: 10/27/2023] [Indexed: 11/08/2023]
Abstract
Brain-derived neurotrophic factor (BDNF) levels are lower in people with depression and are normalized following pharmacological treatment. However, it is unknown if psychological treatments for depression improve BDNF and if change in BDNF is a mediator of intervention effects on depressive symptoms. Therefore, using data from the eIMPACT trial, we sought to determine the effect of modernized collaborative care for depression on 12-month changes in BDNF and cognitive/affective and somatic depressive symptom clusters and to examine whether BDNF changes mediate intervention effects on depressive symptoms. 216 primary care patients with depression from a safety net healthcare system were randomized to 12 months of the eIMPACT intervention (internet cognitive-behavioral therapy [CBT], telephonic CBT, and select antidepressant medications) or usual primary care. Plasma BDNF was measured with commercially available kits, and depressive symptom clusters were assessed by the Patient Health Questionnaire-9. The intervention did not influence BDNF but did improve both the cognitive/affective and somatic clusters over 12 months. Changes in BDNF did not mediate the intervention effect on either cluster. Our findings suggest that modernized collaborative care is an effective treatment for both the cognitive/affective and somatic symptoms of depression and that the mechanism of action is not improvements in BDNF. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT02458690.
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Affiliation(s)
- Christopher A Crawford
- Department of Psychology, Indiana University-Purdue University Indianapolis (IUPUI), 402 North Blackford Street, LD 100E, Indianapolis, IN 46202, USA
| | - Michelle K Williams
- Department of Psychology, Indiana University-Purdue University Indianapolis (IUPUI), 402 North Blackford Street, LD 100E, Indianapolis, IN 46202, USA
| | - Aubrey L Shell
- Department of Psychology, Indiana University-Purdue University Indianapolis (IUPUI), 402 North Blackford Street, LD 100E, Indianapolis, IN 46202, USA
| | - Krysha L MacDonald
- Department of Psychology, Indiana University-Purdue University Indianapolis (IUPUI), 402 North Blackford Street, LD 100E, Indianapolis, IN 46202, USA; Sandra Eskenazi Mental Health Center, Eskenazi Health, Indianapolis, IN, USA
| | - Robert V Considine
- Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Wei Wu
- Department of Psychology, Indiana University-Purdue University Indianapolis (IUPUI), 402 North Blackford Street, LD 100E, Indianapolis, IN 46202, USA
| | - Kevin L Rand
- Department of Psychology, Indiana University-Purdue University Indianapolis (IUPUI), 402 North Blackford Street, LD 100E, Indianapolis, IN 46202, USA
| | - Jesse C Stewart
- Department of Psychology, Indiana University-Purdue University Indianapolis (IUPUI), 402 North Blackford Street, LD 100E, Indianapolis, IN 46202, USA.
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Djelantik AAAMJ, Bui E, O'Connor M, Rosner R, Robinaugh DJ, Simon NM, Boelen PA. Traumatic grief research and care in the aftermath of the COVID-19 pandemic. Eur J Psychotraumatol 2021; 12:1957272. [PMID: 34567440 PMCID: PMC8462871 DOI: 10.1080/20008198.2021.1957272] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND A significant increase in the number of individuals suffering from prolonged grief disorder is expected in the aftermath of the COVID-19 pandemic for two main reasons. First, the number of excess deaths has contributed to an immense number of bereaved individuals. Second, recent literature has shown that circumstances associated with COVID-19 deaths may be contributing to increased risk for the development of prolonged grief disorder. OBJECTIVE To best support those affected by loss during the COVID-19 pandemic, it is important to inform clinicians and researchers about the development, the nature and the treatment of prolonged grief disorder and employ sound research. METHOD In this editorial, we discuss important themes regarding prolonged grief disorder in the aftermath of the COVID-19 pandemic, to gather and present useful information for clinicians and researchers. RESULTS The following themes were addressed: 1. Harmonization in the diagnosis of prolonged grief disorder. 2. Screening tools and interventions. 3. Pharmacotherapy. 4. Special attention for the elderly. 5. Special attention for children and adolescents. 6. A causal system perspective for understanding grief and prolonged grief disorder. CONCLUSIONS If those involved in bereavement research and care manage to collaborate, the tragic consequences of COVID-19 might catalyse improvement of care for those most impaired following the loss of a loved one.
