不同亚型抑郁障碍患者认知功能与脑源性神经营养因子及其前体的相关性分析
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国家重点研发计划(2016YFC1307103);山西省卫生健康委科研基金(2022140);山西省136 兴医工程项目(Y2022136012);山西省自然科学基金(201801D121345)


Correlation analysis of cognitive function and brain-derived neurotrophic factor as well as its precursors in patients with different subtypes of depressive disorder
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    摘要:

    目的 探讨不同亚型抑郁障碍患者认知功能损伤的差异,以及各亚型患者认知功能与脑 源性神经营养因子(BDNF)及其前体(pro-BDNF)的相关性。方法 选取 2020 年 7 月至 2021 年 12 月就诊 于山西医科大学第一医院的 151 例首发重性抑郁障碍(MDD)患者,以及在社区同期招募的 40 名健康志 愿者(对照组)作为研究对象。根据亚型分类标准将首发 MDD 患者分为焦虑 / 躯体型抑郁障碍(ASD)组 78例、忧郁/动力不足型抑郁障碍(MPD)组53例、非典型抑郁障碍(ATD)组20例。比较4组受试者的17 项 汉密尔顿抑郁量表(HAMD-17)评分、重复性神经心理状态测验(RBANS)评分、BDNF 和 pro-BDNF 水平。 采用 Spearman 秩相关分析 3 个亚型 RBANS 评分与 BDNF、pro-BDNF 的相关性。结果 ASD 组、MPD 组的 受教育年限低于对照组[(12.49±4.05)年、(13.19±3.21)年比(14.85±2.65)年],差异有统计学意义(P< 0.05)。ASD组、MPD、ATD组的HAMD-17总分高于对照组[(21.88±3.79)分、(19.87±3.22)分、(18.60±2.35)分 比(2.03±2.36)分],差异有统计学意义(P<0.05)。MPD组、ATD组的HAMD-17 总分低于ASD组,差异有 统计学意义(P<0.05)。ASD 组、MPD 组及 ATD 组的 BDNF 水平高于对照组[0.5(0.3,8.5)pg/ml、0.6(0.3, 39.9)pg/ml、18.8(0.5,61.1)pg/ml 比 0.3(0.2,0.5)pg/ml],差 异 有 统 计 学 意 义(P< 0.05)。4 组 受 试 者 的 RBANS 量表分和即刻记忆、言语功能、注意力、延时记忆因子评分比较,差异有统计学意义(P< 0.05)。 ASD 组的 BDNF 与即刻记忆因子评分呈负相关(r=-0.238,P< 0.05),MPD 组的 pro-BDNF 与视觉广度因 子评分呈正相关(r=0.314,P< 0.05)。结论 不同亚型抑郁障碍患者与健康人群在认知功能和 BDNF 水 平方面存在一定程度的差异,且不同亚型抑郁障碍患者的认知功能损伤与 BDNF 和 pro-BDNF 存在相 关性。

    Abstract:

    Objective To explore the difference of cognitive impairment in patients with different subtypes of depressive disorder, and analyze the correlation between the cognitive function and brain-derived neurotrophic factor (BDNF) and pro-BDNF in patients with different subtypes of depression. Methods A total of 151 patients with first-episode major depressive disorder (MDD) admitted to the First Hospital of Shanxi Medical University from July 2020 to December 2021 and 40 healthy volunteers [health control (HC) group] from the same period were selected as the research objects. According to subtype classification criteria, the first episode MDD patients were divided into anxiety/somatization depression (ASD) group (n=78), melancholy/under powered depression (MPD) group (n=53) and Atypia depression (ATD) group (n=20). The scores of 17-item Hamilton Depression Scale (HAMD-17), Repeatable Battery for the Assessment of Neuropsychological Status (RBANS), BDNF and pro-BDNF were compared among the 4 groups. Spearman rank correlation was used to analyze the correlation between RBANS scores and BDNF and pro-BDNF in ASD, MPD and ATD groups, respectively. Results The length of schooling in ASD and MPD groups was lower than that in HC group [(12.49± 4.05)years、(13.19±3.21)years vs(14.85±2.65)years], and the differences was statistically significant (P < 0.05). The total scores of HAMD-17 in ASD, MPD and ATD groups were higher than that in HC group [(21.88±3.79)、(19.87±3.22)、(18.60±2.35) vs(2.03±2.36)], and the differences was statistically significant (P< 0.05). The total scores of HAMD-17 in MPD and ATD groups were lower than that in ASD group, and the differences was statistically significant (P< 0.05). The concentration of BDNF in ASD, MPD and ATD groups was higher than that in control group [0.5(0.3,8.5)pg/ml、0.6(0.3,39.9)pg/ml、18.8(0.5,61.1)pg/ml vs 0.3 (0.2,0.5)pg/ml], and the differences was statistically significant (P < 0.05). The RBANS scale scores and immediate memory, verbal function, attention, and delayed memory factor scores of the four study groups were significantly different(P< 0.05). There was a negative correlation between BDNF and immediate memory factor in ASD group (r=-0.238, P< 0.05). There was a positive correlation between pro-BDNF and visual span factor in MPD group (r=0.314, P < 0.05). Conclusions The cognitive function and BDNF level of patients with different subtypes of depressive disorder are different from that of healthy controls, and the cognitive function impairment of patients with different subtypes of depressive disorder is correlated with BDNF and pro-BDNF to some extent.

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席燕晴,王宗琦,闵雪,王彦芳.不同亚型抑郁障碍患者认知功能与脑源性神经营养因子及其前体的相关性分析[J].神经疾病与精神卫生,2023,23(6):
DOI :10.3969/j. issn.1009-6574.2023.06.002.

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  • 在线发布日期: 2023-07-14