Journal List > J Korean Neuropsychiatr Assoc > v.54(4) > 1017764

Lee, Kang, Lee, Kim, Zi, Lee, Park, Park, and Yang: Alteration of Brain-Derived Neurotrophic Factor Levels in Panic Disorder

Abstract

Objectives

Brain-derived neurotrophic factor (BDNF), a neurotrophin involved in neurogenesis and synaptic plasticity, has been implicated in the pathophysiology of several neuropsychiatric disorders. However, there have been no consistent findings regarding BDNF levels in panic disorder. In this study, we investigated plasma BDNF levels in panic disorder, and evaluated whether there is an association between plasma BDNF levels and severity of symptoms of panic disorder.

Methods

Plasma BDNF levels were measured in 110 panic disorder patients and 110 normal control subjects using the enzyme-linked immunosorbent assay. The severity of symptoms of panic disorder was determined using the Panic Disorder Severity Scale, Acute Panic Inventory, Agoraphobic Cognition Questionnaire, and Hamilton Anxiety Rating Scale.

Results

The mean plasma BDNF levels of patients with panic disorder were significantly lower compared with those of control subjects (192.50 pg/mL vs. 693.75 pg/mL). No significant association was observed between plasma BDNF levels and the severity of symptoms of panic disorder.

Conclusion

These results suggest that BDNF may play a potential role in the pathophysiology of panic disorder.

Figures and Tables

Fig. 1

Comparison of the plasma BDNF levels between normal controls and patients with panic disorder. Box plots display the median, quartiles and extremes. BDNF : Brain-derived neurotrophic factor.

jkna-54-482-g001
Table 1

Demographic characteristics of the normal controls and the patients with panic disorder

jkna-54-482-i001

PDSS : Panic Disorder Severity Scale, API : Acute Panic Inventory, ACQ : Agoraphobic Cognition Questionnaire, HAMD : Hamilton Depression Rating Scale, HAMA : Hamilton Anxiety Rating Scale, SD : Standard deviation

Table 2

Plasma BDNF level difference between the normal controls and the patients with panic disorder

jkna-54-482-i002

BDNF : Brain-derived neurotrophic factor

Table 3

Correlations among plasma BDNF, PDSS, API, ACQ, and HAMA

jkna-54-482-i003

* : p<0.05. BDNF : Brain-derived neurotrophic factor, PDSS : Panic Disorder Severity Scale, API : Acute Panic Inventory, ACQ : Agoraphobic Cognition Questionnaire, HAMA : Hamilton Anxiety Rating Scale

Notes

Conflicts of Interest The authors have no financial conflicts of interest.