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Affiliation(s)
- A A A Manik J Djelantik
- Department of Psychiatry, University Medical Centre Utrecht, Utrecht, The Netherlands.,Department Youth - KOOS, Altrecht GGZ, Utrecht, The Netherlands
| | - Eric Bui
- Department Psychiatry, University of Caen Normandy, Caen, France
| | - Maja O'Connor
- Department of Psychology, Unit for Bereavement Research, Aarhus University/The Danish National Center for Grief, Aarhus, Denmark
| | - Rita Rosner
- Department of Psychology, Catholic University Eichstaett-Ingolstadt, Eichstaett, Germany
| | - Donald J Robinaugh
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
| | - Naomi M Simon
- Department of Psychiatry, NYU Grossman School of Medicine, New York, NY, USA
| | - Paul A Boelen
- ARQ National Psychotrauma Centre, Diemen, The Netherlands.,ARQ Centrum'45, Diemen, The Netherlands.,Department of Clinical Psychology, Utrecht University, Utrecht, The Netherland
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3
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Wu C, Lu J, Lu S, Huang M, Xu Y. Increased ratio of mature BDNF to precursor-BDNF in patients with major depressive disorder with severe anhedonia. J Psychiatr Res 2020; 126:92-97. [PMID: 32428748 DOI: 10.1016/j.jpsychires.2020.05.010] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Revised: 04/25/2020] [Accepted: 05/11/2020] [Indexed: 12/27/2022]
Abstract
BACKGROUND Although studies have shown that severe anhedonia in patients with major depressive disorder (MDD) is associated with poor treatment outcomes, the biological mechanism of this feature is unclear. The aim of this study was to investigate the dysfunction of brain-derived neurotrophic factor (BDNF) metabolism, measured by the ratio of mature BDNF to precursor-BDNF, in MDD patients with severe anhedonia. METHODS We measured plasma levels of mature BDNF (mBDNF), precursor-BDNF (proBDNF), tissue plasminogen activator (tPA) and tropomyosin-related kinase B (trkB) in outpatients with MDD with anhedonia (n = 26), outpatients with MDD without anhedonia (n = 29) and age- and sex-matched healthy controls (HCs, n = 38) by enzyme-linked immunosorbent assay kits, and we calculated the ratio of mBDNF to proBDNF (M/P). We compared these biological determinants among the three groups and explored the interrelationships between anhedonia severity and BDNF metabolism. RESULTS The levels of mBDNF, proBDNF, and tPA and the ratio of M/P were identified with highly significant differences among the three groups. Compared with MDD patients without anhedonia and healthy controls, MDD patients with anhedonia showed higher level of the ratio of M/P, and it was positively associated with the SHAPS scores in MDD patients. Compared to healthy controls, the plasma tPA concentrations were higher in MDD patients with anhedonia but were not different from those in MDD patients without anhedonia. CONCLUSION These results provide novel evidence regarding the relationship between anhedonia and plasma BDNF metabolism. The hypermetabolism of BDNF may be a function of anhedonia rather than other characteristics in MDD.
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Affiliation(s)
- Congchong Wu
- Department of Psychiatry, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Jing Lu
- Department of Psychiatry, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China; Key Laboratory of Mental Disorder's Management of Zhejiang Province, Hangzhou, China; Brain Research Institute of Zhejiang University, Hangzhou, China
| | - Shaojia Lu
- Department of Psychiatry, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China; Key Laboratory of Mental Disorder's Management of Zhejiang Province, Hangzhou, China; Brain Research Institute of Zhejiang University, Hangzhou, China
| | - Manli Huang
- Department of Psychiatry, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China; Key Laboratory of Mental Disorder's Management of Zhejiang Province, Hangzhou, China; Brain Research Institute of Zhejiang University, Hangzhou, China.
| | - Yi Xu
- Department of Psychiatry, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China; Key Laboratory of Mental Disorder's Management of Zhejiang Province, Hangzhou, China; Brain Research Institute of Zhejiang University, Hangzhou, China.
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4
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Ai M, Wang J, Chen J, Wang W, Xu X, Gan Y, Li X, Gou X, Cao J, Lv Z, Chen X, Wang H, Ma Q, Kuang L. Plasma brain-derived neurotrophic factor (BDNF) concentration and the BDNF Val66Met polymorphism in suicide: a prospective study in patients with depressive disorder. PHARMACOGENOMICS & PERSONALIZED MEDICINE 2019; 12:97-106. [PMID: 31308724 PMCID: PMC6614583 DOI: 10.2147/pgpm.s201187] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/11/2019] [Accepted: 05/18/2019] [Indexed: 12/20/2022]
Abstract
Purpose The relationship was investigated between brain-derived neurotrophic factor (BDNF) concentrations, a BDNF polymorphism (196G>A), and the response to selective serotonin reuptake inhibitors (SSRIs) among Chinese patients with major depressive disorder (MDD). Patients and methods A total of 125 patients and 91 healthy controls were enrolled. The disease progression and treatment responses were evaluated using the Hamilton depression rating scale (HAMD24), the Hamilton anxiety scale, the Beck depression index, and BDNF concentrations at the baseline, 4, 8, and 12 weeks after treatment. Responders were defined as patients with at least a 50% decrease in the HAMD24. Results The BDNF concentrations were significantly lower in MDD (947±297 vs 1187±236 pg/mL, p=0.019), in MDD with attempted suicide than those without (779±231 vs 993±298, p=0.024) at the baseline. The BDNF concentrations remarkably increased in response to SSRI treatment. Significant correlations were noted between the BDNF concentrations and suicide ideation or attempted suicide (p<0.01), but not with HAMD24 or depression. BDNF 196G>A correlated with neither suicide ideation nor treatment responses. Conclusion BDNF concentrations were significantly lower in patients with attempted suicide/ideation. BDNF concentrations could serve as a response marker for antidepressant treatment in MDD.
