Associations between brain-derived neurotrophic factor val66met polymorphism, melancholic feature, and treatment refractoriness in patients with treatment-resistant depression

Yu- Lin, S. Tsai, Mu-Hong Chen
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Abstract

Background: Brain-derived neurotrophic factor (BDNF) Val66Met polymorphism is related to the pathophysiology of treatment-resistant depression (TRD). But whether the Val66Met polymorphism is associated with the clinical manifestations of TRD (such as treatment refractoriness and melancholic and anxious distress features) remains unclear. Methods: Totally, 106 patients with TRD were genotyped for the BDNF Val66Met polymorphism. We used the 17-item Hamilton Depression Rating Scale evaluate depressive symptoms (melancholic and anxious distress features) and Maudsley Staging Method to measure treatment refractoriness. Logistic regression models were constructed to study the relationships among the Val66Met polymorphism, melancholic or anxious distress features, and treatment refractoriness. Results: The risk of Val/Met heterozygosity was associated with significantly greater melancholic features than that of Val/Val homozygosity (odds ratio [95% confidence interval (CI)] = (4.67 [1.16–14.24], p < 0.05). The melancholic feature in Val/Met heterozygosity was significantly higher to have the risk in treatment refractoriness than that of Val/Val homozygosity odd ratio (95% CI) = (6.42 [1.70–24.25], p < 0.05). Conclusion: Patients with TRD carrying the BDNF Val/Met genotype are more likely to present with melancholic feature, which is in turn related to high treatment refractoriness.
难治性抑郁症患者脑源性神经营养因子val66met多态性、抑郁特征和治疗难治性的关系
背景:脑源性神经营养因子(BDNF) Val66Met多态性与难治性抑郁症(TRD)的病理生理有关。但Val66Met多态性是否与TRD的临床表现(如治疗难治性、忧郁焦虑苦恼特征)相关尚不清楚。方法:对106例TRD患者进行BDNF Val66Met多态性基因分型。我们采用17项汉密尔顿抑郁评定量表评估抑郁症状(忧郁和焦虑困扰特征),并采用莫兹利分期法测量治疗难治性。构建Logistic回归模型,研究Val66Met多态性、忧郁或焦虑困扰特征与治疗难治性的关系。结果:Val/Met杂合性与忧郁特征的相关风险显著高于Val/Val纯合性(优势比[95%置信区间(CI)] = (4.67 [1.16-14.24], p < 0.05)。Val/Met杂合度的忧郁特征明显高于Val/Val纯合度奇比(95% CI) = (6.42 [1.70-24.25], p < 0.05)。结论:携带BDNF Val/Met基因型的TRD患者更容易出现抑郁特征,这与治疗难治性高有关。
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