Value of peripheral neurotrophin levels for the diagnosis of depression and response to treatment: A systematic review and meta-analysis

Eur Neuropsychopharmacol. 2020 Dec:41:40-51. doi: 10.1016/j.euroneuro.2020.09.633. Epub 2020 Sep 24.

Abstract

The neurotrophin hypothesis indicates that neurotrophic factors are important for the pathophysiology of major depressive disorder (MDD), with alterations in peripheral neurotrophin levels having potential clinical application for MDD. The present meta-analysis aimed to investigate the diagnostic value for MDD of peripheral neurotrophin levels in cross-sectional studies and the association between peripheral neurotrophin levels and the response to antidepressant treatment in longitudinal studies. Published studies in the PubMed and Web of Science databases were systematically searched up to February 2020. The search terms included depressive disorder, neurotrophic factor, serum/plasma and their synonyms. Human studies reporting on BDNF, GDNF, IGF-2, VEGF, NGF, FGF-2, and S100B levels in MDD patients were included. Data comparing MDD patients and healthy controls, and/or between responders and non-responders before and after antidepressant treatment were extracted. A random effects model was used to calculate standardized mean differences. A total of 177 original studies were identified, including 139 cross-sectional and 38 longitudinal studies. Significantly reduced BDNF and NGF levels and significantly elevated IGF-1, VEGF, and S100B levels were reported in MDD patients compared with healthy controls, while GDNF and FGF-2 levels were not significantly different. Furthermore, compared with non-responders, S100B levels at baseline and BDNF levels following treatment were significantly elevated in responders. In addition, there was a significantly elevated level of VEGF after treatment in responders only. In conclusions, alterations in peripheral neurotrophins levels were strongly associated with the biology and the treatment response of MDD. Further investigations are required to examine potential sources of heterogeneity.

Keywords: Antidepressant treatment; Assessment; Depression; Diagnosis; Meta-analysis; Neurotrophin.

Publication types

  • Meta-Analysis
  • Research Support, Non-U.S. Gov't
  • Systematic Review

MeSH terms

  • Antidepressive Agents / therapeutic use*
  • Biomarkers / blood
  • Biomarkers / metabolism
  • Brain-Derived Neurotrophic Factor / blood
  • Cross-Sectional Studies
  • Depressive Disorder, Major / blood*
  • Depressive Disorder, Major / diagnosis
  • Depressive Disorder, Major / drug therapy*
  • Humans
  • Insulin-Like Growth Factor I / metabolism
  • Nerve Growth Factor / blood
  • Nerve Growth Factors / blood*
  • S100 Calcium Binding Protein beta Subunit / blood
  • Treatment Outcome
  • Vascular Endothelial Growth Factor A / blood

Substances

  • Antidepressive Agents
  • Biomarkers
  • Brain-Derived Neurotrophic Factor
  • IGF1 protein, human
  • NGF protein, human
  • Nerve Growth Factors
  • S100 Calcium Binding Protein beta Subunit
  • S100B protein, human
  • VEGFA protein, human
  • Vascular Endothelial Growth Factor A
  • Insulin-Like Growth Factor I
  • BDNF protein, human
  • Nerve Growth Factor