References

1. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 4th edition. Washington, DC: American Psychiatric Association;1994.
2. Katon WJ. Clinical practice. Panic disorder. N Engl J Med. 2006; 354:2360–2367.
3. Spitzer RL, Kroenke K, Linzer M, Hahn SR, Williams JB, deGruy FV 3rd, et al. Health-related quality of life in primary care patients with mental disorders. Results from the PRIME-MD 1000 Study. JAMA. 1995; 274:1511–1517.
crossref
4. Markowitz JS, Weissman MM, Ouellette R, Lish JD, Klerman GL. Quality of life in panic disorder. Arch Gen Psychiatry. 1989; 46:984–992.
crossref
5. Walker EA, Gelfand AN, Gelfand MD, Katon WJ. Psychiatric diagnoses, sexual and physical victimization, and disability in patients with irritable bowel syndrome or inflammatory bowel disease. Psychol Med. 1995; 25:1259–1267.
crossref
6. Katon WJ, Buchwald DS, Simon GE, Russo JE, Mease PJ. Psychiatric illness in patients with chronic fatigue and those with rheumatoid arthritis. J Gen Intern Med. 1991; 6:277–285.
crossref
7. Coryell W, Noyes R, Clancy J. Excess mortality in panic disorder. A comparison with primary unipolar depression. Arch Gen Psychiatry. 1982; 39:701–703.
8. Zane RD, McAfee AT, Sherburne S, Billeter G, Barsky A. Panic disorder and emergency services utilization. Acad Emerg Med. 2003; 10:1065–1069.
crossref
9. Rubin HC, Rapaport MH, Levine B, Gladsjo JK, Rabin A, Auerbach M, et al. Quality of well being in panic disorder: the assessment of psychiatric and general disability. J Affect Disord. 2000; 57:217–221.
crossref
10. Nesse RM, Cameron OG, Curtis GC, McCann DS, Huber-Smith MJ. Adrenergic function in patients with panic anxiety. Arch Gen Psychiatry. 1984; 41:771–776.
crossref
11. Maddock RJ, Carter CS, Magliozzi JR, Gietzen DW. Evidence that decreased function of lymphocyte beta adrenoreceptors reflects regulatory and adaptive processes in panic disorder with agoraphobia. Am J Psychiatry. 1993; 150:1219–1225.
crossref
12. Maddock RJ, Gietzen DW, Goodman TA. Decreased lymphocyte beta-adrenoreceptor function correlates with less agoraphobia and better outcome in panic disorder. J Affect Disord. 1993; 29:27–32.
crossref
13. Kent JM, Coplan JD, Gorman JM. Clinical utility of the selective serotonin reuptake inhibitors in the spectrum of anxiety. Biol Psychiatry. 1998; 44:812–824.
crossref
14. Klein DF. False suffocation alarms, spontaneous panics, and related conditions. An integrative hypothesis. Arch Gen Psychiatry. 1993; 50:306–317.
crossref
15. Papp LA, Martinez JM, Klein DF, Coplan JD, Norman RG, Cole R, et al. Respiratory psychophysiology of panic disorder: three respiratory challenges in 98 subjects. Am J Psychiatry. 1997; 154:1557–1565.
16. Pavlov PI. Conditioned reflexes: an investigation of the physiological activity of the cerebral cortex. Ann Neurosci. 2010; 17:136–141.
crossref
17. Yeragani VK, Pohl R, Berger R, Balon R, Ramesh C, Glitz D, et al. Decreased heart rate variability in panic disorder patients: a study of power-spectral analysis of heart rate. Psychiatry Res. 1993; 46:89–103.
crossref
18. Numata S, Ueno S, Iga J, Yamauchi K, Hongwei S, Ohta K, et al. Brain-derived neurotrophic factor (BDNF) Val66Met polymorphism in schizophrenia is associated with age at onset and symptoms. Neurosci Lett. 2006; 401:1–5.
crossref
19. Lin PY. State-dependent decrease in levels of brain-derived neurotrophic factor in bipolar disorder: a meta-analytic study. Neurosci Lett. 2009; 466:139–143.
crossref
20. Shim SH, Hwangbo Y, Kwon YJ, Jeong HY, Lee BH, Lee HJ, et al. Increased levels of plasma brain-derived neurotrophic factor (BDNF) in children with attention deficit-hyperactivity disorder (ADHD). Prog Neuropsychopharmacol Biol Psychiatry. 2008; 32:1824–1828.
