Effect of Oxcarbazepine on Serum Brain Derived Neurotrophic Factor in Bipolar Mania: An Exploratory Study
2
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Objective: In bipolar disorder, serum brain-derived neurotrophic factor (BDNF) level decreases leading to dysfunctions of critical neurotrophic, cellular plasticity and neuroprotective processes. The present study was conducted to evaluate the change in serum BDNF level with oxcarbazepine monotherapy in bipolar mania. Methods: The present study is a prospective, interventional, open label clinical study conducted on 25 patients of bipolar mania and 25 healthy controls. Detailed history, clinical evaluation including Young Mania Rating Scale (YMRS) scoring and serum BDNF were assessed at baseline for all 50 subjects. The bipolar patients were prescribed tablet oxcarbazepine and followed up after 4 weeks for clinical evaluation and re-estimation of serum BDNF and YMRS scoring. Results: The serum BDNF level in bipolar manic patients were compared with healthy controls at baseline and results revealed that there is a significant reduction (p=0.002) in serum BDNF level in bipolar patients. At follow-up after 4 weeks, the mean change in serum BDNF in bipolar group who were on oxcarbazepine monotherapy was found statistically significant (p=0.02) in comparison to healthy controls. In bipolar group, the YMRS score and serum BDNF at baseline have an inverse relation(r=−0.59) whereas change of the YMRS score had a positive correlation (r=0.67) with the change of serum BDNF over 4 weeks. Conclusion: In bipolar mania serum BDNF level is low and it is found to be increased with short term monotherapy with oxcarbazepine.
Abstract
Objective: In bipolar disorder, serum brain-derived neurotrophic factor (BDNF) level decreases leading to dysfunctions of critical neurotrophic, cellular plasticity and neuroprotective processes. The present study was conducted to evaluate the change in serum BDNF level with oxcarbazepine monotherapy in bipolar mania. Methods: The present study is a prospective, interventional, open label clinical study conducted on 25 patients of bipolar mania and 25 healthy controls. Detailed history, clinical evaluation including Young Mania Rating Scale (YMRS) scoring and serum BDNF were assessed at baseline for all 50 subjects. The bipolar patients were prescribed tablet oxcarbazepine and followed up after 4 weeks for clinical evaluation and re-estimation of serum BDNF and YMRS scoring. Results: The serum BDNF level in bipolar manic patients were compared with healthy controls at baseline and results revealed that there is a significant reduction (p=0.002) in serum BDNF level in bipolar patients. At follow-up after 4 weeks, the mean change in serum BDNF in bipolar group who were on oxcarbazepine monotherapy was found statistically significant (p=0.02) in comparison to healthy controls. In bipolar group, the YMRS score and serum BDNF at baseline have an inverse relation(r=−0.59) whereas change of the YMRS score had a positive correlation (r=0.67) with the change of serum BDNF over 4 weeks. Conclusion: In bipolar mania serum BDNF level is low and it is found to be increased with short term monotherapy with oxcarbazepine.
