공황장애의 임상적 특성과 Brain-Derived Neurotrophic Factor 농도와의 관계 = Associations between Clinical Characteristics and Plasma BDNF Levels of Panic Disorder

다국어 초록 (Multilingual Abstract)

Objective : Brain-derived neurotrophic factor (BDNF) is implicated in the pathophysiology of several neuropsychiatric disorders. However, there are few studies on BDNF of panic disorder. In this study, we investigated plasma BDNF levels in patients with panic disorder, and evaluated whether there are associations between clinical characteristics of panic disorder and plasma BDNF levels. Methods : We included 110 patients with panic disorder and 110 health controls in the current study. Plasma BDNF levels were measured by the enzyme-linked immunosorbent assay (ELISA). Plasma BDNF level differences were evaluated according to the clinical characteristics, such as duration of illness, recent stressful life event, agoraphobia, and insomnia. Results : The mean plasma BDNF levels of patients with panic disorder were significantly lower, as compared with those of controls (192.50 pg/mL vs. 693.75 pg/mL, t=8.838, p<0.001). The mean plasma BDNF levels of patients who had recent stressful life events were significantly higher, as compared with those who did not ($269.79{\pm}358.96pg/mL$ vs. $136.94{\pm}187.06pg/mL$, t=-2.525, p=0.013). Conclusion : These results suggested that BDNF plays a potential role in the pathophysiology of panic disorder.

참고문헌 (Reference)

1 이중서, "한국판 Hamilton 우울증 평가 척도의 신뢰도, 타당도 연구" 대한신경정신의학회 44 (44): 456-465, 2005

2 김용구, "우울증 환자의 혈액에서 측정되는 BDNF 농도 변화와 그 의미" 대한신경정신의학회 48 (48): 203-206, 2009

3 Pollack MH, "WCA Recommendations for the Long-Term Treatment of Panic Disorder" 8 : S17-S30, 2003

4 Pan W, "Transport of brain-derived neurotrophic factor across the blood-brain barrier" 37 : 1553-1561, 1998

5 Angelucci F, "Transcranial magnetic stimulation and BDNF plasma levels in amyotrophic lateral sclerosis" 15 : 717-720, 2004

6 Holmes TH, "The social readjustment rating scale" 11 (11): 213-218, 1967

7 Fiammetta C, "The psychological development of panic disorder: implications for neurobiology and treatment" 34 : S09-S31, 2012

8 Van Der Kolk BA, "The psychobiology and psychopharmacology of PTSD" 16 : S49-S64, 2001

9 Rosen JB, "The neurobiology of conditioned and unconditioned fear : a neurobehavioral system analysis of the amygdala" 3 : 23-41, 2004

10 Lommatzsch M, "The impact of age, weight and gender on BDNF levels in human platelets and plasma" 26 : 115-123, 2005

11 Hamilton M, "The assessment of anxiety states by rating" 32 : 50-55, 1959

12 Brindle PK, "The CREB family of transcription activators" 2 : 199-204, 1992

13 First MB, "Structured Clinical Interview for DSM-IV Axis I Disorders-Non-Patient Edition (SCID-I/NP), version 2.0" New York State Psychiatric Institute, Biometrics Research 1996

14 First MB, "Structured Clinical Interview for DSM-IV Axis I Disorders, Patient Edition (SCID-P), version 2" New York State Psychiatric Institute, Biometrics Research 1995

15 Smith MA, "Stress and glucocorticoids affect the expression of brainderived neurotrophic factor and neurotrophin-3 mRNAs in the hippocampus" 15 : 1768-1777, 1995

16 Lin PY, "State-dependent decrease in levels of brain-derived neurotrophic factor in bipolar disorder : a meta-analytic study" 466 : 139-143, 2009

17 Ziegenhorn AA, "Serum neurotrophins : a study on the time course and influencing factors in a large old age sample" 28 : 1436-1445, 2007

18 Kobayashi K, "Serum brain-derived neurotrophic factor(BDNF)levels in patients with panic disorder : As a biological predictor of response to group cognitive behavioral therapy" 29 : 658-663, 2005

19 Maron E, "Serotonin function in panic disorder: important, but why?" 31 : 1-11, 2006

20 Bremner JD, "SPECT [I-123]iomazenil measurement of the benzodiazepine receptor in panic disorder" 47 : 96-106, 2000

21 Lee BH, "Reduced platelet BDNF level in patients with major depression" 33 : 849-853, 2009

22 Marmigere F, "Rapid induction of BDNF expression in the hippocampus during immobilization stress challenge in adult rats" 13 : 646-655, 2003

23 Rosenfeld RD, "Purification and identification of brain-derived neurotrophic factor from human serum" 6 : 465-471, 1995

24 Radka SF, "Presence of brain-derived neurotrophic factor in brain and human and rat but not mouse serum detected by a sensitive and specific immunoassay" 709 : 122-301, 1996

25 Lewin GR, "Physiology of the neurotrophins" 19 : 289-317, 1996

26 Poduslo JF, "Permeability at the blood-brain and blood nerve barriers of the neurotrophic factors : NGF, CNTF, NT-3, BDNF" 36 : 280-286, 1996

