Serum and plasma brain-derived neurotrophic factor and response in a randomized controlled trial of riluzole for treatment resistant depression

• Published in: Journal of affective disorders 2018-12, Vol.241, p.514-518
• Main Authors: Wilkinson, Samuel T., Kiselycznyk, Carly, Banasr, Mounira, Webler, Ryan D., Haile, Colin, Mathew, Sanjay J.
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Antidepressive Agents - therapeutic use; BDNF; Brain-Derived Neurotrophic Factor - blood; Depressive Disorder, Major - drug therapy; Depressive Disorder, Major - physiopathology; Depressive Disorder, Treatment-Resistant - drug therapy; Depressive Disorder, Treatment-Resistant - physiopathology; Excitatory Amino Acid Antagonists - therapeutic use; Female; Humans; Male; MDD; Middle Aged; Plasma; Riluzole; Riluzole - therapeutic use; Serum; Young Adult
• ISSN: 0165-0327; 1573-2517
• DOI: 10.1016/j.jad.2018.08.075

•Riluzole responders had lower pre-treatment pBDNF and sBDNF at a trend level.•There was no significant correlation between baseline BDNF levels and improvement in depressive symptoms.•Small sample size in longitudinal BDNF samples resulted in unstable means, limiting our ability to draw conclusions about the effects of riluzole treatment on BDNF over time.•Individuals with MDD and low BDNF levels may be more responsive to riluzole treatment. Serum brain-derived neurotrophic factor (BDNF) is decreased in individuals with major depressive disorder (MDD). Pre-clinical and clinical reports suggest that the glutamate release inhibitor riluzole increases BDNF and may have antidepressant properties. Here we report serum (sBDNF) and plasma (pBDNF) levels from a randomized controlled, adjunctive, sequential parallel comparison design trial of riluzole in MDD. Serum and plasma BDNF samples were drawn at baseline and weeks 6 and 8 from 55 subjects randomized to adjunctive treatment with riluzole or placebo for 8 weeks. Riluzole responders had lower baseline serum (19.08 ng/ml [SD 9.22] v. 28.80 ng/ml [9.63], p = 0.08) and plasma (2.72 ng/ml [1.07] v. 4.60 ng/ml [1.69], p = 0.06) BDNF compared to non-responders at a trend level. This pattern was nominally seen in placebo responders for baseline pBDNF to some degree (1.21 ng/ml [SD 1.29] v. 3.58 ng/ml [SD 1.67], p = 0.12) but not in baseline sBDNF. A number of limitations warrant comment, including the small sample size of viable BDNF samples and the small number of riluzole responders. Preliminary evidence reported here suggests that lower baseline BDNF may be associated with better clinical response to riluzole.