RESUMEN
AIMS: Alterations of plasma amyloid-ß (Aß) peptides have been related to a high risk for cognitive impairment and dementia. The present study aimed to measure plasma Aß peptides (Aß40, Aß42) and the Aß40/Aß42 ratio in a sample of drug-resistant bipolar depressed patients, as well as to explore the possible correlation between biological parameters and clinical changes along an electroconvulsive therapy (ECT) course. METHODS: Aß40 and Aß42 were measured by means of an ELISA assay in 25 drug-resistant bipolar depressed patients before (T0) and 1 week after (T1) the end of ECT. The patients were clinically evaluated by means of the Hamilton Rating Scale for Depression, 21-item (HRSD-21), the Mini-Mental State Examination, and the Clinical Global Impressions-Severity of Illness Scale. RESULTS: Plasma Aß levels and the Aß40/Aß42 ratio were similar at T0 and T1. The Aß40/Aß42 ratio correlated positively with the HRSD total score at both T0 and T1. At T0, a negative correlation was found between the Aß40/Aß42 ratio and the improvement of depressive and cognitive symptoms. Moreover, remitters (n = 9; HRSD ≤10) showed a significantly lower Aß40/Aß42 ratio at T0 than nonremitters. CONCLUSION: The present data suggest that a low Aß40/Aß42 ratio might characterize a subgroup of depressed patients who respond to ECT, while higher values of this parameter seem to be typical of more severe cases of patients with cognitive impairment.
Asunto(s)
Péptidos beta-Amiloides/sangre , Trastorno Bipolar/sangre , Trastorno Bipolar/terapia , Depresión/sangre , Depresión/complicaciones , Resistencia a Medicamentos , Terapia Electroconvulsiva , Fragmentos de Péptidos/sangre , Adulto , Trastorno Bipolar/complicaciones , Depresión/terapia , Femenino , Humanos , Masculino , Persona de Mediana Edad , Escalas de Valoración Psiquiátrica , Inducción de RemisiónRESUMEN
OBJECTIVE: Depression may increase the risk of developing Alzheimer's disease (AD). Recent studies have shown modifications in blood beta-amyloid (Aß) levels in depressed patients. This literature review examines the potential relationship between Aß-mediated neurotoxicity and pathophysiology of mood disorders. DESIGN: We conducted a review of the literature focusing on recent studies reporting alterations of plasma and serum Aß peptides levels in patients suffering from mood disorders. RESULTS: Different data suggest that patients with mood disorders are at great risk of developing cognitive impairment and dementia. In particular, low plasma levels of Aß42 peptide and a high Aß40/Aß42 ratio have been found in depressed patients. In addition, changes in Aß protein levels in patients with mood disorders have been associated with the severity of cognitive impairment and correlated positively with the number of episodes and severity of illness course. CONCLUSIONS: Given the intriguing association between change in plasma level of Aß, depression and cognitive impairment, future work should focus on the relationship between Aß peripheral level(s), biomarkers of neurodegeneration and development of dementia in patients affected by mood disorders.
Asunto(s)
Péptidos beta-Amiloides/sangre , Trastornos del Humor/sangre , Enfermedades Neurodegenerativas/sangre , Trastornos del Conocimiento/sangre , HumanosRESUMEN
BACKGROUND: Patients with mood disorders present a great risk for dementia and generally for cognitive decline. Low levels of ß-amyloid peptide 1-42 (Aß42) and high Aß40/Aß42 ratio have been associated with this risk and have been reported also in geriatric patients suffering from depression. The aim of the present study was to compare the plasma levels of Aß40 and Aß42 in patients with bipolar depression and healthy subjects, and to correlate them with the characteristics of clinical course. METHODS: Levels of Aß40 and Aß42 were measured by using specific ELISA kits in 16 patients with bipolar depression and in 16 control subjects with a negative history for somatic, psychiatric, neurological and substance abuse disorders. RESULTS: Patients presented significantly lower plasma Aß42 levels and higher Aß40/Aß42 ratio, as compared with control subjects. Moreover, a significant negative correlation was found between Aß42 plasma levels and the duration of the illness, while a positive correlation was detected between the Aß40/Aß42 ratio and the number of affective episodes. LIMITATIONS: The major limitations of the study are the small sample size, the scanty characterization of the illness episodes and the fact that all the patients were under psychopharmacological treatment. CONCLUSION: Although further research is necessary to establish firm conclusions, the present data would suggest that changes in plasma levels of different Aß peptides might represent a useful tool to identify the risk for cognitive decline in bipolar patients.
Asunto(s)
Péptidos beta-Amiloides/sangre , Trastorno Bipolar/sangre , Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Proyectos PilotoRESUMEN
BACKGROUND: There is increasing evidence that the brain-derived neurotrophic factor (BDNF) is involved in the pathophysiology of mood disorders and that its peripheral levels represent a reliable mirror of its concentration in the brain. The aim of the present study was to measure BDNF plasma levels in patients affected by major depression and to explore the possible relationship between the biological parameter and characteristics of the illness. METHOD: BDNF plasma levels were evaluated in 30 inpatients suffering from major depression, according to DSM-IV criteria, by means of a commonly employed ELISA method. The clinical characteristics were assessed by the Hamilton Rating Scale for Depression (HRSD) and the Clinical Global Impression Scale. RESULTS: BDNF plasma levels were significantly lower in the patients with the severest illness compared with the others, and the same was true for patients with dissociative symptoms, severe sleep disturbance and recurrent depression. A significant and negative correlation was observed between the biological parameter and the retardation factor score of the HRSD. CONCLUSION: These findings suggest that low BDNF levels are related to both recurrence and severity of depression, as well as to symptoms typical of dysfunctions of the hypothalamic-pituitary-adrenal axis.