BDNF blood levels after eletroconvulsive therapy in patients with mood disorders: a systematic review and meta-analysis

• Grant number: 20/04024-5
• Support Opportunities: Scholarships in Brazil - Scientific Initiation
• Effective date (Start): October 01, 2020
• Effective date (End): September 30, 2021
• Field of knowledge: Health Sciences - Medicine - Psychiatry
• Principal Investigator: Andre Russowsky Brunoni
• Grantee: Rebeca Pelosof
• Host Institution: Instituto de Psiquiatria Doutor Antonio Carlos Pacheco e Silva (IPq). Hospital das Clínicas da Faculdade de Medicina da USP (HCFMUSP). Secretaria da Saúde (São Paulo - Estado). São Paulo , SP, Brazil

Abstract

Major Depressive Disorder (MDD) is characterized by depressed mood and anhedonia. About 30% of patients do not respond to conventional drug treatment. Electroconvulsive therapy (ECT) uses an electrical current that passes through the brain to induce a generalized seizure. Although this is the most effective treatment, indicated mainly for refractory depression, little is known about its mechanisms of action. Just over two decades ago, the neurotrophic hypothesis of depression was introduced, with the BDNF (brain-derived neurotrophic factor) playing core role as a biomarker for brain neuroplasticity. Despite the ongoing movement, there is still a lot of heterogeneity in research and many questions keep on hovering over the practical role that BDNF carries. The nature of the relationship between BDNF and electroconvulsive therapy, or long term assessment in the patient's clinical improvement, with previous meta-analysis showing inconclusive results. Therefore, the objective of this project is to carry out a systematic review and updated meta-analysis to assess the relationship between ECT and serum BDNF levels and associate it with the clinical improvement of patients, taking into account a series of more recent studies published in the last years. The study will be consucted in accordance with Cochrane's recommendations and the guidelines of the PRISMA group; with the study protocol being registered on the PROSPERO platform. First, the systematic review will be carried out by searching for studies involving the analysis of BDNF pre and post ECT in patients with uni and bipolar depression in the PubMed / Medline, WebofScience and SCOPUS database, in addition to reference lists of recent articles and contact with experts in the field. We will assess the quality of the studies using the Cochrane bias risk tool. Bias risks will also be assessed using meta-regression techniques, funnel plots and sensitivity analysis. The results will be analyzed using programs using Stata (R). We will calculate the differences in means and standard deviation for each of the items of the goal regression comparing with the main outcome of the works. With that, we will calculate the measure of effect, using Hedges' g. In conclusion, this study may bring important information about the relationship of BDNF, major depressive disorder and ECT, which can help understand the etiopathogenesis of depression and the effectiveness of electroconvulsive therapy.

Publicações científicas

(Referências obtidas automaticamente do Web of Science e do SciELO, por meio da informação sobre o financiamento pela FAPESP e o número do processo correspondente, incluída na publicação pelos autores)

PELOSOF, REBECA; DOS SANTOS, LEONARDO A.; FARHAT, LUIS C.; GATTAZ, WAGNER F.; TALIB, LEDA; BRUNONI, ANDRE R.. BDNF blood levels after electroconvulsive therapy in patients with mood disorders: An updated systematic review and meta-analysis. WORLD JOURNAL OF BIOLOGICAL PSYCHIATRY, v. N/A, p. 10-pg., 2022-04-20. (20/04024-5)