Abstract
Remission is the primary goal of treatment for major depressive disorder (MDD). However, some patients do not respond to treatment. The main purpose of this study was to determine whether brain-derived neurotrophic factor (BDNF) levels are correlated with treatment outcomes. In a naturalistic study, we assessed whether plasma BDNF levels were correlated with clinical outcomes by measuring plasma BDNF in patients with depressive syndrome (MADRS score ≥18), and subsequently comparing levels between the subgroup of patients who underwent remission (MADRS score ≤8) and the subgroup who were refractory to treatment (non-responders). Patients with depressive syndrome who underwent remission had significantly higher plasma BDNF levels (p<0.001), regardless of age or sex. We also found a significant negative correlation between MADRS scores and plasma BDNF levels within this group (ρ = –0.287, p = 0.003). In contrast, non-responders had significantly lower plasma BDNF levels (p = 0.029). Interestingly, plasma BDNF levels in the non-responder group were significantly higher than those in the remission group in the initial stage of depressive syndrome (p = 0.002). Our results show that plasma BDNF levels are associated with clinical outcomes during the treatment of depression. We suggest that plasma BDNF could potentially serve as a prognostic biomarker for depression, predicting clinical outcome.Trial RegistrationUMIN Clinical Trials Registry UMIN000006264
Highlights
Remission is defined in The Diagnostic and Statistical Manual (DSM-IV) as the absence of significant signs or symptoms, and is the primary goal of treatment for major depressive disorder (MDD)
No significant differences were found between the remission and nonresponder groups in terms of gender, age or Montgomery-Asberg Depression Rating Scale (MADRS) score in the depressive syndrome stage
To gain insight into the different outcomes during the course of treatment for depression, we examined whether plasma Brain-derived neurotrophic factor (BDNF) levels underwent a change at different stages and the equivalent time points in non-responders, focusing on differences between remission and non-responder groups
Summary
Remission is defined in The Diagnostic and Statistical Manual (DSM-IV) as the absence of significant signs or symptoms, and is the primary goal of treatment for major depressive disorder (MDD). The category of depression (e.g., severe, moderate, mild or remission) is primarily evaluated by the patient using various subjective indices; there is currently no biomarker that could serve as an objective index for evaluating the severity or progression of MDD. Brain-derived neurotrophic factor (BDNF) has increasingly attracted attention among researchers investigating MDD, as numerous reports have indicated that it plays an important role in the illness [1]. BDNF is a member of the neurotrophin family and plays a critical role in the survival, differentiation and outgrowth of peripheral and central neurons during development and in adulthood [2,3]. Serum and plasma levels of BDNF are decreased in patients suffering from MDD [4,5,6,7,8]. BDNF levels in the hippocampus and prefrontal cortex are significantly reduced in suicide victims compared with non-suicide controls [12]
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