Abstract
Several studies have investigated the relationship between non-pharmacological interventions (NPIs) and peripheral brain-derived neurotrophic factor (BDNF) in schizophrenia patients. We conducted a systematic review and meta-analysis to review the efficacy of NPIs on peripheral serum and plasma BDNF in subjects with schizophrenia (including schizoaffective disorder). Meta-analyses were conducted to examine the effects of NPIs on blood BDNF levels by using the standardized mean differences (SMDs) between the intervention groups and controls. In total, six randomized controlled trials with 289 participants were included. Of them, five studies used exercise, physical training or diet products. One study used cognitive training. Overall, the BDNF levels in the NPI group increased significantly compared with the control groups (SMD = 0.95, 95% confidence interval (CI) = 0.07 to 1.83, p = 0.03). Subgroup analyses indicated beneficial effects of a non-exercise intervention on peripheral BDNF levels (SMD = 0.41, 95% CI = 0.08 to 0.74, p = 0.01). Meta-regression analyses showed that the completion rate influenced the variation in SMD (p = 0.01). Despite insufficient evidence to draw a conclusion, our results suggest that use of NPIs as adjunctive treatments, specifically non-exercise interventions, may affect positively serum or plasma BDNF in patients with schizophrenia.
Highlights
Over the past several decades, treatments with both first- and second-generation antipsychotics (FGAs and SGAs, respectively) have certainly reduced psychotic symptoms in patients with schizophrenia
We found there was a significant association between the standardized mean differences (SMDs) of the effects of non-pharmacological interventions (NPIs) on peripheral Brain-derived neurotrophic factor (BDNF) levels and the completion rate (Figure 3)
A reduction in BDNF concentrations has been reported in the prefrontal cortex (PFC) and hippocampus in schizophrenia compared with controls [51,52,53,54]
Summary
Over the past several decades, treatments with both first- and second-generation antipsychotics (FGAs and SGAs, respectively) have certainly reduced psychotic symptoms (e.g., hallucinations and delusions) in patients with schizophrenia. A considerable number of studies, at both the preclinical and clinical levels, have examined the relationship between BDNF and mental disorders, not just psychotic disorders but depression [8,9], anxiety disorder [8], post-traumatic stress disorder (PTSD) [10], and Alzheimer’s disease [11]. A recent meta-analysis demonstrated that peripheral levels of serum and plasma BDNF were moderately decreased in schizophrenia compared with controls [12]. With respect to the association between antipsychotic therapy and changes in BDNF levels in schizophrenia, findings from previous studies are inconsistent, the same meta-analysis [12] demonstrated that the plasma levels of BDNF, not serum levels, increased with antipsychotic treatment independent of each patient’s response to medication
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