Brain derived neurotrophic factor as the predictor of efficacy for repetitive transcranial magnetic stimulation in the treatment of refractory depression

doi:10.3969/j.issn.1006-7795.2022.02.011

Abstract

Abstract: Objective To investigate the predictive effect of brain-derived neurotrophic factor (BDNF) on the efficacy of repetitive transcranial magnetic stimulation (rTMS) in the treatment of refractory depression. Methods Fifty-nine patients with refractory depression were randomly divided into treatment group (34 patients) and control group (25 patients). The treatment group received high frequency (10 Hz) rTMS for 2 weeks, while the control group was treated with sham rTMS stimulation. Hamilton Depression Scale-17 Item (HAMD-17) and Hamilton Anxiety Scale (HAMA) were used to evaluate clinical symptoms. Enzyme linked immunosorbent assay (ELISA) was used to examine the level of serum BDNF. The evaluation time point was baseline, 2 weeks after treatment, and 6 weeks follow-up. Results The scores of HAMD-17 and HAMA in the treatment and control groups decreased with the treatment time (P_time<0.05). There was no significant difference between the two groups (P _group>0.05). The response rate of the treatment group (70.59%) was higher than that of the control group (44%) after 2 weeks, with a statistically significant difference (P _group = 0.04). After treatment, the change of BDNF level in the treatment group was significantly more than that in the control group (P _group<0.05). There was a positive correlation between baseline BDNF level and efficacy (P<0.05). No serious adverse events occurred during the treatment. Conclusion rTMS was effective in the treatment of refractory depression. The treatment effect of rTMS was better in patients with high baseline level of serum BDNF than that with low baseline level. BDNF could be used as a predictor of the antidepressant effect of rTMS.

Key words: repetitive transcranial magnetic stimulation (rTMS), depression, brain-derived neurotrophic factor (BDNF)

CLC Number:

R749

Sun Congcong, Wu Han, Zhou Danna, Jiang Wei, Wang Wen, Yang Chunlin, Ma Xin, Ren Yanping. Brain derived neurotrophic factor as the predictor of efficacy for repetitive transcranial magnetic stimulation in the treatment of refractory depression[J]. Journal of Capital Medical University, 2022, 43(2): 227-232.

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URL: https://journal03.magtech.org.cn/Jweb_sdykdxxb/EN/10.3969/j.issn.1006-7795.2022.02.011

