Brain-Derived Neurotrophic Factor (BDNF) as a biomarker of treatment response in patients with Treatment Resistant Depression (TRD): A systematic review & meta-analysis. (November 2022)

• Record Type: Journal Article
• Authors: Meshkat, Shakila; Alnefeesi, Yazen; Jawad, Muhammad Youshay; D Di Vincenzo, Joshua; B Rodrigues, Nelson; Ceban, Felicia; MW Lui, Leanna; McIntyre, Roger S; Rosenblat, Joshua D.
• Is Part Of: Psychiatry research. Volume 317(2022)
• Publication Date: 2022-11
• Subjects: Depression -- ECT -- BDNF -- Biomarker -- Neurotrophins -- Treatment resistant depression -- Brain-Derived Neurotrophic Factor -- TRD; Psychiatry -- Periodicals; Psychiatry -- periodicals; Psychiatrie -- Périodiques; 616.89
• DOI: 10.1016/j.psychres.2022.114857
• Languages: English
• ISSNs: 0165-1781

Abstract

Highlights: 36 articles involving 1198 patients with TRD were included in the systematic review. Electroconvulsive therapy (ECT), ketamine, and repetitive transcranial magnetic stimulation (rTMS) were the most common TRD treatments. 21 articles involving 523 patients with TRD were included in the meta-analysis. Change in BDNF was not associated with change in depressive symptoms ( p ≥ 0.05). Abstract: Multiple lines of evidence have implicated brain-derived neurotrophic factor (BDNF) in treatment-resistant depression (TRD). The aim of this synthesis was to determine the impact of TRD treatments on peripheral BDNF levels, and ascertain whether these changes are associated with antidepressant effects. Thirty-six articles involving 1198 patients with TRD were included herein. Electroconvulsive therapy (ECT), ketamine, and repetitive transcranial magnetic stimulation (rTMS) were the most common TRD treatments investigated. Serum BDNF levels significantly increased in six, two, four and one studies following ECT, ketamine, rTMS and atypical antipsychotics, respectively. The estimated mean baseline serum BDNF concentration in TRD patients ± 95% CI was 15.5 ± 4.34 ng/mL. Peripheral BDNF levels significantly increased overall (Hedges' g ± 95% CI = 0.336 ± 0.302; p < 0.05), but no association with depressive symptoms was found ( p ≥ 0.05). These results demonstrate that peripheral measurements of total BDNF (i.e., mature and percursor forms of BDNF) are inadequate predictors of treatment response in TRD patients, and other considerations suggest that this would still apply to separable measurements of mature BDNF and its precursor.