Akademik Veri Yönetim Sistemi
Klinik Psikofarmakoloji Bulteni, cilt.19, sa.SUPPL. 1, 2009 (SCI-Expanded)
Objective: We have investigated BDNF levels in pre- and post-treatment serum in patients with bipolar disorder manic episode. Methods: The patient group was formed by 29 patients (14 females, 15 males), with diagnosis of bipolar disorder manic episode and the control group was formed by 29 healthy subjects (14 females, 15 males) who were similar to the patient group, in terms of age and educational level. Blood samples were collected from the healthy controls and patients before, and at the 30th day of treatment. Patients included in the study were evaluated for their autobiography, family history, and sociodemographics, and were applied the Young Mania Rating Scale (YMRS). After collecting venous blood samples, serums were separated by centrifugation. Removed serums were incubated at -70 oC for 2-6 months. Based on the sandwich enzyme immunoassay principle, the microElisa system was applied for the detection of BDNF levels. In the study, Quantikine Human BDNF Kit was used. The test was performed properly according to the kit instructions. Due to small sample size and non-normal distribution, nonparametric tests (Mann-Whitney U and Wilcoxon Signed Ranks Test for continuous variables, Fisher's exact test for categoricalvariables) were used. The effects of medications, age and educational status on pre- and posttreatment changes in BDNF levels were examined by Kruskall Wallis Test and multiple regression analysis. Results: Mean age of bipolar patients was 32.62 ± 8.32 (18-45) years and their mean lengt of education was 8.79 ± 4.08 (0-18) grades. Mean age of control subjects was 33.83 ± 6.65 (17-45) years and mean length of education was 8.31 ± 4.22 (0-17) grades. No significant difference was found between the two groups in terms of age distribution (p=0.483) and educational status (p=0.550).The patients were ill for 9.68±8.92 years and, the mean duration of last manic episode prior to admission was 36.68±29.36 days. Two patients had their first episode. Previously used medications included valproate in 11 patients, lithium in 2, carbamazepine in 1 patient and atypical antipsychotics in 5 patients. None of the patients used a psychotropic medication in the last two months prior to the study. Lithium was administered to 10 patients and valproate to 17. Two patients did not receive mood stabilizers. Additionally, a typical antipsychotic was administered to 14 patients, and atypical antipsychotic to 12 patients. At baseline, mean BDNF levels were 14.35±5.85 pg/ml in patients and 40.17±9.74 pg/ml in controls. The difference was statistically significant. A statistically significant reduction of mean YMRS score was noticed from baseline 35.86±9.36 to 5.18±8.07, after the 30th day of treatment (p□0.001). Mean BDNF levels were increased from baseline 14.35±5.85 pg/ml to 20.48±7.33 pg/ml after the 30th day, which was also statistically significant (p□0.001). When the effects of each treatment to the change in YMRS and BDNF level were examined neither type of the antipsychotic (p=0.111), type of mood stabilizer (p=0.514), the presence of family history (p=0.512) (kruskall wallis test) nor the severity of manic symptoms (p=0.705), frequency of manic episodes (p= 0.460) and the length of the disease (p=0.776) were found to be effecting the BDNF levels. Conclusions: Lower BDNF levels in manic patients compared to healthy controls suggest the significance of this neurotrophic factor in mania. However, long-term follow-up studies with large sample sizes and investigating different periods of bipolar disorder (mania, depression and euthymic) are needed in order to evaluate the effects of mood stabilizer and antipsychotic treatments on BDNF levels in mania.