https://journal03.magtech.org.cn/Jweb_sdykdxxb/EN/Y2022/V43/I2/227

References

[1] Nemeroff C B. Prevalence and management of treatment-resistant depression[J]. J Clin Psychiatry, 2007, 68(Suppl 8): 17-25.
[2] Wang H Y, Crupi D, Liu J J, et al. Repetitive transcranial magnetic stimulation enhances BDNF-TrkB signaling in both brain and lymphocyte[J]. J Neurosci, 2011, 31(30): 11044-11054.
[3] Furtado C P, Hoy K E, Maller J J, et al. An investigation of medial temporal lobe changes and cognition following antidepressant response: a prospective rTMS study[J]. Brain Stimul, 2013, 6(3): 346-354.
[4] Molendijk M L, Bus B A A, Spinhoven P, et al. Serum levels of brain-derived neurotrophic factor in major depressive disorder: state-trait issues, clinical features and pharmacological treatment[J]. Mol Psychiatry, 2011, 16(11): 1088-1095.
[5] Haile C N, Murrough J W, Iosifescu D V, et al. Plasma brain derived neurotrophic factor (BDNF) and response to ketamine in treatment-resistant depression[J]. Int J Neuropsychopharmacol, 2014, 17(2): 331-336.
[6] 袁娇, 徐乐平, 刘玉芝, 等. 重复经颅磁刺激对抑郁症患者血清脑源性神经营养因子水平影响的研究[J]. 中华行为医学与脑科学杂志, 2013, 22(3): 228-230.
[7] Su N, Zhang L, Fei F, et al. The brain-derived neurotrophic factor is associated with alcohol dependence-related depression and antidepressant response[J]. Brain Res, 2011, 1415: 119-126.
[8] Duclot F, Kabbaj M. Epigenetic mechanisms underlying the role of brain-derived neurotrophic factor in depression and response to antidepressants[J]. J Exp Biol, 2015, 218(Pt 1): 21-31.
[9] Yukimasa T, Yoshimura R, Tamagawa A, et al. High-frequency repetitive transcranial magnetic stimulation improves refractory depression by influencing catecholamine and brain-derived neurotrophic factors[J]. Pharmacopsychiatry, 2006, 39(2): 52-59.
[10] Lang U E, Bajbouj M, Gallinat J, et al. Brain-derived neurotrophic factor serum concentrations in depressive patients during vagus nerve stimulation and repetitive transcranial magnetic stimulation[J]. Psychopharmacology, 2006, 187(1): 56-59.
[11] Zhao X X, Li Y P, Tian Q, et al. Repetitive transcranial magnetic stimulation increases serum brain-derived neurotrophic factor and decreases interleukin-1β and tumor necrosis factor-α in elderly patients with refractory depression[J]. J Int Med Res, 2019, 47(5): 1848-1855.
[12] American Psychiatric Association. Diagnostic and statistical manual for mental disorders-text revision[M]. 4th ed. Washington DC: American Psychiatric Association,2000.
[13] George M S, Post R M. Daily left prefrontal repetitive transcranial magnetic stimulation for acute treatment of medication-resistant depression[J]. Am J Psychiatry, 2011, 168(4): 356-364.
[14] Berlim M T, Van den Eynde F, Tovar-Perdomo S, et al. Response, remission and drop-out rates following high-frequency repetitive transcranial magnetic stimulation (rTMS) for treating major depression: a systematic review and meta-analysis of randomized, double-blind and sham-controlled trials[J]. Psychol Med, 2014, 44(2): 225-239.
[15] Gedge L, Beaudoin A, Lazowski L, et al. Effects of electroconvulsive therapy and repetitive transcranial magnetic stimulation on serum brain-derived neurotrophic factor levels in patients with depression[J]. Front Psychiatry,2012, 3: 12
[16] Zanardini R, Gazzoli A, Ventriglia M, et al. Effect of repetitive transcranial magnetic stimulation on serum brain derived neurotrophic factor in drug resistant depressed patients[J]. J Affect Disord, 2006, 91(1): 83-86.
[17] 赵国宁, 史振娟, 刘飞, 等. 重复经颅磁刺激联合艾司西酞普兰对抑郁症的临床疗效分析[J]. 临床研究, 2021, 29(9): 40-41.
[18] 钟健荣, 林本, 郑春玉, 等. 不同侧的背外侧前额叶rTMS治疗抑郁症的效果及对血清NSE、BDNF水平的影响[J]. 数理医药学杂志, 2021, 34(12): 1748-1750.
[19] 徐清, 程灶火, 刘晓伟, 等. 重复经颅磁刺激对慢性精神分裂症患者认知功能和血清脑源性神经营养因子水平的影响研究[J]. 中国全科医学, 2017, 20(25): 3171-3177.
[20] 马俊, 喻丽芝, 吴香云, 等. 重复经颅磁刺激对精神分裂症患者事件相关电位N400及血清脑源性神经营养因子水平的影响[J]. 临床精神医学杂志, 2019, 29(2): 87-90.
[21] 乔卉, 安书成, 徐畅. BDNF与抑郁症的研究现状及进展[J]. 生理科学进展, 2011, 42(3): 195-200.
[22] 丁苏彭, 蔡雨婷, 邵明, 等. 脑源性神经营养因子和抑郁症因果关系的两样本孟德尔随机化研究[J]. 徐州医科大学学报, 2021, 41(9): 640-645.
[23] 何嘉丽, 赖顺凯, 钟舒明, 等. 抑郁症认知功能损害与脑源性神经营养因子的基因遗传研究进展[J]. 中华精神科杂志, 2021, 54(1): 45-49.
[24] Lam R W, Chan P, Wilkins-Ho M, et al. Repetitive transcranial magnetic stimulation for treatment-resistant depression: a systematic review and metaanalysis[J]. Can J Psychiatry, 2008, 53(9): 621-631.
[25] Schutter D J L G. Antidepressant efficacy of high-frequency transcranial magnetic stimulation over the left dorsolateral prefrontal cortex in double-blind sham-controlled designs: a meta-analysis[J]. Psychol Med, 2009, 39(1): 65-75.