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Affiliation(s)
- Ming Ai
- Department of Psychiatry, First Affiliated Hospital, Chongqing Medical University, Chongqing, People's Republic of China
| | - Jun Wang
- Department of Psychiatry, First Affiliated Hospital, Chongqing Medical University, Chongqing, People's Republic of China
| | - Jianmei Chen
- Department of Psychiatry, First Affiliated Hospital, Chongqing Medical University, Chongqing, People's Republic of China
| | - Wo Wang
- Mental Health Center, University-Town Hospital of Chongqing Medical University, Chongqing, People's Republic of China
| | - Xiaoming Xu
- Department of Psychiatry, First Affiliated Hospital, Chongqing Medical University, Chongqing, People's Republic of China
| | - Yao Gan
- Department of Psychiatry, First Affiliated Hospital, Chongqing Medical University, Chongqing, People's Republic of China
| | - Xuemei Li
- Department of Psychiatry, First Affiliated Hospital, Chongqing Medical University, Chongqing, People's Republic of China
| | - Xinyuan Gou
- Department of Psychiatry, First Affiliated Hospital, Chongqing Medical University, Chongqing, People's Republic of China
| | - Jun Cao
- Department of Psychiatry, First Affiliated Hospital, Chongqing Medical University, Chongqing, People's Republic of China
| | - Zhen Lv
- Department of Psychiatry, First Affiliated Hospital, Chongqing Medical University, Chongqing, People's Republic of China
| | - Xiaorong Chen
- Department of Psychiatry, First Affiliated Hospital, Chongqing Medical University, Chongqing, People's Republic of China
| | - Hengguang Wang
- Department of Psychiatry, First Affiliated Hospital, Chongqing Medical University, Chongqing, People's Republic of China
| | - Qing Ma
- Mental Health Center, University-Town Hospital of Chongqing Medical University, Chongqing, People's Republic of China.,Translational Pharmacology Research Core, New York State Center of Excellence in Bioinformatics and Life Sciences, School of Pharmacy and Pharmaceutical Sciences, University at Buffalo, Buffalo, NY, USA
| | - Li Kuang
- Department of Psychiatry, First Affiliated Hospital, Chongqing Medical University, Chongqing, People's Republic of China.,Mental Health Center, University-Town Hospital of Chongqing Medical University, Chongqing, People's Republic of China
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Data-driven biological subtypes of depression: systematic review of biological approaches to depression subtyping. Mol Psychiatry 2019; 24:888-900. [PMID: 30824865 DOI: 10.1038/s41380-019-0385-5] [Citation(s) in RCA: 120] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Revised: 02/11/2019] [Accepted: 02/14/2019] [Indexed: 12/20/2022]
Abstract
Research into major depressive disorder (MDD) is complicated by population heterogeneity, which has motivated the search for more homogeneous subtypes through data-driven computational methods to identify patterns in data. In addition, data on biological differences could play an important role in identifying clinically useful subtypes. This systematic review aimed to summarize evidence for biological subtypes of MDD from data-driven studies. We undertook a systematic literature search of PubMed, PsycINFO, and Embase (December 2018). We included studies that identified (1) data-driven subtypes of MDD based on biological variables, or (2) data-driven subtypes based on clinical features (e.g., symptom patterns) and validated these with biological variables post-hoc. Twenty-nine publications including 24 separate analyses in 20 unique samples were identified, including a total of ~ 4000 subjects. Five out of six biochemical studies indicated that there might be depression subtypes with and without disturbed neurotransmitter levels, and one indicated there might be an inflammatory subtype. Seven symptom-based studies identified subtypes, which were mainly determined by severity and by weight gain vs. loss. Two studies compared subtypes based on medication response. These symptom-based subtypes were associated with differences in biomarker profiles and functional connectivity, but results have not sufficiently been replicated. Four out of five neuroimaging studies found evidence for groups with structural and connectivity differences, but results were inconsistent. The single genetic study found a subtype with a distinct pattern of SNPs, but this subtype has not been replicated in an independent test sample. One study combining all aforementioned types of data discovered a subtypes with different levels of functional connectivity, childhood abuse, and treatment response, but the sample size was small. Although the reviewed work provides many leads for future research, the methodological differences across studies and lack of replication preclude definitive conclusions about the existence of clinically useful and generalizable biological subtypes.
