Evaluation of BDNF levels in patients hospitalized for physical trauma at an emergency hospital in Porto Alegre, southern Brazil.

Cleonice Zatti,Márcia Rosane Moreira Santana,Vitor Crestani Calegaro,Luciano Santos Pinto Guimarães,Eliana Ferreira Gonçalves Scherner,Mariana Lunardi Spader,Renato Piltcher,Bianca Wollenhaupt-Aguiar,Emílio Salle,Lúcia Helena Machado Freitas

doi:10.1590/2237-6089-2018-0060

Abstract

To assess the association between brain-derived neurotrophic factor (BDNF) levels and acute stress disorder (ASD) in patients who have suffered physical trauma. Data were collected at an emergency hospital in Porto Alegre, state of Rio Grande do Sul, southern Brazil. Participants were over 18 years of age, victims of physical trauma, and had been hospitalized for a minimum of 48 hours. A total of 117 hospitalized patients who agreed to participate in the research were grouped according to the shift in which blood was collected (38 subjects from the morning shift and 79 from the afternoon shift), had their BDNF levels measured and responded to other questionnaires. Respondents were further grouped by age into three ranges: 18-30, 31-50 and 51-70 years. We found a significant difference in the distribution of BDNF between the two shifts in which blood samples were collected, with the afternoon group having higher BDNF levels (U = 1906.5, p = 0.018). A difference was observed only between the 18-30 group and the 51-70 group in the afternoon shift (Umorning = 1107, pmorning = 0.575; Uafternoon = 7175, pafternoon = 0.028). The population whose blood samples were collected in the afternoon showed significantly higher values of BDNF compared to those of the morning shift. This same population presented lower BDNF levels when associated with ASD subtypes A1, A2, and A. We hypothesize that the lower values of BDNF measured in the morning shift were due to a response to the circadian cycle of cortisol, whose action inhibits the expression of serum neurotrophins.

Highlights

Acute stress disorder (ASD) is a diagnosis organized under disorders related to trauma and stressors introduced in the Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV)
In the DSM-5, ASD is characterized by the onset of a minimum set of symptoms 3 to 30 days after the person has been exposed to a traumatic event
brain-derived neurotrophic factor (BDNF) participates in the formation of long-term memory and other cognitive processes and is an important factor to be evaluated in patients who have developed posttraumatic stress disorder (PTSD).[17]

Summary

Introduction

Acute stress disorder (ASD) is a diagnosis organized under disorders related to trauma and stressors introduced in the Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV). A series of works have attempted to evaluate to what extent ASD might be a predictor of posttraumatic stress disorder (PTSD).[1] the centrality defined by the DSM-IV says that symptoms need to last for only two days for a diagnosis of ASD to be made. For ASD only, we used DSM-5 criteria for diagnosis. In the DSM-5, ASD is characterized by the onset of a minimum set of symptoms 3 to 30 days after the person has been exposed to a traumatic event. After the 30-day mark, diagnosis should be changed to PTSD.[2]

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Results

Conclusion