27 Kasper S, "Panic disorder : the place of benzodiazepines and selective serotonin reuptake inhibitors" 11 : 307-321, 2001

28 Eaton WW, "Panic and panic disorder in the United States" 151 : 413-420, 1994

29 Eaton WW, "Panic Disorder: Clinical, Biological, and Treatment Aspects" John Wiley & Sons, Inc 50-65, 1995

30 Hirschfeld RM, "Panic Disorder : Diagnosis, epidemiology, and clinical course" 57 : 3-8, 1996

31 Lindsay RM, "Neurotrophic factors : from molecule to man" 17 : 182-190, 1994

32 Asberg M, "Neurotransmitters and suicidal behavior. The evidence from cerebrospinal fluid studies" 836 : 158-181, 1997

33 Gorman JM, "Neuroanatomical hypothesis of panic disorder, revised" 157 : 493-505, 2000

34 Coryell W, "Mortality among outpatients with anxiety disorders" 143 : 508-510, 1986

35 Trajkovska V, "Measurements of brain-derived neurotrophic factor: methodological aspects and demographical data" 73 : 143-, 2007

36 Spielberger C, "Manual for the State-Trait Anxiety Inventory" Consulting Psychologists Press 1983

37 Beck AT, "Manual for the Beck Depression Inventory-II" Psychological Corporation 1996

38 Karege F, "Low brain-derived neurotrophic factor(BDNF)levels in serum of depressed patients probably results from lowered platelet BDNF release unrelated to platelet reactivity" 57 : 1068-1072, 2005

39 Sadock BJ, "Kaplan and Sadock’s Synopsis of Psychiatry" Williams and Wilkins 599-609, 2003

40 Shim SH, "Increased levels of plasma brain-derived neurotrophic factor(BDNF)in children with attention deficit-hyperactivity disorder(ADHD)" 32 : 1824-1828, 2008

41 Abelson JL, "HPA axis activity in patients with panic disorder : review and synthesis of four studies" 24 : 66-76, 2007

42 Coryell W, "Excess mortality in panic disorder. A comparison with primary unipolar depression" 39 : 701-703, 1982

43 Musselman DL, "Exaggerated platelet reactivity in major depression" 153 : 1313-1317, 1996

44 Baldwin DS, "Evidence-based pharmacological treatment of generalized anxiety disorder" 14 : 697-710, 2011

45 Laghrissi-Thode F, "Elevated platelet factor 4 and beta-thromboglobulin plasma levels in depressed patients with ischemic heart disease" 42 : 290-295, 1997

46 American Psychiatric Association, "Diagnostic and Statistical Manual of Mental Disorder" American Psychiatric Publishing 430-443, 1994

47 Kim JB, "Development of the Korean Version of the Panic Disorder Severity Scale" 10 : 140-151, 2001

48 Malizia AL, "Decreased brain GABA(A)-benzodiazepine receptor binding in panic disorder : preliminary results from a quantitative PET study" 55 : 715-720, 1998

49 Hong KE, "Construction of Korean ‘social readjustment rating scale’-A methodological study-" 21 : 123-136, 1982

50 Kent JM, "Clinical utility of the selective serotonin reuptake inhibitors in the spectrum of anxiety" 44 : 812-824, 1998

51 Rosenbaum JF, "Clinical issues in the long-term treatment of panic disorder" 57 (57): 44-48, 1996

52 Murakamia S, "Chronic stress, as well as acute stress, reduces BDNF mRNA expression in the rat hippocampus but less robustly" 53 : 129-139, 2005

53 Nibuya M, "Chronic antidepressant administration increases the expression of cAMP response element binding protein(CREB)in rat hippocampus" 16 : 2365-2372, 1996

54 Numata S, "Brain-derived neutrotrophic factor(BDNF)Val66Met polymorphism in schizophrenia is associated with age at onset and symptoms" 401 : 1-5, 2006

55 Spina MB, "Brain-derived neurotrophic factor protects dopamine neurons against 6-hydroxydopamine and N-methyl-4-phenylpyridinium ion toxicity : involvement of the glutathione system" 59 : 99-106, 1992

56 Fujimura H, "Brain-derived neurotrophic factor is stored in human platelets and released by agonist stimulation" 87 : 728-734, 2002

57 Gold SM, "Basal serum levels and reactivity of nerve growth factor and brain-derived neurotrophic factor to standardized acute exercise in multiple sclerosis and controls" 138 : 99-105, 2003

58 Lee BH, "BDNF mRNA in peripheral blood mononuclear cells of depressive patients with or without attempted suicide" 2007

59 Mattson MP, "BDNF and 5-HT : a dynamic duo in age-related neuronal plasticity and neurodegenerative disorders" 27 : 589-594, 2004

60 Lam P, "Association study of a Brain-Derived Neurotrophic Factor(Val 66Met)Genetic polymorphism and Panic disorder" 49 : 178-181, 2004

61 Nesse RM, "Adrenergic function in patients with panic anxiety" 41 : 771-776, 1984

62 Molteni R, "Acute stress responsiveness of the neurotrophin BDNF in the rat hippocampus is modulated by chronic treatment with the antidepressant duloxetine" 34 : 1523-1532, 2009