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The role of hormonal, metabolic and inflammatory biomarkers on sleep and appetite in drug free patients with major depression: A systematic review. J Affect Disord 2019; 250:249-259. [PMID: 30870775 DOI: 10.1016/j.jad.2019.03.015] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2018] [Revised: 01/30/2019] [Accepted: 03/03/2019] [Indexed: 01/08/2023]
Abstract
BACKGROUND Major depressive disorder (MDD) is a complex and heterogeneous disorder in which clinical symptoms can widely differ among patients. Neurovegetative symptoms, i.e. decreased or increased appetite, changes in body weight and sleep disturbances, described as 'melancholic' or 'atypical' features of a depressive episode, are the most variable symptoms among patients with MDD. We hypothesized biomarkers differences underlying this neurovegetative variability in major depression. METHODS We systematically reviewed, according to the PRISMA guidelines, the role of specific metabolic, hormonal and inflammatory biomarkers in drug-free MDD patients, that could have neurobiological effects on appetite, weight regulation and circadian rhythms, influencing eating behaviour and sleep patterns. All studies regarding the co-occurrence of disturbed sleep and appetite were examined. RESULTS Besides the well-known leptin and ghrelin, other biomarkers such as BDNF, VEGF, NPY, orexin, and the recent discovered nesfatin-1 seem to be involved in neurovegetative changes in depressive disorders playing a role in the regulation of affective states, stress reactions and sleep patterns. Interestingly, based on the existing evidence, ghrelin, orexin and nesfatin-1 could be linked both to sleep and appetite regulation in depressed patients. LIMITATIONS Heterogeneous studies with low sample size. CONCLUSIONS Despite the wide heterogeneity of results, studies on biomarkers of appetite and sleep in MDD are an interesting field of research to explain the neurobiological substrates of depressive symptoms that deserve further investigation.
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7
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Effects of Cytochrome P450 2C19 Genetic Polymorphisms on Responses to Escitalopram and Levels of Brain-Derived Neurotrophic Factor in Patients With Panic Disorder. J Clin Psychopharmacol 2019; 39:117-123. [PMID: 30742590 DOI: 10.1097/jcp.0000000000001014] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE/BACKGROUND The purpose of this study was to examine the relationships between ytochrome P450 family 2 subfamily C member 19 (CYP2C19) polymorphisms, brain-derived neurotrophic factor (BDNF) plasma levels, and treatment responses to escitalopram in Chinese patients with panic disorder (PD). METHODS/PROCEDURES Ninety patients with PD were administered the Panic Disorder Severity Scale-Chinese Version (PDSS-CV) and Hamilton Anxiety Scale (HAMA-14) from baseline to 8 weeks. Escitalopram treatment (10 mg/d) was administered for 8 consecutive weeks. Three CYP2C19 metabolizers, including extensive metabolizers, intermediate metabolizers, and poor metabolizers (PMs), and 5 CYP2C19 genotypes were detected by polymerase chain reaction-genotyping microarray analysis. Baseline plasma BDNF levels were tested using human BDNF enzyme-linked immunosorbent assay kits. FINDINGS/RESULTS Our findings showed no significant differences in demographic data, baseline PDSS-CV scores, or HAMA-14 scores between the 3 CYP2C19 metabolizer groups (P's > 0.05). Repeated-measures analysis showed a significant reduction in PDSS-CV (F = 221.49, df = 3, P < 0.001) and HAMA-14 (F = 260.47, df = 3, P < 0.001) scores over 8 weeks in PD patients. In addition, patients with PMs had a greater reduction in HAMA-14 scores (F = 2.14, P = 0.049) than did those with extensive metabolizers and intermediate metabolizers. Moreover, our findings showed that patients with *2/*2 genotypes had a greater reduction in PDSS-CV scores than did those with other genotypes (F = 2.14, df = 12, P = 0.015). IMPLICATIONS/CONCLUSIONS Our study provides preliminary evidence of the effects of CYP2C19 PMs on treatment responses to escitalopram in Chinese PD patients, but no significant correlation between treatment responses and BDNF levels was found.
