首发未用药抑郁症患者认知功能障碍与血清BDNF水平相关性研究

目的:探讨血清脑源性神经营养因子与中国汉族首发未用药抑郁症患者认知功能的关系.方法:对50例FDD组患者和50名健康对照组人员进行血清BDNF水平检测;采用威斯康星卡片分类测试(WCST)对FDD组患者和健康对照组进行认知功能评估.结果:FDD组患者血清BDNF水平显著低于健康对照组.FDD患者WCST的完成分类数(C...     

首发未用药抑郁症患者认知功能障碍与血清BDNF水平的相关性研究

目的:探讨血清脑源性神经营养因子与中国汉族首发未用药抑郁症患者认知功能的关系。方法:对50例FDD组患者和50名健康对照组人员进行血清BDNF水平检测;采用威斯康星卡片分类测试(WCST)对FDD组患者和健康对照组进行认知功能评估。结果:FDD组患者血清BDNF水平显著低于健康对照组。FDD患者WCST的完成分类数(Cc)、错误应答数(Re)、持续性错误数(Rpe)及非持续性错误(nRpe)均显著差于健康对照组。在FDD患者中,血清BDNF水平与WCST完成分类数评分呈正相关,并且与错误应答数(Re)和持续性错误数(Rpe)评分呈负相关。结论:低BDNF可能与抑郁症易感性及其认知功能损害具有相关性。     

无抽搐电休克对抑郁症患者疗效及血清脑源性神经营养因子的影响

目的分析抑郁症患者应用无抽搐电休克治疗对患者疗效及血清脑源性神经营养因子的影响。方法将80例抑郁症患者,按照入院先后顺序随机分为研究组和对照组各40例。所有患者采用艾司西酞普兰治疗,研究组外加无抽搐电休克治疗。比较2组患者汉密尔顿抑郁量表（HAMD）和临床变化总体评价量表（CGI）得分等。结果治疗前,2组患者脑源性神经营养因子（brain-derived neurotrophic factor,BDNF）水平差异无统计学意义（P〉0.05）;治疗后,2组患者均显著升高（P〈0.05）,且研究组显著优于对照组（P〈0.05）。研究组治疗有效率为92.50%（37/40）,对照组为82.50%（33/40）,差异有统计学意义（P〈0.05）。2组患者治疗前后HAMD、HAMA以及CGI、认知功能均得到显著改善（均P〈0.05）。结论无抽搐电休克治疗抑郁症患者,可有效改善患者抑郁、焦虑以及认知功能,提高患者BDNF水平,对患者性功能不会产生影响。     

BDNF在癫痫儿童的表达及意义

目的分析BDNF在不同治疗时期、不同发作类型、不同抽搐持续时间、不同治疗效果的癫痫儿童中的表达规律及意义。方法将癫痫患儿分成治疗前组,控制不佳组及控制良好组,并测定其血清BDNF浓度。结果癫痫组血清BDNF浓度显著高于对照组。而在不同治疗时期、不同发作类型、不同治疗效果的癫痫患儿中,BDNF的表达无显著差异。抽搐持续时间大于5分钟者,血清BDNF浓度显著高于抽搐持续时间小于5分钟者。结论癫痫儿童血清BDNF浓度高于正常儿童,BDNF参与了儿童癫痫的发生与发展过程。     

BDNF在癫痫儿童的表达及意义

目的分析BDNF在不同治疗时期、不同发作类型、不同抽搐持续时间、不同治疗效果的癫痫儿童中的表达规律及意义。方法将癫痫患儿分成治疗前组,控制不佳组及控制良好组,并测定其血清BDNF浓度。结果癫痫组血清BDNF浓度显著高于对照组。而在不同治疗时期、不同发作类型、不同治疗效果的癫痫患儿中,BDNF的表达无显著差异。抽搐持续时间大于5分钟者,血清BDNF浓度显著高于抽搐持续时间小于5分钟者。结论癫痫儿童血清BDNF浓度高于正常儿童,BDNF参与了儿童癫痫的发生与发展过程。     

