Serum Mature BDNF Level Is Associated with Remission Following ECT in Treatment-Resistant Depression.

Marion Psomiades,Jérôme Brunelin,Nathalie Mandairon,Mikail Nourredine,Marine Mondino,Filipe Galvão,Marie-Françoise Suaud-Chagny

doi:10.3390/brainsci12020126

Abstract

The search for a biological marker predicting the future failure or success of electroconvulsive therapy (ECT) remains highly challenging for patients with treatment-resistant depression. Evidence suggests that Brain-Derived Neurotrophic Factor (BDNF), a protein known to be involved in brain plasticity mechanisms, can play a key role in both the clinical efficacy of ECT and the pathophysiology of depressive disorders. We hypothesized that mature BDNF (mBDNF), an isoform of BDNF involved in the neural plasticity and survival of neural networks, might be a good candidate for predicting the efficacy of ECT. Total BDNF (tBDNF) and mBDNF levels were measured in 23 patients with severe treatment-resistant depression before (baseline) they received a course of ECT. More precisely, tBDNF and mBDNF measured before ECT were compared between patients who achieved the criteria of remission after the ECT course (remitters, n = 7) and those who did not (non-remitters, n = 16). We found that at baseline, future remitters displayed significantly higher mBDNF levels than future non-remitters (p = 0.04). No differences were observed regarding tBDNF levels at baseline. The multiple logistic regression model controlled for age and sex revealed that having a higher baseline mBDNF level was significantly associated with future remission after ECT sessions (odd ratio = 1.38; 95% confidence interval = 1.07–2.02, p = 0.04). Despite the limitations of the study, current findings provide additional elements regarding the major role of BDNF and especially the mBDNF isoform in the clinical response to ECT in major depression.

Highlights

Depressive disorders are common and costly mental disorders affecting 4.4% of the world’s population according to “Depression and Other Common Mental Disorders: Global Health Estimates”, released by the World Health Organization (WHO, 2017) [1]
The exploratory multiple logistic regression model with age and sex revealed that having a higher baseline mature BDNF (mBDNF) level was significantly associated with future remission after electroconvulsive therapy (ECT) sessions in patients with treatment-resistant depression (TRD) (odds ratio (OR) = 1.38; 95% confidence interval (CI) = 1.07–2.02, p = 0.040)
We reported that remission of depression after ECT treatment is significantly associated with a higher level of mBDNF at baseline, with no influence of both age and sex

Summary

Introduction

Depressive disorders are common and costly mental disorders affecting 4.4% of the world’s population according to “Depression and Other Common Mental Disorders: Global Health Estimates”, released by the World Health Organization (WHO, 2017) [1]. In the case of severe and/or treatment-resistant symptoms, patients can benefit from electroconvulsive therapy (ECT) In such cases, ECT shows great clinical efficacy with a remission rate of approximately 50% in patients with unipolar depressive disorder [2]. Patients who remain in a depressive episode have a poorer prognosis for their medical condition and an increased use of health services [4]. In this context, a predictive clinical or biological marker of ECT outcome would be an opportunity to improve patient care and reduce the cost of depressive disorders for the community [5]. The search for a biological marker predicting the future failure or success of ECT remains highly challenging [6,7]

Objectives

Methods

Discussion

Conclusion