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Primo de Carvalho Alves L, Sica da Rocha N. Lower levels of brain-derived neurotrophic factor are associated with melancholic psychomotor retardation among depressed inpatients. Bipolar Disord 2018. [PMID: 29516593 DOI: 10.1111/bdi.12636] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
OBJECTIVES Melancholic depression is a type of depression which is closely related to biological variables than are other types of depression. Its clinical features can be assessed using six items on the Hamilton Depression Rating Scale (HAM-D6 ). Previous studies have shown, using item response theory, that the symptom depressed mood is the least severe melancholic feature; work and activities, somatic symptoms and psychic anxiety are of moderate severity; and feelings of guilt and psychomotor retardation are the most severe. We aimed to evaluate whether the more severe melancholic signs or symptoms were associated with decreases in brain-derived neurotrophic factor (BDNF) levels. METHODS A total of 151 severely depressed inpatients had their BDNF levels analyzed by comparing those who presented with each HAM-D6 melancholic feature to those for whom the HAM-D6 feature was absent, using multiple linear regressions. The levels of BDNF of patients who presented with each melancholic feature were also compared with those of 100 healthy controls. RESULTS Depressed patients' median BDNF level was 44.06 ng/mL (interquartile range [IQR]: 33.99-62.4 ng/mL), and controls' median BDNF level was 65.22 ng/mL (IQR: 49.87-76.08 ng/mL) (P < .001). The presence of depressed mood, work and activities, somatic symptoms, psychic anxiety, and guilty feelings was not associated with BDNF levels. However, the presence of psychomotor retardation was associated with reduced BDNF (median reduction -10.07 ng/mL; 95% confidence interval [CI]: -19.43 to -0.71; P = .03). CONCLUSIONS To the best of our knowledge, this study is the first to associate BDNF levels with melancholic features in a sample of severely depressed inpatients. The main finding of this study was that severely depressed inpatients who presented the most severe melancholic feature, psychomotor retardation, had significantly reduced BDNF levels in the blood.
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Affiliation(s)
- Lucas Primo de Carvalho Alves
- Federal University of Rio Grande do Sul, Porto Alegre, Brazil.,Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil.,Programa de Pós-Graduação em Psiquiatria e Ciências do Comportamento, Porto Alegre, Brazil
| | - Neusa Sica da Rocha
- Federal University of Rio Grande do Sul, Porto Alegre, Brazil.,Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil.,Programa de Pós-Graduação em Psiquiatria e Ciências do Comportamento, Porto Alegre, Brazil
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Dinga R, Marquand AF, Veltman DJ, Beekman ATF, Schoevers RA, van Hemert AM, Penninx BWJH, Schmaal L. Predicting the naturalistic course of depression from a wide range of clinical, psychological, and biological data: a machine learning approach. Transl Psychiatry 2018; 8:241. [PMID: 30397196 PMCID: PMC6218451 DOI: 10.1038/s41398-018-0289-1] [Citation(s) in RCA: 69] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2017] [Revised: 08/08/2018] [Accepted: 09/10/2018] [Indexed: 12/20/2022] Open
Abstract
Many variables have been linked to different course trajectories of depression. These findings, however, are based on group comparisons with unknown translational value. This study evaluated the prognostic value of a wide range of clinical, psychological, and biological characteristics for predicting the course of depression and aimed to identify the best set of predictors. Eight hundred four unipolar depressed patients (major depressive disorder or dysthymia) patients were assessed on a set involving 81 demographic, clinical, psychological, and biological measures and were clinically followed-up for 2 years. Subjects were grouped according to (i) the presence of a depression diagnosis at 2-year follow-up (yes n = 397, no n = 407), and (ii) three disease course trajectory groups (rapid remission, n = 356, gradual improvement n = 273, and chronic n = 175) identified by a latent class growth analysis. A penalized logistic regression, followed by tight control over type I error, was used to predict depression course and to evaluate the prognostic value of individual variables. Based on the inventory of depressive symptomatology (IDS), we could predict a rapid remission course of depression with an AUROC of 0.69 and 62% accuracy, and the presence of an MDD diagnosis at follow-up with an AUROC of 0.66 and 66% accuracy. Other clinical, psychological, or biological variables did not significantly improve the prediction. Among the large set of variables considered, only the IDS provided predictive value for course prediction on an individual level, although this analysis represents only one possible methodological approach. However, accuracy of course prediction was moderate at best and further improvement is required for these findings to be clinically useful.
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Affiliation(s)
- Richard Dinga
- 0000 0004 1754 9227grid.12380.38Department of Psychiatry and Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit, Amsterdam, The Netherlands
| | - Andre F. Marquand
- 0000000122931605grid.5590.9Donders Centre for Cognitive Neuroimaging, Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, The Netherlands ,0000 0001 2322 6764grid.13097.3cDepartment of Neuroimaging, Institute of Psychiatry, King’s College London, London, United Kingdom
| | - Dick J. Veltman
- 0000 0004 1754 9227grid.12380.38Department of Psychiatry and Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit, Amsterdam, The Netherlands
| | - Aartjan T. F. Beekman
- 0000 0004 1754 9227grid.12380.38Department of Psychiatry and Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit, Amsterdam, The Netherlands
| | - Robert A. Schoevers
- 0000 0004 0407 1981grid.4830.fUniversity Medical Center Groningen, Department of Psychiatry, Research School of Behavioural and Cognitive Neurosciences (BCN), University of Groningen, Groningen, The Netherlands
| | - Albert M. van Hemert
- 0000000089452978grid.10419.3dDepartment of Psychiatry, Leiden University Medical Center, Leiden, The Netherlands
| | - Brenda W. J. H. Penninx
- 0000 0004 1754 9227grid.12380.38Department of Psychiatry and Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit, Amsterdam, The Netherlands
| | - Lianne Schmaal
- Department of Psychiatry and Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit, Amsterdam, The Netherlands. .,Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, VIC, Australia. .,Centre for Youth Mental Health, The University of Melbourne, Melbourne, VIC, Australia.