BDNF对小鼠卵母细胞体外成熟及发育能力的影响

目的:观察脑源性神经营养因子(BDNF)对小鼠未成熟卵的体外成熟及发育能力的影响。方法:以α-MEM为基础培养液,添加不同浓度(0、1、5、10 ng/ml)的BDNF以及FSH、FBS培养小鼠未成熟卵,并进行体外受精,观察卵母细胞成熟率、受精率和胚胎发育至囊胚的能力,了解不同培养条件下BDNF对卵母细胞发育能力的影响。结果:当体外成熟培养液中含有FSH和10%的FBS时,与体外成熟对照组比较,BDNF虽然不影响卵母细胞的成熟率和受精率,但BDNF 5 ng/ml组的囊胚形成率(75.00%)显著高于体外成熟对照组(56.63%),而接近体内成熟组(76.92%);当培养液中仅含FBS时,各组间卵母细胞成熟率和受精率没有差异,但与对照组比较,BDNF显著提高囊胚形成率;当培养液中不含FBS、FSH时,虽然无囊胚形成,但BDNF显著提高了卵母细胞的受精率。结论:BDNF能促进小鼠未成熟卵胞质的发育,提高卵母细胞的发育能力。     

地塞米松治疗新生儿化脓性脑膜炎的疗效及对血浆BDNF水平的影响

目的观察地塞米松治疗新生儿化脓性脑膜炎的疗效及对血浆脑源性神经营养因子(BDNF)水平的影响。方法选取2015年1月-2018年1月在我院住院治疗的化脓性脑膜炎新生儿80例,采用随机数字表法分为对照组和观察组,各40例。对照组给予头孢曲松钠治疗,观察组在对照组基础上给予地塞米松治疗。治疗1周后,比较两组治疗有效率;比较两组患儿退热时间、脑膜刺激征消失时间及住院时间;比较两组患儿治疗1周后脑脊液白细胞数量、蛋白浓度、糖浓度;比较两组患儿治疗1周后血浆BDNF、血同型半胱氨酸(Hcy)、血浆溶血磷脂酸(LPa)浓度;记录两组治疗期间不良反应发生情况。结果治疗1周后,观察组治疗有效率高于对照组(P0.05),退热时间、脑膜刺激征消失时间及住院时间短于对照组(P0.05),脑脊液白细胞数量、蛋白浓度、糖浓度及Hcy浓度、LPa浓度均低于对照组(P0.05),血浆BDNF浓度高于对照组(P0.05),两组不良反应发生情况对比无明显差异(P0.05)。结论地塞米松治疗新生儿化脓性脑膜炎有效率高,不仅能缩短患儿退热时间、脑膜刺激征消失时间和住院时间,还能改善血浆BDNF水平。     

不同年龄女性血清性激素与BDNF的相关性

目的:探讨不同性激素水平时脑源性神经营养因子(BDNF)的变化。方法:筛选62例围绝经期及绝经后女性,按STRAW分期及绝经年限长短分组,并募集16例健康育龄女性作对照。采集晨间空腹血标本,分别测定血清雌二醇(E2)、睾酮(T)、卵泡刺激素(FSH)及BDNF的水平。结果:围绝经期组及绝经后组女性血清BDNF的水平明显低于健康育龄组女性,BDNF的水平与E2水平有显著相关性(r=0.303,P=0.017)。结论:血清BDNF的水平与内源性雌激素水平有关。     

亚慢性砷暴露对大鼠海马组织BDNF表达的影响

目的探讨亚慢性饮水型砷暴露对大鼠海马组织BDNF表达的影响。方法将40只SD大鼠按体重随机分为4组,分别为对照组(蒸馏水)和2.4、12、60 mg/L亚砷酸钠溶液染毒组,每组10只,雌雄各半,采用自由饮水的方式连续染毒100 d。检测脑砷含量、海马组织BDNF mRNA及蛋白表达。结果各染砷组大鼠脑砷含量均高于对照组(P0.05),且脑砷含量随着染毒剂量的增加呈上升趋势;各染砷组大鼠海马组织BDNF mRNA及其蛋白表达均低于对照组(P0.05)。结论亚慢性砷暴露可引起大鼠海马组织BDNF mRNA及其蛋白表达的降低。     

