Plasma Brain-Derived Neurotrophic Factor Levels Predict the Clinical Outcome of Depression Treatment in a Naturalistic Study

Remission is the primary goal of treatment for major depressive disorder (MDD). However, some patients do not respond to treatment. The main purpose of this study was to determine whether brain-derived neurotrophic factor (BDNF) levels are correlated with treatment outcomes. In a naturalistic study, we assessed whether plasma BDNF levels were correlated with clinical outcomes by measuring plasma BDNF in patients with depressive syndrome (MADRS score ≥18), and subsequently comparing levels between the subgroup of patients who underwent remission (MADRS score ≤8) and the subgroup who were refractory to treatment (non-responders). Patients with depressive syndrome who underwent remission had significantly higher plasma BDNF levels (p<0.001), regardless of age or sex. We also found a significant negative correlation between MADRS scores and plasma BDNF levels within this group (ρ = –0.287, p = 0.003). In contrast, non-responders had significantly lower plasma BDNF levels (p = 0.029). Interestingly, plasma BDNF levels in the non-responder group were significantly higher than those in the remission group in the initial stage of depressive syndrome (p = 0.002). Our results show that plasma BDNF levels are associated with clinical outcomes during the treatment of depression. We suggest that plasma BDNF could potentially serve as a prognostic biomarker for depression, predicting clinical outcome

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Flowchart of patient numbers through the study.

<p>Flowchart of patient numbers through the study.</p

Changes in plasma BDNF levels in MDD patients (remission [▪, n = 38] and non-responder [□, n = 10] groups).

<p>The period-matched symptom-response and symptom-remission outcomes were examined at 8 and 12 weeks, respectively, in the non-responder group. Plasma BDNF levels were measured by immunoassay. Each point represents the mean. The statistical significance of differences was calculated using repeated-measures ANOVA with <i>post-hoc</i> Bonferroni testing (*<i>p</i><0.05). The statistical significance of differences in plasma BDNF levels between remission (▪) and non-responder (□) groups at the depressive syndrome stage were calculated using the Students’ t-test (^#<i>p</i><0.05).</p

Mean changes in outcome measures.

<p>Values are the mean (SD).</p><p>Statistical analyses were carried out using one-way repeated measures analysis of variance.</p><p>Statistically significant (**<i>p</i><0.01, ***<i>p</i><0.001).</p><p>YMRS, Young Mania Rating Scale; MADRS, Montgomery–Åsberg Depression Rating Scale; MHPG, 3-methoxy-4-hydroxyphenylglycol; HVA, homovanillic acid;</p><p>BDNF, brain-derived neurotrophic factor.</p

Correlation of plasma BDNF levels and MADRS scores in the remission group (n = 38*, 3 states).

<p>There was a significant negative correlation between plasma BDNF levels and MADRS scores (ρ = –0.287, <i>p</i> = 0.003). Statistical analysis was performed using Spearman’s correlation test.</p

Initial Characteristics of Remission and Non-responder groups among MDD patients.

<p>MADRS, Montgomery-Åsberg Depression Rating Scale; BDNF, brain-derived neurotrophic factor.</p>a<p>Chi square test.</p>b<p>Student’s t-test.</p