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Distinct association of plasma BDNF concentration and cognitive function in depressed patients treated with vortioxetine or escitalopram

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Abstract

Rationale

Cognitive dysfunction is frequent in major depressive disorder (MDD), and brain-derived neurotrophic factor (BDNF) is involved both in regulation of cognition and in therapeutic response in MDD.

Objectives

The aim of this study was to determine if baseline plasma BDNF might predict change in cognitive function in MDD patients treated with vortioxetine or escitalopram, and whether the alterations in BDNF levels correlate with changes in cognitive performance during treatment.

Methods

Drug-naive or drug-free patients with MDD (N=121) were sampled and evaluated at baseline and 4 weeks after treatment initiation with vortioxetine or escitalopram. Cognitive function was evaluated using the F-A-S test, Digit Span test, and Digit Symbol Coding test. Plasma BDNF was determined using ELISA.

Results

The results of the study indicate that both vortioxetine (V) and escitalopram (E) improved cognitive functions evaluated with F-A-S test (V: p<0.001; r=−0.427, E: p<0.001; r=−0.370), Digit Symbol Coding test (V: p<0.001; r=−0.706, E: p<0.001; r=−0.435), and Digit Span test-backward span (V: p=0.001; r=−0.311, E: p=0.042; r=−0.185), while only vortioxetine (p<0.001; r=−0.325) improved cognition evaluated with the Digit Span test-forward span. A moderate positive correlation between pretreatment plasma BDNF levels and improvement in cognitive performance was only detected in patients treated with vortioxetine (delta F-A-S test: p=0.011; r=0.325, delta Digit Span test-forward span: p=0.010, r=0.326).

Conclusions

These results suggest that higher baseline plasma BDNF levels might be associated with improvements in verbal fluency and working memory in vortioxetine, but not escitalopram treated patients. Vortioxetine treatment was superior in simple attention efficiency.

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Funding

This study was funded by the project “The influence of religiosity on treatment outcome in depression: clinical and biochemical parameters,” sponsored by University of Zagreb, BM126, led by Marina Sagud, and by the project No. 098-0982522-2455 “Molecular basis and treatment of psychiatric and stress-related disorders” funded by the Ministry of Sciences, Education and Sports of Croatia, led by Nela Pivac.

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Authors and Affiliations

  1. Department of Psychiatry and Psychological Medicine, University Hospital Centre Zagreb, Kispaticeva 12, 10000, Zagreb, Croatia

    Marina Sagud, Nenad Jaksic, Bjanka Vuksan-Cusa, Maja Zivkovic, Zorana Kusevic & Alma Mihaljevic-Peles

  2. School of Medicine, University of Zagreb, Salata 3, 10000, Zagreb, Croatia

    Marina Sagud, Bjanka Vuksan-Cusa, Maja Zivkovic, Zorana Kusevic & Alma Mihaljevic-Peles

  3. Rudjer Boskovic Institute, Bijenicka cesta 54, 10000, Zagreb, Croatia

    Matea Nikolac Perkovic & Nela Pivac

  4. University Psychiatric Hospital Vrapce, Bolnicka cesta 32, 10090, Zagreb, Croatia

    Anja Dvojkovic

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  1. Marina Sagud
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  2. Matea Nikolac Perkovic
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Correspondence to Nela Pivac.

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Sagud, M., Nikolac Perkovic, M., Dvojkovic, A. et al. Distinct association of plasma BDNF concentration and cognitive function in depressed patients treated with vortioxetine or escitalopram. Psychopharmacology 238, 1575–1584 (2021). https://doi.org/10.1007/s00213-021-05790-2

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