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Vinnik T, Kirby M, Bairachnaya M, Koman I, Tarkina T, Sadykova G, Abildinova G, Batpenova G, Pinhasov A. Seasonality and BDNF polymorphism influences depression outcome in patients with atopic dermatitis and psoriasis. World J Biol Psychiatry 2017; 18:604-614. [PMID: 27409526 DOI: 10.1080/15622975.2016.1212171] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVES To examine the effect of seasonality and rs6265 genotype on depression outcome and brain-derived neurotrophic factor (BDNF) level with dermatitis patients from onset through remission. METHODS Atopic dermatitis (AD, 56) and psoriasis (PS, 33) patients and healthy controls (HC, 49) were recruited over the 2014 calendar year. Patients were subdivided by immunoglobulin E (IgE) sensitivity (AD only), season and rs6265 genotype. Assessments were performed at onset and week 10 (Hamilton Depression Rating Scale [HAM-D], SCORAD/PASI, IgE, BDNF). Patients received standard corticosteroid and antihistamine interventions. RESULTS All patients responded to corticosteroid treatment. Seasonally differential outcomes were observed in all groups. HAM-D was elevated at onset and improved over 10 weeks: AD cohort 1 (autumn/winter, AD-1) patients improved and AD cohort 2 (spring/summer, AD-2) patients remained elevated. BDNF levels were elevated in AD and seasonal differential: AD-2 declined at 10 weeks, whereas AD-1 remained high (intrinsic AD) or elevated further (extrinsic AD). PS cohort 2 declined to below control at 10 weeks. AD Val/Val had persistently elevated HAM-D and AD Val/Met were either normal (AD-1) or persistently elevated (AD-2). CONCLUSIONS Findings presented here suggest a strong influence of seasonality on depression outcome and BDNF expression in AD and PS and likely reflect separate patient populations which differentially respond to environment-based stressors.
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Affiliation(s)
- Tatyana Vinnik
- a Department of Dermatovenereology , Astana Medical University , Astana , Kazakhstan
| | - Michael Kirby
- b Department of Molecular Biology , Ariel University , Ariel , Israel
| | | | - Igor Koman
- b Department of Molecular Biology , Ariel University , Ariel , Israel
| | - Tatyana Tarkina
- a Department of Dermatovenereology , Astana Medical University , Astana , Kazakhstan
| | - Gulnaz Sadykova
- a Department of Dermatovenereology , Astana Medical University , Astana , Kazakhstan
| | - Gulshara Abildinova
- c National Research Centre of Maternal and Child Health , Astana , Kazakhstan
| | - Gulnara Batpenova
- a Department of Dermatovenereology , Astana Medical University , Astana , Kazakhstan
| | - Albert Pinhasov
- b Department of Molecular Biology , Ariel University , Ariel , Israel
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11
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Illness severity and biomarkers in depression: Using a unidimensional rating scale to examine BDNF. Compr Psychiatry 2017; 75:46-52. [PMID: 28301802 DOI: 10.1016/j.comppsych.2017.02.014] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2017] [Revised: 02/27/2017] [Accepted: 02/28/2017] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Numerous studies have reported reduced peripheral brain-derived neurotrophic factor (BDNF) in major depression (MD). However, most of these studies used multidimensional depression rating scales, and failed to identify a relationship between BDNF levels and depression severity. Unidimensional scales are a more valid measure of syndrome severity. In these scales, items are ordered in increasing severity, so that as scores increase, syndrome severity increases; thus, each item adds unique information, and items can be totaled to a meaningful sum. The current study used the HAM-D6, a unidimensional measure of depression, to examine if it could identify a correlation between serum BDNF and depression severity. METHODS Serum BDNF levels and symptom severity were assessed in 163 depressed patients, including those with both unipolar (84.0%) and bipolar (16.0%) depression. The evaluation of depression severity included the total HAM-D17 and 3 subscales, including the HAM-D6. RESULTS On average, patients presented moderate to severe depression (HAM-D17=21.2±5.5). Overall BDNF levels were 60.4±22.6ng/mL. The correlation between serum BDNF and depression severity was modest and not different when assessed by the HAM-D6 subscale or the HAM-D17 as a whole (z=0.951; p=0.341), despite being statistically significant for the HAM-D6 (r=-0.185; p=0.019; 95% CI: -0.335 to -0.033), but not for the entire HAM-D17 (r=-0.127; p=0.108; 95% CI: -0.272 to 0.027). CONCLUSION We could not identify a strong relationship between serum BDNF levels and depression severity using the HAM-D6. This is in concordance with results of previous studies that reported no correlation between these variables, and indicates that the properties of the clinical measures used cannot explain the results these studies.