crossref
21. Gonul AS, Akdeniz F, Taneli F, Donat O, Eker C, Vahip S. Effect of treatment on serum brain-derived neurotrophic factor levels in depressed patients. Eur Arch Psychiatry Clin Neurosci. 2005; 255:381–386.
crossref
22. Karege F, Perret G, Bondolfi G, Schwald M, Bertschy G, Aubry JM. Decreased serum brain-derived neurotrophic factor levels in major depressed patients. Psychiatry Res. 2002; 109:143–148.
crossref
23. Shimizu E, Hashimoto K, Okamura N, Koike K, Komatsu N, Kumakiri C, et al. Alterations of serum levels of brain-derived neurotrophic factor (BDNF) in depressed patients with or without antidepressants. Biol Psychiatry. 2003; 54:70–75.
crossref
24. Brunoni AR, Lopes M, Fregni F. A systematic review and meta-analysis of clinical studies on major depression and BDNF levels: implications for the role of neuroplasticity in depression. Int J Neuropsychopharmacol. 2008; 11:1169–1180.
crossref
25. Lee BH, Kim H, Park SH, Kim YK. Decreased plasma BDNF level in depressive patients. J Affect Disord. 2007; 101:239–244.
crossref
26. Kim YK, Lee HP, Won SD, Park EY, Lee HY, Lee BH, et al. Low plasma BDNF is associated with suicidal behavior in major depression. Prog Neuropsychopharmacol Biol Psychiatry. 2007; 31:78–85.
crossref
27. David DJ, Samuels BA, Rainer Q, Wang JW, Marsteller D, Mendez I, et al. Neurogenesis-dependent and -independent effects of fluoxetine in an animal model of anxiety/depression. Neuron. 2009; 62:479–493.
crossref
28. Chen ZY, Jing D, Bath KG, Ieraci A, Khan T, Siao CJ, et al. Genetic variant BDNF (Val66Met) polymorphism alters anxiety-related behavior. Science. 2006; 314:140–143.
crossref
29. Maina G, Rosso G, Zanardini R, Bogetto F, Gennarelli M, Bocchio-Chiavetto L. Serum levels of brain-derived neurotrophic factor in drug-naïve obsessive-compulsive patients: a case-control study. J Affect Disord. 2010; 122:174–178.
crossref
30. Rios M, Fan G, Fekete C, Kelly J, Bates B, Kuehn R, et al. Conditional deletion of brain-derived neurotrophic factor in the postnatal brain leads to obesity and hyperactivity. Mol Endocrinol. 2001; 15:1748–1757.
crossref
31. Nibuya M, Morinobu S, Duman RS. Regulation of BDNF and trkB mRNA in rat brain by chronic electroconvulsive seizure and antidepressant drug treatments. J Neurosci. 1995; 15:7539–7547.
crossref
32. Suliman S, Hemmings SM, Seedat S. Brain-Derived Neurotrophic Factor (BDNF) protein levels in anxiety disorders: systematic review and meta-regression analysis. Front Integr Neurosci. 2013; 7:55.
crossref
33. Kobayashi K, Shimizu E, Hashimoto K, Mitsumori M, Koike K, Okamura N, et al. Serum brain-derived neurotrophic factor (BDNF) levels in patients with panic disorder: as a biological predictor of response to group cognitive behavioral therapy. Prog Neuropsychopharmacol Biol Psychiatry. 2005; 29:658–663.
crossref
34. Fujimura H, Altar CA, Chen R, Nakamura T, Nakahashi T, Kambayashi J, et al. Brain-derived neurotrophic factor is stored in human platelets and released by agonist stimulation. Thromb Haemost. 2002; 87:728–734.
crossref
35. Rosenfeld RD, Zeni L, Haniu M, Talvenheimo J, Radka SF, Bennett L, et al. Purification and identification of brain-derived neurotrophic factor from human serum. Protein Expr Purif. 1995; 6:465–471.
crossref
36. Pan W, Banks WA, Fasold MB, Bluth J, Kastin AJ. Transport of brain-derived neurotrophic factor across the blood-brain barrier. Neuropharmacology. 1998; 37:1553–1561.
crossref
37. Yi JS, Bae SO, Ahn YM, Park DB, Noh KS, Shin HK, et al. Validity and reliability of the Korean Version of the Hamilton Depression Rating Scale (K-HDRS). J Korean Neuropsychiatr Assoc. 2005; 44:456–465.
