Serum Brain-derived neurotrophic factor levels in post-stroke depression

Li, Jie; Zhao, Yandong; Zeng, Junwei; Chen, Xiaoyan; Wang, Ruo-Dan; Cheng, Sai‐Yu

doi:10.1016/j.jad.2014.07.011

Cited by 80 publications

(58 citation statements)

References 36 publications

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“…Inflammation may be an important mechanism underlying dementia and cognitive decline among older people [42]. A relationship between inflammation (as indicated by CRP) and BDNF levels is suggested by the current results, and several previous studies [43,44]. Thus, BNDF might play a role in MCI through inflammatory pathways.…”

Section: Discussionsupporting

confidence: 64%

Reduced Serum Levels of Brain-Derived Neurotrophic Factor Are Related to Mild Cognitive Impairment in Chinese Patients with Type 2 Diabetes Mellitus

Sun

Liu

et al. 2018

Ann Nutr Metab

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Background: Brain-derived neurotrophic factor (BDNF) is involved in obesity, type 2 diabetes mellitus (T2DM), and cognitive dysfunction. The present study sought to assess the role of serum levels of BDNF in the pathophysiological process of mild cognitive impairment (MCI), a preclinical phase of dementia in 715 Chinese patients with T2DM. Methods: Cross-sectional data were obtained from 715 patients with T2DM recruited from a Chinese diabetes center. Serum levels of BDNF were measured with sandwich enzyme-linked immunosorbent assay. The influence of BDNF on MCI was examined using univariate and multivariate binary logistic regression analyses. Results: In univariate and multivariate logistic regression analyses, for each one-unit increase of BDNF, the unadjusted and adjusted risk of MCI decreased by 9% (OR 0.91; 95% CI 0.88–0.93, p < 0.001) and 6% (0.94; 0.87–0.98, p < 0.001) respectively. In multivariate models comparing the first (Q1), second and third quartiles against the fourth quartile of BDNF, BDNF in Q1 and Q2 were associated with MCI, and increased risk of MCI by 275% (OR 3.75; 95% CI 2.38–6.03) and 155% (2.55; 1.32–4.02). These results suggested that for each 1 ng/mL increase of serum level of BDNF, the association became stronger among obese diabetic patients (OR 0.91, 95% CI 0.85–0.96; p < 0.001) versus nonobese diabetic patients (OR 0.95, 95% CI 0.86–0.98; p = 0.001). Conclusion: The present data demonstrated that reduced serum levels of BDNF were associated with increased risk of MCI and might be useful for identifying diabetic patients at risk of dementia for early prevention strategies.

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Section: Discussionsupporting

confidence: 64%

Reduced Serum Levels of Brain-Derived Neurotrophic Factor Are Related to Mild Cognitive Impairment in Chinese Patients with Type 2 Diabetes Mellitus

Sun

Liu

et al. 2018

Ann Nutr Metab

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“…Inflammatory cytokines also influence brain-derived neurotrophic factor (BDNF) receptor (TrkB) phosphorylation, thereby further interfering with BDNF signaling [47]. Similarly, Li et al [2] found that there was a strong relationship between serum BDNF levels at admission and the development of PSD within 3 months. Secondly, neopterin not only is a biomarker of inflammation and cell-mediated immunity but also serves as an indirect indicator of oxidative stress resulting from increased production of reactive oxygen and nitrogen intermediates secreted by activated macrophages [48].…”

Section: Discussionmentioning

confidence: 99%

“…Cross-sectional studies of stroke survivors have demonstrated that about one third of patients develop acute PSD and more than half suffer depression at some later point in their lives [1]. PSD is strongly associated with a range of adverse clinical outcomes including increased length of hospital stay, higher risk of dependency, increased degree of neurological impairment, and, finally, with worse rehabilitation outcome [2]. Patients with PSD show far less recovery from functional impairments compared with no depressed patients with stroke and are 3.4 times more likely to die during the first 10 years after stroke [3].…”

Section: Introductionmentioning

confidence: 99%

Elevated Serum Levels of Neopterin at Admission Predicts Depression After Acute Ischemic Stroke: a 6-Month Follow-Up Study

et al. 2015

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Inflammation and cell-mediated immune activation are attributed to the pathogenesis and pathophysiology in depression. Our aim was to test the possible association between serum levels of neopterin and the development of post-stroke depression (PSD) in Chinese patients. The subjects were first-ever acute ischemic stroke patients who were hospitalized at the First Affiliated Hospital of Xinxiang Medical University during the period from December 2012 to December 2013. Clinical information and stroke severity were collected at admission. Neurological and neuropsychological evaluations were conducted at the 6-month follow-up. Serum neopterin levels were measured using fluorometry and a high performance liquid chromatography (HPLC) method. Multivariate analyses were performed using logistic regression models. During the study period, 226 patients were included and finished the 6-month follow-up. Sixty-nine patients (30.5 %) were diagnosed as having major depression at 6 months. Patients with major depression showed higher levels of serum neopterin (21.6[IQR, 18.9-25.7]nmol/L vs. 14.6[IQR, 12.2-18.4]nmol/L, P < 0.0001) at admission. In multivariate analyses, serum neopterin was an independent predictor of PSD at 6 months [odds ratio (OR): 1.952 (95 % CI, 1.358-2.805), P < 0.0001]. With an AUC of 0.850 (95 % CI, 0.797-0.902), neopterin showed a significantly greater discriminatory ability as compared with high-sensitivity C-reactive protein, age, body mass index, and National Institutes of Health and Stroke Scale score. Neopterin is a novel, independent predictor of the development of depression 6 months after stroke. This indicated that the elevated neopterin levels may play a significant role in the pathology of depression and that the pathways leading to inflammation and cell-mediated immune activation warrant further exploration.

