AUTHOR=Zhang Yuxuan , Cui Bo , Wang Tianyu , Lu Yan , Chen Zhenlin , Zou Zhilu , Miao Jinlin , Zhao Xiuli , Yuan Yonggui , Wang Haosen , Chen Gang 

TITLE=Early Enhancement of Neuroplasticity Index, the Ratio of Serum Brain-Derived Neurotrophic Factor Level to HAMD-24 Score, in Predicting the Long-Term Antidepressant Efficacy

JOURNAL=Frontiers in Behavioral Neuroscience

VOLUME=Volume 15 - 2021

YEAR=2021

URL=https://www.frontiersin.org/journals/behavioral-neuroscience/articles/10.3389/fnbeh.2021.712445

DOI=10.3389/fnbeh.2021.712445

ISSN=1662-5153

ABSTRACT=Background: Current mainstream treatment of major depressive disorder (MDD) has a disadvantage in delayed onset of efficacy, making detection of early signatures predicative of the long-term treatment efficacy urgent.
Methods: MDD patients were scored with HAMD-24 and serum brain-derived neurotrophic factor (BDNF) levels were measured at different times in two independent trials: a single-arm observation of Yueju pill, a clinically approved traditional multiherbal medicine, and a two-arm random placebo-controlled trial with Yueju and escitalopram. The ratio of the BDNF level to HAMD-24 score, or neuroplasticity index (NI), and its derived parameter were used to perform the correlation analysis and receiver operating characteristic (ROC) analysis. 
Results: Yueju and escitalopram both significantly reduced HAMD-24 scores, but only Yueju increased BDNF at both the early (≤ 7 days) and final (28th) day. However, for either Yueju or escitalopram treatment, NI, but not BDNF, at baseline was correlated to NIs at the early or final treatment day. NI at early time was significantly correlated to early enhancement of NI from the baseline for both Yueju and escitalopram. In both trials, NI at early time was significantly correlated to final NI enhancement for Yueju. ROC analysis supported the predictability of Yueju’s final treatment efficacy from early NI enhancement.
Limitations: The small sample size and 28 days of treatment time may lead to the impossibility of ROC analysis of escitalopram.
Conclusion: Early NI enhancement is useful for prediction of long-term efficacy of Yueju and presumably some other antidepressants (Clinical Trail Registry: ChiCTR1900021114).