38. Shear MK, Brown TA, Barlow DH, Money R, Sholomskas DE, Woods SW, et al. Multicenter collaborative panic disorder severity scale. Am J Psychiatry. 1997; 154:1571–1575.
crossref
39. Kim JB. Development of the Korean version of the Panic Disorder Severity Scale. Korean J Psychopathol. 2001; 10:140–151.
40. Dillon DJ, Gorman JM, Liebowitz MR, Fyer AJ, Klein DF. Measurement of lactate-induced panic and anxiety. Psychiatry Res. 1987; 20:97–105.
crossref
41. Chambless DL, Caputo GC, Bright P, Gallagher R. Assessment of fear of fear in agoraphobics: the body sensations questionnaire and the agoraphobic cognitions questionnaire. J Consult Clin Psychol. 1984; 52:1090–1097.
crossref
42. Hamilton M. The assessment of anxiety states by rating. Br J Med Psychol. 1959; 32:50–55.
crossref
43. Piccinni A, Marazziti D, Catena M, Domenici L, Del Debbio A, Bianchi C, et al. Plasma and serum brain-derived neurotrophic factor (BDNF) in depressed patients during 1 year of antidepressant treatments. J Affect Disord. 2008; 105:279–283.
crossref
44. Radka SF, Holst PA, Fritsche M, Altar CA. Presence of brain-derived neurotrophic factor in brain and human and rat but not mouse serum detected by a sensitive and specific immunoassay. Brain Res. 1996; 709:122–301.
crossref
45. Laghrissi-Thode F, Wagner WR, Pollock BG, Johnson PC, Finkel MS. Elevated platelet factor 4 and beta-thromboglobulin plasma levels in depressed patients with ischemic heart disease. Biol Psychiatry. 1997; 42:290–295.
crossref
46. Musselman DL, Tomer A, Manatunga AK, Knight BT, Porter MR, Kasey S, et al. Exaggerated platelet reactivity in major depression. Am J Psychiatry. 1996; 153:1313–1317.
crossref
47. Göğçegöz Gül I, Eryılmaz G, Ozten E, Hızlı Sayar G. Decreased mean platelet volume in panic disorder. Neuropsychiatr Dis Treat. 2014; 10:1665–1669.
48. Mattson MP, Maudsley S, Martin B. BDNF and 5-HT: a dynamic duo in age-related neuronal plasticity and neurodegenerative disorders. Trends Neurosci. 2004; 27:589–594.
crossref
49. Brindle PK, Montminy MR. The CREB family of transcription activators. Curr Opin Genet Dev. 1992; 2:199–204.
crossref
50. Nibuya M, Nestler EJ, Duman RS. Chronic antidepressant administration increases the expression of cAMP response element binding protein (CREB) in rat hippocampus. J Neurosci. 1996; 16:2365–2372.
crossref
51. Asberg M. Neurotransmitters and suicidal behavior. The evidence from cerebrospinal fluid studies. Ann N Y Acad Sci. 1997; 836:158–181.
52. Kasper S, Resinger E. Panic disorder: the place of benzodiazepines and selective serotonin reuptake inhibitors. Eur Neuropsychopharmacol. 2001; 11:307–321.
crossref
53. Van Der Kolk BA. The psychobiology and psychopharmacology of PTSD. Hum Psychopharmacol. 2001; 16:S49–S64.
crossref
54. Baldwin DS, Waldman S, Allgulander C. Evidence-based pharmacological treatment of generalized anxiety disorder. Int J Neuropsychopharmacol. 2011; 14:697–710.
crossref
55. Briggs AC, Stretch DD, Brandon S. Subtyping of panic disorder by symptom profile. Br J Psychiatry. 1993; 163:201–209.
crossref
56. Freire RC, Perna G, Nardi AE. Panic disorder respiratory subtype: psychopathology, laboratory challenge tests, and response to treatment. Harv Rev Psychiatry. 2010; 18:220–229.
crossref
57. Pattyn T, Van Den Eede F, Lamers F, Veltman D, Sabbe BG, Penninx BW. Identifying panic disorder subtypes using factor mixture modeling. Depress Anxiety. 2015; 32:509–517.
crossref
58. Mann JJ, Waternaux C, Haas GL, Malone KM. Toward a clinical model of suicidal behavior in psychiatric patients. Am J Psychiatry. 1999; 156:181–189.
TOOLS
Similar articles