The Correlation Between Generalized Anxiety Disorder And Blood Brain-derived Neurotrophic Factor (BDNF),Glial Cell Line-Derived Neurotrophic Factor (GDNF)

Objective:To observe the efficacy and safety of escitalopram and Venlafaxine on the treatment of GAD patients and explore The correlation between GAD and brain-derived neurotrophic factor (BDNF), Glial cell line-Derived Neurotrophic Factor (GDNF).Methods:74patients who meet ICD-10criteria for GAD were treated with escitalopram (n=38) or venlafaxine (n=36) for8weeks. The anxiety status and efficacy was evaluated with HAMA on the baseline,1st,2th,4th,8th weekend respectively while the depression status was evaluated by HAMD, and the safety was evaluated by TESS and laboratory examination. The serum BDNF, GDNF concentration of the GAD patients before the therapy and the normal control was detected, and the serum BDNF, GDNF concentration of the GAD patients was detected on1st,2th,4th,8th weekend after the treatment respectively.Results:The HAMA scores of both group declined significantly by the end of1st week (P<0.01), and the reduction of HAMA scores in the escitalopram group is greater than that in venlafaxine group at the end of1st,2th,4th weekend (P<0.05), while there were no significant difference between the two groups at the end of8th weekend (P>0.05). There are significant difference in remission rate60.5%vs.66.7%, and response rate78.9%vs86.1%between the two groups (P<0.01). And the HAMD scores decreased significantly after8weeks treatment in both groups (P<0.01). The side effects of both groups have no significant difference (P>0.05). The serum BDNF concentration of GAD patients and normal control is (1113.10±321.36) pg/ml vs.(1379.14±385.04)pg/ml (t=5.716, P=0.000), while the GDNF concentration is (5.71±3.80)pg/ml vs.(12.03±10.42) pg/ml (t=5.286, P=0.000). After8weeks’ treatment, the serum BDNF concentration of GAD patients is (1238.86±468.40) pg/ml which is significantly elevated than that on baseline (t=3.009, P=0.003), while the serum GDNF concentration (5.67±4.11) pg/ml has no significantly difference than the baseline (t=0.089, P=0.929). The reduction of HAMA is(13.01±4.20), the elevation of BDNF level is (125.76±383.08) pg/ml, while the reduction of GDNF level is (0.04±4.20)pg/ml. The serum BDNF concentration is negatively correlated with the HAMA scores(r=-0.115,P<0.05), the reduction of HAMA scales is positively correlated with elevation of BDNF level (r=0.277, P<0.05), while the serum GDNF concentration has no relation with HAMA scores (r=0.071, P>0.05) and the reduction of HAMA scales has no relation with reduction of GDNF level (r=-0.023, P>0.05). Conclusion:Either escitalopram or venlafaxine would be effective for GAD, but it seems that venlafaxine is more effective than escitalopram, and escitalopram responses faster, while the safety is similar. Serum BDNF level seems to be one of the biomarkers of the status of GAD, while the GDNF level may be not the biomarker.