早期妊娠孕妇血清脑源性神经营养因子水平降低对产前抑郁症的影响

目的探讨早期妊娠孕妇血清中脑源性神经营养因子(BDNF)浓度变化对产前抑郁症发生的影响。方法选取2013年3月-2014年6月在该院产科门诊进行产前检查的孕妇960例为研究对象。采用PHQ-9抑郁量表评估孕妇抑郁症的发病率及程度,同时应用酶联免疫吸附实验(ELISA)方法检测孕妇外周血BDNF的浓度,并分析BDNF浓度变化与产妇抑郁症发生的关系。结果产前抑郁症孕妇的血清BDNF浓度明显低于正常孕妇,差异有统计学意义(P<0.05)。血清BDNF浓度处于下四分位数孕妇抑郁症的发病率是处于上四分位数孕妇的1.6倍(OR=1.6,95%CI为1.1~2.3)。结论早期妊娠孕妇产前抑郁症的发生可能与血清BDNF浓度的降低有关。血清BDNF变化可能成为预测产前抑郁症发生的潜在指标,可能有利于改善产前抑郁症的防治疗效。     

脑源性神经营养因子对阿尔茨海默病的作用

脑源性神经营养因子(BDNF)是神经营养因子家族中的一员,BDNF对周围和中枢神经元有广泛的生物学作用。阿尔茨海默病(AD)是以认知功能障碍和记忆损害为特征的神经退行性疾病,是老年人中常见的一种痴呆症。目前对BDNF与AD的关系和对AD的作用的研究已成为热点。本文重点综述了近年BDNF对AD作用的研究进展。     

Extra-Virgin Olive Oil Improves Depression Symptoms Without Affecting Salivary Cortisol and Brain-Derived Neurotrophic Factor in Patients With Major Depression: A Double-Blind Randomized Controlled Trial

BackgroundMany patients with depression are reluctant to take psychiatric medications. Hence, complementary therapies such as nutritional considerations could be advantageous. The antidepressant potential of olive oil has been proved in observational studies.ObjectiveThe effect of extra-virgin olive oil (EVOO) on depression symptoms and cortisol and brain-derived neurotrophic factor (BDNF) levels in patients with depression was examined.Design and participantsThis was a double-blind randomized controlled trial conducted on 73 patients suffering from major depressive disorder in Shiraz, Iran, in 2016.InterventionThe patients were randomly assigned to intervention (EVOO) and control (sunflower oil) groups and consumed 25 mL/d of the corresponding oil for 52 days.Main outcome measuresDepression symptoms were assessed by Beck Depression Inventory-II (BDI-II) and 7-item Hamilton Depression Rating Scale (HAMD-7). Salivary cortisol levels were determined immediately after awakening and 30 minutes later. Cortisol awakening response and the area under the curve with respect to ground and increase were computed. Serum BDNF concentrations were also measured.Statistical analyses performedStatistical analysis was conducted based on intention-to-treat and per-protocol approaches. Within-group changes were examined with repeated measures (for BDI-II and HAMD-7) and with paired t test (for other variables). Between-group comparisons were performed with analysis of covariance after adjustment for confounding factors.ResultsIn intention-to-treat analysis, HAMD-7 score was the only variable with significant changes within and between groups, the latter as a greater decline in EVOO group (P = .001). BDI-II score did not show significant change in either group but the between-group comparison revealed a significant difference (P = .021). EVOO showed antidepressant effect in severely depressed patients (P = .017 for BDI-II and 0.008 for HAMD-7) but not in mild/moderate depression category. Serum BDNF concentrations, salivary cortisol levels at immediately after awakening (T₀) and 30 minutes later, cortisol awakening response, the area under the curve with respect to ground and increase did not change within or between groups. Results of per-protocol analysis were not different.ConclusionsThe results of this study suggested beneficial effects of EVOO on depression symptoms in patients with severe depression but not in those with mild to moderate depression. The effects were significant from both statistical and clinical points of view.     

