International Medical Journal, Vol. 21., Iss. 1, 2015, P. 71−77.
BLOOD PLASMA BRAIN-DERIVED NEUROTROPHIC FACTOR (BDNF) IN PATIENTS WITH SUBCORTICAL VASCULAR MILD COGNITIVE DISORDERS: MARKER VALUE FOR THE DIAGNOSIS AND THERAPY EFFECTIVENESS EVALUATION
Central Hospital of Kommunarsky District, Zaporizhzhia, Ukraine
The aim of the study was to evaluate the brain−derived neurotrophic factor (BDNF) blood plasma levels in patients with subcortical vascular mild cognitive impairments (SVMCI) before and after escitalopram treatment. The study involved 22 patients with SVMCI, according to G.B. Frisoni et al. (2002) criteria and 16 age, sex and education level matched persons without cognitive impairments (WCI). Comparison groups included elderly and senile persons. BDNF blood plasma levels were evaluated by ELISA method in all enrolled persons at baseline and in 10 SVMCI patients 2 months after escitalopram therapy (10 mg per day). Clinical protocol included neuropsychological testing (Luria`s tests, MMSE and other valid approaches), psychopathological study (The Neuropsychiatric Inventory), neurological examination, disturbances in daily life activities study (The Bristol Activities of Daily Living Scale). It was shown that plasma BDNF levels decreased in group of SVMCI (25939.55±10410.46 pg/ml) versus the controls (31581.50±8092.29 pg/ml). Reduction of BDNF level had the highest correlation with some parameters of executive dysfunction: violation of active recall (r = 0.41, p < 0.05) and kinetic apraxia (r = 0.35, p < 0.05), reflecting the violation of the link between the prefrontal cortex and subcortical structures due to microvascular brain lesions in SVMCI group. Escitalopram treatment led to increased level of plasma BDNF in SVMCI (30066.00±10796.43 pg/ml) group. The increase in BDNF level was significantly related to the improvement in MMSE and The Neuropsychiatric Inventory scores of the patients. In conclusion, the reduction in BDNF blood plasma concentration can be used for validation of SVMCI diagnosis and its increase as a reliable marker of the therapy effectiveness.
Key words: brain−derived neurotrophic factor, subcortical vascular mild cognitive disorder, escitalopram.