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Siuda J, Patalong-Ogiewa M, Żmuda W, Targosz-Gajniak M, Niewiadomska E, Matuszek I, Jędrzejowska-Szypułka H, Lewin-Kowalik J, Rudzińska-Bar M. Cognitive impairment and BDNF serum levels. Neurol Neurochir Pol 2016; 51:24-32. [PMID: 28341039 DOI: 10.1016/j.pjnns.2016.10.001] [Citation(s) in RCA: 74] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2016] [Revised: 09/29/2016] [Accepted: 10/04/2016] [Indexed: 11/29/2022]
Abstract
BACKGROUND/AIMS To investigate the alterations of brain-derived neurotrophic factor (BNDF) serum levels in subjects with different intensity of cognitive impairment and different neurodegenerative processes. MATERIAL AND METHODS Serum BDNF levels were analyzed by ELISA kit in 378 subjects: 134 Alzheimer's disease (AD) patients, 115 amnestic mild cognitive impairment (MCI) patients, and 129 controls divided into two groups: neurodegenerative control group (ND), consisting of 49 Parkinson's disease patients without any cognitive complaints, and cognitively normal control group (CN), consisting of 80 subjects without any neurological disorders. RESULTS AD patients had significantly lower (p<0.001) BDNF serum levels compared to MCI, CN and ND controls. Age and education had significant influence on BDNF serum levels regardless the diagnosis or group assignment. We have found no influence of depression on BDNF serum levels either in our group as a whole, or in each group assessed separately. We found significant correlation between BDNF serum levels and cognitive impairments. After multiple comparisons between the groups, we found that, after adjustment for confounding factors (age, gender, education, depression, cognitive impairment), BDNF serum levels were the lowest in AD group (p=0.05). CONCLUSIONS Advanced age and low educational level are associated with decreased BDNF serum levels. Decreased BDNF serum levels correspond to the severity of cognitive impairment. There is no correlation between BDNF serum levels and depressive symptoms.
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Affiliation(s)
- Joanna Siuda
- Department of Neurology, School of Medicine in Katowice, Medical University of Silesia, Katowice, Poland; Department of Neurology, Central University Hospital, Katowice, Poland.
| | | | - Weronika Żmuda
- Department of Neurology, Central University Hospital, Katowice, Poland
| | | | - Ewa Niewiadomska
- Department of Biostatistics, School of Public Health in Bytom, Medical University of Silesia, Katowice, Poland
| | - Iwona Matuszek
- Department of Physiology, School of Medicine in Katowice, Medical University of Silesia, Katowice, Poland
| | | | | | - Monika Rudzińska-Bar
- Department of Neurology, School of Medicine in Katowice, Medical University of Silesia, Katowice, Poland; Department of Neurology, Central University Hospital, Katowice, Poland
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Geoffroy HAS, Puig S, Benturquia N, Noble F. Temporal regulation of peripheral BDNF levels during cocaine and morphine withdrawal: comparison with a natural reward. Int J Neuropsychopharmacol 2014; 18:pyu088. [PMID: 25522421 PMCID: PMC4376544 DOI: 10.1093/ijnp/pyu088] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2014] [Accepted: 10/25/2014] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Brain-derived neurotrophic factor (BDNF) is a neurotrophin that has long been studied in the field of addiction and its importance in regulating drug addiction-related behavior has been widely demonstrated. The aim of our study was to analyze the consequences of a repeated exposure to drugs of abuse or natural reward on plasma BDNF levels during withdrawal. METHODS Rats were chronically injected with morphine (subcutaneously, 5mg/kg) or cocaine (intraperitoneally, 20mg/kg) or fed with a butter biscuit (per os, 4g) once per day for 14 days. Blood collection was performed on the 1st (withdrawal day 1 or WD1) or on (WD14), either at the same time point rats had been exposed to drugs or natural reward or at a different time point (used to quantify basal brain-derived neurotrophic factor levels). RESULTS Cocaine treatment led to a rapid (WD1) and persistent (WD14) decrease of basal BDNF levels compared with saline-treated animals, whereas morphine induced an increase on WD14 without any alteration on WD1. On the contrary, the natural reward induced a significant increase of basal brain-derived neurotrophic factor levels only on WD1. The analysis of BDNF levels at the usual time point at which animals had been exposed showed that both drugs, but not the natural reward, increased BDNF levels compared with basal levels. CONCLUSION Our data highlight that only drugs of abuse are able to persistently alter BDNF levels and to induce specific variations of this neurotrophic factor at the usual hour of injection.