脑源性神经营养因子与老年患者术后认知功能障碍的研究进展

近年来,越来越多人关注术后认知功能障碍(POCD),但其发生机制目前仍然未能清楚阐明。探讨老年POCD发生机制与脑源性神经营养因子(BDNF)表达及其下游信号通路激活的关系是研究重点。为进一步明确老年POCD的发生机制,减少老年POCD的出现,提高老年患者生存质量,本文选择Web of Science、PubMed检索并回顾有关BDNF及POCD的文献以探讨二者的关系。     

文拉法辛合并喹硫平治疗难治性抑郁症的对照研究

目的探讨文拉法辛合并喹硫平治疗难治性抑郁症的安全性和疗效。方法将92例难治性抑郁症患者随机分为2组,研究组采用文拉法辛合并喹硫平治疗,对照组采用文拉法辛治疗,分别在治疗后第2、4、8、12周末,评定汉密顿抑郁量表（HAMD）和临床总体印象量表（CGI）,同时采用Asberg抗抑郁剂副反应量表评定2组药物的不良反应。结果根据HAMD评分,2组8周末减分率分别为（31．85±12．78）、（19．00±11．88）,2组12周末减分率分别为（48．46±20．75）、（29．54±16．85）,2组间差异均具有统计学意义（P〈0．05）。根据CGI评分,2组8周末评分分别为（2．31±0．95）、（3．15±1．06）,2组12周末评分分别为（2．00±1．00）、（2．99±1．19）,2组间差异具有统计学意义（P〈o．05）。药物不良反应2组问无明显差异（P〉0．05）。结论文拉法辛合并喹硫平治疗难治性抑郁症的疗效好,不良反应无明显增加。     

瑞波西汀和万拉法辛治疗难治性抑郁症的疗效

目的探讨瑞波西汀治疗难治性抑郁症的疗效及安全性。方法将83例难治性抑郁症患者随机分为两组,瑞波西汀组(42例)给予瑞波西汀治疗,平均每日剂量(10.00±2.65)mg,万拉法辛组(41例)给予万拉法辛治疗,平均每日剂量(165.00±28.40)mg,疗程6周。应用汉密顿抑郁量表(HAMD)和副反应量表(TESS)分别评定药物的疗效和不良反应。结果瑞波西汀组与万拉法辛组治疗前后HAMD评分比较,差别均有统计学意义(P<0.01)。两组的有效率分别为73.8%,75.6%,差别无统计学意义(P>0.05),瑞波西汀和万拉法辛的有效剂量范围分别为每日8～12mg和100～250mg。TESS评定显示,两组不良反应差别无统计学意义(P>0.05),发生率均较低,程度较轻。结论瑞波西汀治疗难治性抑郁症起效快。     

西酞普兰合并小剂量利培酮治疗难治性抑郁症的疗效

目的探讨小剂量利培酮对西酞普兰治疗难治性抑郁症的辅助效果及安全性。方法将100例难治性抑郁症患者随机分为两组,每组各50例。西酞普兰合并利培酮组:在西酞普兰(20mg/d)治疗的同时合并应用利培酮(0.5～2.0mg/d)。西酞普兰组:单用西酞普兰(20mg/d)治疗,两组持续治疗观察期均为4周。于入组前及入组后第1、2、4周末分别采用汉密尔顿抑郁量表(HAMD17项),汉密尔顿焦虑量表(HAMA)及不良反应量表(TESS)评定。结果治疗第2、4周末两组间HAMD、HAMA总分及减分率的差别有统计学意义(P<0.05或P<0.01)。西酞普兰合并利培酮组和西酞普兰组总有效率分别为76/和48/。TESS评分,西酞普兰合并利培酮组和西酞普兰组分别为(5.36±1.68)分和(7.82±2.91)分,两组比较,差别有统计学意义(P<0.01)。结论西酞普兰合并小剂量利培酮治疗难治性抑郁症的疗效优于单用西酞普兰。     

影响血清脑源性神经营养因子浓度相关因素的分析

目的测定研究对象血清脑源性神经营养因子(BDNF)的浓度,初步分析影响血清BDNF浓度的相关因素。方法采用酶联免疫吸附法测定外周血清BDNF的浓度,常规方法检测研究对象的肝功能、肾功能、血糖、血脂、甲状腺功能、血常规、体重指数。相关因素的分析采用多元线形回归的逐步筛选法。结果总T3、总T4、游离T4、促甲状腺素、尿素氮、血钠、红细胞数、血小板数是血清BDNF浓度的相关因素,其中红细胞数相关性最强,标准化回归系数为1.10207。结论 BDNF作为中介参与了促红细胞生成素的神经保护作用,介导甲状腺激素在中枢神经系统和周围组织的作用,可能参与尿素氮的代谢。     

