The Effects Of Antipsychotic Drugs And Modified Electrocon Vuisive Therapy On The Levels Of BDNF And GDNF In The Serums Of Patients With Schizophrenia And Cognitive Function

Objective:Neurotrophic factors play an important role in the growth, development and neural plasticity of central and peripheral nervous systems. The neurotrophic hypothesis of sc hizophrenia believes that the change in the brain structure of patients with schizophreni a results from the unbalanced of these neurotrophic factors. A lot of researches have s hown that brain derived neurotrophic factor (BDNF) and glial cell derived neurotrophic factor (GDNF) have certain correlations with schizophrenia, but they lead to inconsist ent results. In particular, the correlations of BDNF and GDNF with the cognitive funct ion of schizophrenia and the effects of relevant treatments on them still need further st udies. In this study, the author explores the effects of antipsychotic drugs on the levels of BDNF and GDNF in the serums of patients with schizophrenia, change in the cog nitive function and the correlations of BDNF and GDNF with the cognitive function o f patients with schizophrenia. Also, the changes in the levels of BDNF and GDNF in the serums of patients with schizophrenia were detected before and after modified elect ric convulsive therapy (MECT).Methods:A group of patients with selected from August 2013 to January 2014, yangzhou, j iangsu province wutai hospital in hospitalized patients with schizophrenia. A positive a nd negative syndrome scale (PANSS) questionnaire has been used to recognize the sev erity of the disease. Four neurocognitive scales including Trail Making Test (TMT)、Ve rbal Fluency Test (VFT)、Stroop Test and Hopkins Verbal Learning Test-Revised (HVL T-R) were utilized to evaluate the cognitive functions of patients with schizophrenia be fore and after the use of antipsychotic medication and normal subjects. Meanwhile, the concentrations of BDNF and GDNF in the serums of patients with schizophrenia befo re and after the use of antipsychotic medication as well as MECT were examined by ELISA, and these concentrations were compared with those in the normal control grou p.Results:1. Before the use of antipsychotic drugs, the serum BDNF and GDNF levels in p atient group (n=80) [(9.8±3.1)ng/ml] and [(390.2±131.2)pg/ml] were significantly lowe r than the levels in normal group (n=77) [(12.4±3.2)ng/ml] and [(572.9±261.5)pg/ml] (P<0.01). After eight week antipsychotic drugs, the serum BDNF and GDNF levels [(11.7±3.15)ng/ml] and [(552.7±298.2)pg/ml] are significantly increase as compare to before treatment in patient group (P<0.01). Moreover, there is no significant differenc e between the patient group and normal group after antipsychotic drugs (P>0.05); All the cognitive function scales of patients with schizophrenia before and after the use o f antipsychotic medication (except for the subitems without change their percentages in HVLT-R) showed statistically significant difference when compared with the control gr oup (P<0.01). Although the cognitive function of patients after treatment was much b etter than those before treatment, it still fails to reach the normal level. The concentrat ion of BDNF in the serum before treatment showed significant correlations with the sc ores of intermediate recall of HVLT-R Test I and II, total recall and TMT-B(r=0.505,P <0.01; r=0.164, P<0.05; r=0.353, P<0.01; r=-0.056, P<0.01), while the concentr ation of GDNF was associated with Stroop Color-word Test, TMT-B and the movemen t tests in VFT (r=0.587, P<0.01; r=-0.488, P<0.01; r=0.172, P<0.05). In the nor mal group, the scores of all cognitive function scales showed no correlations with the levels of BDNF and GDNF in the serum.2. Before MECT, the serum BDNF and GDNF levels in patient group (n=80) [(9. 7±2.1)ng/ml] and [(383.2±113.7)pg/ml] were significantly lower than the levels in nor mal group (P<0.01). After MECT, the serum BDNF and GDNF levels [(11.9±3.3)ng/ ml] and [565.1±233.7)pg/ml] are significantly increase as compare to before MECT in patient group (P<0.01). Moreover, there is no significant difference between the patie nt group and normal group after MECT (P>0.05).Conclusions:1. Before the use of antipsychotic drugs, the concentrations of BDNF and GDNF in the serums of patients with schizophrenia were lower than those of normal people. After 8 weeks of antipsychotic medication, the concentrations of BDNF and GDNF we re significantly increased and even close to the normal level. Patients with schizophren ia suffered from obvious cognition impairment, thus affecting learning memory, attentio n, word fluency, executive function and other aspects in the field of cognition. After 8 weeks of antipsychotic medication, functions were obviously improved and still failed to reach the normal levels. The levels of BDNF and GDNF in the serum were correl ated with the cognitive function of schizophrenia.2. Before MECT, the serum BDNF and GDNF levels in patient group were signif icantly lower than the levels in normal group. After MECT, the serum BDNF and GD NF levels are significantly increase as compare to before MECT in patient group. Mor eover, there is no significant difference between the patient group and normal group af ter MECT. MECT may. play a role of antipsychotic through improve the level of neur otrophic factors.