참고문헌 (27)
- Frey BN, "Biomarkers in bipolar disorder : a positional paper from the International Society for Bipolar Disorders Biomarkers Task Force", Aust N Z J Psychiatry, 47, pp.321~332 (2013)
- Mufson EJ, "Distribution and retrograde transport of trophic factors in the central nervous system : functional implications for the treatment of neurodegenerative diseases", Prog Neurobiol, 57, pp.451~484 (1999)
- Kaplan DR, "Neurotrophin signal transduction in the nervous system", Curr Opin Neurobiol, 10, pp.381~391 (2000)
- Huang EJ, "Neurotrophins : roles in neuronal development and function", Annu Rev Neurosci, 24, pp.677~736 (2001)
- Poo MM, "Neurotrophins as synaptic modulators", Nat Rev Neurosci, 2, pp.24~32 (2001)
- Post RM, "Role of BDNF in bipolar and unipolar disorder : clinical and theoretical implications", J Psychiatr Res, 41, pp.979~990 (2007)
- Hashimoto K, "Critical role of brainderived neurotrophic factor in mood disorders", Brain Res Brain Res Rev, 45, pp.104~114 (2004)
- Karege F, "Low brain-derived neurotrophic factor(BDNF)levels in serum of depressed patients probably results from lowered platelet BDNF release unrelated to platelet reactivity", Biol Psychiatry, 57, pp.1068~1072 (2005)
- Cunha AB, "Serum brain-derived neurotrophic factor is decreased in bipolar disorder during depressive and manic episodes", Neurosci Lett, 398, pp.215~219 (2006)
- Sen S, "Serum brain-derived neurotrophic factor, depression, and antidepressant medications:meta-analyses and implications", Biol Psychiatry, 64, pp.527~532 (2008)
- Fernandes BS, "Brain-derived neurotrophic factor as a state-marker of mood episodes in bipolar disorders : a systematic review and meta-regression analysis", J Psychiatr Res, 45, pp.995~1004 (2011)
- Ray MT, "Decreased BDNF and TrkB mRNA expression in multiple cortical areas of patients with schizophrenia and mood disorders", Transl Psychiatry, 4, pp.e389~ (2014)
- Fernandes BS, "Peripheral brain-derived neurotrophic factor(BDNF)as a biomarker in bipolar disorder : a meta-analysis of 52 studies", BMC Med, 13, pp.289~ (2015)
- Munkholm K, "Peripheral blood brain-derived neurotrophic factor in bipolar disorder : a comprehensive systematic review and meta-analysis", Mol Psychiatry, 21, pp.216~228 (2016)
- de Sousa RT, "Lithium increases plasma brainderived neurotrophic factor in acute bipolar mania : a preliminary 4-week study", Neurosci Lett, 494, pp.54~56 (2011)
- Kakkar AK, "Comparative efficacy and safety of oxcarbazepine versus divalproex sodium in the treatment of acute mania : a pilot study", Eur Psychiatry, 24, pp.178~182 (2009)
- Vasudev A, "Oxcarbazepine for acute affective episodes in bipolar disorder", Cochrane Database Syst Rev, (12), pp.CD004857~ (2011)
- Ghaemi SN, "Oxcarbazepine treatment of refractory bipolar disorder : a retrospective chart review", Bipolar Disord, 4, pp.70~74 (2002)
- Mosolov SN, "Comparative efficacy and tolerability of carbamazepine and oxcarbazepine during long therapy of patients with bipolar and schizoaffective disorders", Zh Nevrol Psikhiatr Im S S Korsakova, 109, pp.36~41 (2009)
- Wing JK, "Schedules for clinical assessment in neuropsychiatry", Arch Gen Psychiatry, 47, pp.589~593 (1990)
- Young RC, "A rating scale for mania: reliability, validity and sensitivity", Br J Psychiatry, 133, pp.429~435 (1978)
- Machado-Vieira R, "Decreased plasma brain derived neurotrophic factor levels in unmedicated bipolar patients during manic episode", Biol Psychiatry, 61, pp.142~144 (2007)
- Lin PY, "State-dependent decrease in levels of brain-derived neurotrophic factor in bipolar disorder : a meta-analytic study", Neurosci Lett, 466, pp.139~143 (2009)
- Rabie MA, "Serum level of brain derived neurotrophic factor(BDNF)among patients with bipolar disorder", J Affect Disord, 162, pp.67~72 (2014)
- Dunham JS, "Expression of hippocampal brain-derived neurotrophic factor and its receptors in Stanley consortium brains", J Psychiatr Res, 43, pp.1175~1184 (2009)
- Chang YC, "Chronic administration of mood stabilizers upregulates BDNF and bcl-2 expression levels in rat frontal cortex", Neurochem Res, 34, pp.536~541 (2009)
- Mai L, "BDNF-mediated signal transduction is modulated by GSK3beta and mood stabilizing agents", J Neurochem, 82, pp.75~83 (2002)