Zinc monotherapy increases serum brain-derived neurotrophic factor (BDNF) levels and decreases depressive symptoms in overweight or obese subjects: A double-blind,randomized, placebo-controlled trial

Abstract

Objective

Previous studies have shown a positive effect of zinc as an adjunctive therapy on reducing depressive symptoms. However, to our knowledge, no study has examined the effect of zinc monotherapy on mood. The aim of the present study was to determine the effects of zinc monotherapy on depressive symptoms and serum brain-derived neurotrophic factor (BDNF) levels in overweight or obese subjects.

Methods

Fifty overweight or obese subjects were randomly assigned into two groups and received either 30 mg zinc or placebo daily for 12 weeks. At baseline and post-intervention, depression severity was assessed using Beck depression inventory II (BDI II), and serum BDNF and zinc levels were determined by enzyme-linked immunosorbent assay and atomic absorption spectrophotometry, respectively.

Results

The trial was completed with 46 subjects. After a 12-week supplementation, serum zinc and BDNF levels increased significantly in the zinc-supplemented group compared with the placebo group. BDI scores declined in both the groups at the end of the study, but reduction in the zinc-supplemented group was significantly higher than the placebo group. More analysis revealed that following supplementation, BDI scores decreased in subgroup of subjects with depressive symptoms (BDI ≥ 10) (n = 30), but did not change in the subgroup of non-depressed subjects (BDI < 10) (n = 16). Moreover, a significant inverse correlation was observed between serum BDNF levels and depression severity in all participants. Interestingly, a significant positive correlation was found between serum BDNF and zinc levels at baseline.

Conclusion

Zinc monotherapy improves mood in overweight or obese subjects most likely through increasing BDNF levels.     

体外冲击波碎石疗效的影响因素及对策

体外冲击波碎石技术是目前各种泌尿系结石治疗方法中的首选,但在体外冲击波碎石过程中经常会出现影响治疗效果的各种因素：由于元器件质量问题、安装问题、老化问题等,造成性能参数发生变化,影响冲击波能量的发生、传导、聚集;人体本身的肥胖、胃肠积气、腹式呼吸、结石的理化性质等因素,使能量传递不良、聚集不良、效率变差。文中列举和分析了各种影响疗效的因素和原因,并提出了相应的解决方案。     

Brain-derived neurotrophic factor (BDNF) Val66Met polymorphism and its implication in executive functions in adult offspring of alcohol-dependent probands

Impairment of executive functions (EFs) mediated by the prefrontal lobe is regarded as a cognitive endophenotype of alcohol dependence, being observed both in probands and in healthy offspring. Given its impact on the anatomy of the prefrontal cortex, the brain-derived neurotrophic factor (BDNF) Val66Met polymorphism may well be involved in this specific endophenotype. Forty-six healthy adult children of alcoholics (HACA) and 82 healthy controls (HC) took part in the study. All the participants were assessed with the Diagnostic Interview for Genetic Studies, and their family histories of alcohol and substance use were assessed with the Family Informant Schedule and Criteria. The Trail Making Test, Arithmetic Switching Task, Stroop Color-Word Test and Wisconsin Card Sorting Test were administered to assess EFs. An overall executive factor score was calculated using factorial analyses. Genotyping of the BDNF Val66Met polymorphism was performed using the TaqMan^® allelic discrimination assay. HACA had significantly lower EFs performance than HC. Genetic analysis showed that BDNF genotype distributions were in Hardy–Weinberg equilibrium in the HACA and HC. Genotype and allele distributions did not differ significantly between the two groups. Participants with the Met allele performed significantly more poorly than participants with the Val allele, and a group by allele interaction was observed, the BDNF Met allele being associated with a poorer executive factor score in the HACA group. These results suggest that the BDNF Val66Met polymorphism may contribute to alcohol dependence vulnerability via lower EFs performance.