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“…67 Despite this, few of the studies reviewed here included social factors as potential confounders of sex differences with the exception of a small number of studies that adjusted for marital status or living alone. 18,42 A prospective study of ischemic stroke survivors found that social isolation, but not living alone, was associated with a 40% increase in the risk of cardiovascular events or death. 68 Others reported harmful effects of living alone on mortality in younger but not older people.…”

Section: Discussionmentioning

confidence: 99%

“…Multivariable adjustment, most commonly for age, stroke severity, and activity limitations, did not appreciably change these results, with women still significantly being more likely to have higher prevalence, incidence, or symptoms of depression than men. 40,42,43,[45][46][47][48][49] Notably, studies of PSD include a wider range of covariates than other outcomes, such as work status, 41 social factors, 42,46 and cognition. 40,43,46 Cognitive Impairment…”

Section: Poststroke Depressionmentioning

confidence: 99%

Focused Update of Sex Differences in Patient Reported Outcome Measures After Stroke

Gall

Phan

Madsen

et al. 2018

Stroke

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W omen experience worse outcomes after stroke than men 1 despite their lower age-adjusted incidence of stroke.2 Previous reviews of sex differences in select stroke outcomes, including activity limitations, 3-5 participation restriction, 4 poststroke depression (PSD), 3 and health-related quality of life (HRQoL), 3,4 demonstrated that women had worse outcomes than men across many of these measures. Women's greater age and stroke severity, as well as poorer prestroke function, seem to contribute to the sex difference in outcomes, but data on other contributing factors are limited.4 Existing reviews included studies published >5 years ago, and given the rapid increase in the number of studies addressing sex differences in stroke outcomes, an updated review is warranted. MethodsFull details of our methods are provided in the online-only Data Supplement. A previous review included studies up to 2007, 3 so we reviewed studies from 2007 onwards that examined sex differences in patient reported outcome measures (PROMs) at ≤12 months after stroke, including activity limitations, HRQoL, participation restriction, impaired cognition, and mood. 6 Full results tables are shown in the online-only Data Supplement. Results Activity LimitationsOf 1875 articles identified, 22 studies (3 population based) that were designed to examine sex differences (Results and Table I in the online-only Data Supplement) met criteria for inclusion. The most common instrument to assess activity limitations was the modified Rankin Scale, followed by the Barthel Index.In 8 studies including ischemic and hemorrhagic strokes, unadjusted estimates showed that women had more activity limitations than men through significantly lower odds of good outcome (odds ratio [OR] range: 0.44-0.61) 7-9 or greater odds of poor outcome (OR range: 1.29-1.62).10-14 In multivariable adjusted analyses, women had worse outcome than men with significantly lower odds of good outcome (OR range: 0.37-0.75) or greater odds of poor outcome (OR range: 1.17-1.74). 7,8,10,12,13 In 2 studies, there was no statistically significant difference between women and men.11,14 Adjustment for covariates, most commonly age, stroke severity, comorbidities, and prestroke function, reduced the associations between 9% and 20%, suggesting these factors partly explain the greater activity limitations for women after stroke.In 11 studies of ischemic stroke ( Table I in the online-only Data Supplement), women generally had worse outcome than men demonstrated by greater odds of poor outcome (mostly modified Rankin Scale ≥3 versus <3; range in ORs: 1.13-2.40) or lower odds of good outcome (eg, modified Rankin Scale ≤1 versus >1 or independent walking).15-25 Among 13 multivariable adjusted comparisons between men and women (some studies had >1 comparison), women's significantly worse outcome compared with men persisted in 7 comparisons with a greater odds of poor outcome (range, 1.30-3.40) or a higher activities of daily living score. [17][18][19][22][23][24] Common covariates included age, stro...

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Serum Brain-derived neurotrophic factor levels in post-stroke depression

Cited by 80 publications

References 36 publications

Reduced Serum Levels of Brain-Derived Neurotrophic Factor Are Related to Mild Cognitive Impairment in Chinese Patients with Type 2 Diabetes Mellitus

Reduced Serum Levels of Brain-Derived Neurotrophic Factor Are Related to Mild Cognitive Impairment in Chinese Patients with Type 2 Diabetes Mellitus

Elevated Serum Levels of Neopterin at Admission Predicts Depression After Acute Ischemic Stroke: a 6-Month Follow-Up Study

Focused Update of Sex Differences in Patient Reported Outcome Measures After Stroke

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