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Affiliation(s)
- Hélène Anne-Sophie Geoffroy
- Centre National de la Recherche Scientifique, France (Ms Geoffroy, Drs Puig and Noble); Institut National de la Santé et de la Recherche Médicale, France (Ms Geoffroy, Drs Puig, Benturquia, and Noble); Université Paris Descartes, Paris, France (Ms Geoffroy, Drs Puig, Benturquia, and Noble)
| | - Stephanie Puig
- Centre National de la Recherche Scientifique, France (Ms Geoffroy, Drs Puig and Noble); Institut National de la Santé et de la Recherche Médicale, France (Ms Geoffroy, Drs Puig, Benturquia, and Noble); Université Paris Descartes, Paris, France (Ms Geoffroy, Drs Puig, Benturquia, and Noble)
| | - Nadia Benturquia
- Centre National de la Recherche Scientifique, France (Ms Geoffroy, Drs Puig and Noble); Institut National de la Santé et de la Recherche Médicale, France (Ms Geoffroy, Drs Puig, Benturquia, and Noble); Université Paris Descartes, Paris, France (Ms Geoffroy, Drs Puig, Benturquia, and Noble)
| | - Florence Noble
- Centre National de la Recherche Scientifique, France (Ms Geoffroy, Drs Puig and Noble); Institut National de la Santé et de la Recherche Médicale, France (Ms Geoffroy, Drs Puig, Benturquia, and Noble); Université Paris Descartes, Paris, France (Ms Geoffroy, Drs Puig, Benturquia, and Noble).
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Spanemberg L, Caldieraro MA, Vares EA, Wollenhaupt-Aguiar B, Kauer-Sant'Anna M, Kawamoto SY, Galvão E, Parker G, Fleck MP. Biological differences between melancholic and nonmelancholic depression subtyped by the CORE measure. Neuropsychiatr Dis Treat 2014; 10:1523-31. [PMID: 25187716 PMCID: PMC4149384 DOI: 10.2147/ndt.s66504] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND The purpose of this study was to compare melancholic patients rated by the CORE measure of observable psychomotor disturbance with nonmelancholic and control subjects across a set of biomarkers. METHODS Depressed patients were classified as melancholic or nonmelancholic by using the CORE measure. Both groups of patients, as well as control subjects, were compared for a set of clinical and laboratory measures. Serum levels of brain-derived neurotrophic factor, of two markers of oxidative stress (protein carbonyl content [PCC] and thiobarbituric acid reactive substances [TBARS]), and of several immunity markers (interleukin [IL]-2, IL-4, IL-6, IL-10, IL-17, tumor necrosis factor-alpha, and interferon-gamma) were analyzed. RESULTS Thirty-three depressed patients and 54 healthy controls were studied. Depressive patients showed higher IL-4, IL-6, and PCC values than healthy controls. Thirteen (39%) of the depressed patients were assigned as melancholic by the CORE measure. They generated lower interferon-gamma (compared with nonmelancholic depressed patients) and TBARS (compared with both the nonmelancholic subset and controls) and returned higher IL-6 levels than controls. Both depressive groups generated higher PCC scores than controls, with no difference between melancholic and nonmelancholic subsets. CONCLUSION A sign-based measure to rate melancholia was able to replicate and extend biological findings discriminating melancholic depression. Signs of psychomotor disturbance may be a useful diagnostic measure of melancholia.
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Affiliation(s)
- Lucas Spanemberg
- Mood Disorders Program, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil ; Department of Psychiatry, Hospital São Lucas da Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil
| | - Marco Antonio Caldieraro
- Mood Disorders Program, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Edgar Arrua Vares
- Mood Disorders Program, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Bianca Wollenhaupt-Aguiar
- INCT Translational Medicine, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil ; Bipolar Disorders Program and Laboratory of Molecular Psychiatry, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Márcia Kauer-Sant'Anna
- INCT Translational Medicine, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil ; Bipolar Disorders Program and Laboratory of Molecular Psychiatry, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Sheila Yuri Kawamoto
- Mood Disorders Program, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Emily Galvão
- INCT Translational Medicine, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil ; Bipolar Disorders Program and Laboratory of Molecular Psychiatry, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil ; Centro Universitário Metodista, Porto Alegre, Brazil
| | - Gordon Parker
- School of Psychiatry, University of New South Wales, Sydney, NSW, Australia ; Black Dog Institute, Sydney, NSW, Australia
| | - Marcelo P Fleck
- Mood Disorders Program, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil ; Neuromodulation Research Clinic, Douglas Mental Health University Institute, Montréal, ON, Canada
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