SALİH SAYGIN EKER, Ülkü SARIKAVAKLI, ŞENGÜL CANGÜR, CENGİZ AKKAYA

Serum BDNF düzeyleri yineleyici majör depresif bozuklukla iki uçlu bozuklu ğun depresif ataklarını ayırmada belirleyici olabilir mi?

Amaç: Serum beyin kaynaklı nörotrofik faktör (BDNF) düzeylerinin yineleyici majör depresif bozuklukla iki uçlu duygudurum bozukluğunun depresif ataklarını ayırmada biyokimyasal bir gösterge olup olamayacağının araştırılması hedeflenmiştir. Yöntem: Ruh sağlığı ve hastalıkları anabilim dalı polikliniğine başvuran 18-65 yaş arasında DSM-IV'e göre 'iki uçlu duygudurum bozukluğu-depresif atak' (BD) ve 'yineleyici majör depresif bozukluk' (UD) tanı ölçütlerini karşılayan, en az dört haftadır herhangi bir psikotrop ilaç kullanmayan hastalar, hasta grubuna alındı. DSM-IV'e göre değerlendirildiği kesitte herhangi bir psikiyatrik bozukluk tanısı konmayan, herhangi bir bedensel hastalığı olmayan, 18-65 yaş aralığında olan, çalışmaya gönüllü olarak katılmayı kabul edenler kontrol grubuna alındı. Hasta grubunda 24 hasta (11'i BD, 13'ü UD) yer alırken, kontrol grubunda 18 kişi vardı. Çalışmaya alınan tüm deneklere Hamilton Depresyonu Derecelendirme Ölçeği (HAM-D) uygulandı. Deneklerden alınan kan örneklerinden elde edilen serumlar Enzyme-Linked Immunosorbentassay yöntemi ile çalışılarak BDNF değerleri saptandı. Sonuçlar: Çalışmaya alınan gruplar arasında sosyodemografik açıdan anlamlı fark saptanmadı. Toplam depresif atak sayısı BD grubunda, UD grubuna göre daha fazlaydı. Serum BDNF ortalama değerleri açısından BD ve UD grupları arasında fark yoktu. Serum BDNF ortalama değerleri kontrol grubuna göre hasta gruplarında daha düşüktü. Hasta ve kontrol gruplarında yaş, cinsiyet ve beden kitle endeksi ile serum BDNF değerleri arasında ilişki yoktu. Her iki hasta grubunda serum BDNF değerleri ile HAM-D ortalama değerleri ve depresif atak sayıları arasında anlamlı ilişki saptanmadı. Tartışma: Bu çalışmanın sonuçları değerlendirildiğinde serum BDNF değerlerinin UD ve BD grupları arasında farklılık göstermediği, ancak sağlıklı kontrol grubuna göre anlamlı derecede düşük olduğu saptanmıştır. Bu çalışmadan elde edilen veriler ışığında, serum BDNF düzeylerinin BD ve UD ataklarının ayırt edilmesinde faydalı bir biyolojik belirteç olarak kullanılamayacağı sonucu çıkarılabilir.

Can serum level of BDNF be used as a biomarker in distinctionbetween the depressive episodes of bipolar disorder and recurrentmajor depressive disorder?

Objective: This is study aimed to determine if serum levels of brain derived neurotrophic factor (BDNF) can be used as a biological marker to make a distinction between the depressive episodes of bipolar disorder (BD) and recurrent major depressive disorder (UD). Methods: Patients between 18-65 years of age and diagnosed with BD and UD according to DSM-IV-TR diagnostic criteria, who were admitted to the outpatient clinic of psychiatry department were enrolled to the patient arm of the study. Volunteers between 18 and 65 years of age, who had no physical morbidity and clinical psychopathology according to DSM-IV-TR diagnostic criteria, were enrolled to the control arm of the study. There were 24 patients (11 BD and 13 UD) and 18 healthy volunteers. Patients were required to be drug naïve for the past four weeks prior to the study enrollment. Hamilton Depression Rating Scale (HDRS) were applied to all patients. The serum levels of BDNF of all the subjects were studied. Results: There were no differences between groups in terms of sociodemoghraphic variables. Total number depressive episodes were higher in BD group compared to UD group. There were no differences between BD and UD groups in terms of serum levels of BDNF. However, in patient group serum BDNF values were lower than the control group. Serum BDNF levels did not correlate with age, body mass index or gender in each group. Serum BDNF levels did not correlate with mean scores of HDRS or number of depressive episodes. Discussion: Considering the outcomes of the present study, serum BDNF levels did not demonstrate any significant difference between patient groups. However, serum BDNF levels were lower in patient groups compared to controls. For the time being there is no valid biological diagnostic marker for psychiatric disorders. The data of the present study is far from generating a biological marker for the distinction of depressive episodes of UD and BD.

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