| ObjectiveResearch background and purpose According to the statistics of WHO,depression is one of the ten most serious diseases in the world.Its lifetime prevalence rate is about,and depression is a high suicide risk disease.The suicide rate of depression is about.It has caused a heavy burden to the society and the family.At present,the treatment of depression is mainly based on drug treatment,followed by physical therapy and psychotherapy.Electroconvulsive therapy especially MECT modified electroconvulsive therapy as a physical therapy,occupy a very important position in the physical therapy of depression,compared with the other treatments,with faster onset time,less residual symptoms and the clinical remission rate higher incidence;prodroma insomnia is both depression.And also closely related to the prognosis for depression,about 40% of patients with depression before the onset of symptoms related to sleep and sleep disorders associated with non MDD individuals at risk of MDD sleep disorder is two times higher than that of no sleep in the process of life,insomnia patients with depression often showed more severe depressive symptoms,and is associated with a higher risk Dutch act.Therefore,searching for biomarkers associated with sleep disorders and exploring the correlation between depression and insomnia are important for improving the level of diagnosis and treatment of MDD.BDNF is a kind of protein synthesis in the brain,it is widely distributed in the central nervous system,plays an important role in the growth and survival of neurons and repair process,therefore to explore the relationship between methylation regulation mechanism and MDD concentration of BDNF and BDNF gene in human sleep disorders associated with disease and clinical manifestations have been has become a hot research topic.Enzyme linked immunosorbent assay(ELISA)was used to determine the concentration of plasma brain derived neurotrophic factor protein.The role of BDNF protein in drug therapy and electroconvulsive therapy was preliminarily explored,and the difference of BDNF protein changes between two different antidepressant treatments was also explored.Determination of electric shock treatment before and after the case group and 15 healthy control group BDNF gene in peripheral blood of CpG island in the promoter region of I methylation using bisulfite sequencing and methylation of BDNF Chinese investigated whether the risk associated with depression and depression and to explore the relevance of the analysis.Association Dutch act ideation,depressive symptoms and their.At the same time with the Hamilton Depression Scale(Hamilton Depression Scale,HAMD),life events scale(Life Event Scale,LES)evaluation revealed peripheral blood BDNF concentration and gene methylation and play a therapeutic role in sleep symptoms in patients with depression.It is more effective to predict what kind of treatment is to improve the condition of MDD and to further optimize the treatment.Method:(1)according to the research group,January 2017 December 2017 in a hospital inpatient and outpatient treatment of depression associated with sleep disorders in patients with 40 cases as the case group,the case group included 20 cases only drug treatment group and 20 cases of drug combined with electroconvulsive therapy group,41 healthy volunteers were selected as normal control group matched in age and sex.(2)venous blood 5ml drugs and electroconvulsive therapy group were collected before each group of peripheral,centrifuge 3000 rpmfor 10 minutes,after centrifugation,the upper plasma for measuring BDNF concentration in peripheral blood,lower blood cell components used to extract genomic DNA for detection of BDNF promoter region methylation.4 weeks after the drug treatment group and 6 times of electroshock treatment,the peripheral blood was repeated again to repeat the above operation.(3)peripheral blood after assessment and patients with Hamilton depression scale and Pittsburgh sleep index,life event scale and cerebral evoked potentials P300.(4)SPSS18.0 software is used in this study.Independent sample t test,paired sample t test and correlation line analysis were used to analyze the collected data.All the experimental statistical data were expressed in the form of mean + standard(Mean + SD).Result(1)the concentration of plasma BDNF(40 cases)before medication in the case group was significantly lower than that of the normal control group(41 cases),and the concentration of plasma BDNF was significantly lower than that of the normal control group(41 cases).The plasma BDNF concentration(20 cases)after the drug treatment was higher than that of the plasma BDNF before the drug treatment(20 cases),and the difference was statistically significant.There was no significant difference in plasma BDNF concentration before and after convulsive electroconvulsive shock.(2)before the power of BDNF promoter I region average methylation rate and CpG locus 3,4,6,7,8,9,11,12,13,14 of the average methylation rate was significantly lower than the normal control group the average methylation rate of shock treatment,the difference was statistically significant;there was no significant electric shock therapy the case group before the BDNF promoter region of I gene 15 CpG sites methylation level difference.(3)MECT after HAMD score(HAMD)decreased significantly compared with before treatment,the difference was statistically significant;MECT group HAMD score was significantly higher than the treatment group,the difference was statistically significant.To split the factor scores of Hamilton depression scale,Hamilton found that each factor in weight and block and peripheral blood BDNF the correlation between I gene promoter methylation level;evaluation of life events scale,not found the concentration of BDNF and the life events scale are related.conclusion(1)the plasma BDNF concentration in peripheral blood of patients with depression can be used as a diagnostic marker.With the drug treatment,the plasma BDNF concentration is significantly increased,which can be used as a marker for the efficacy of drug therapy.There was no significant difference in the concentration of BDNF in peripheral blood between patients before and after modified electroconvulsive therapy,suggesting that tic can play an antidepressant effect through other ways,and on the other hand,it may be related to the time of treatment.(2)the level of methylation of 3,4,6,7,8,9,11,12,13,and 13 sites in the 15 CpG loci at I of BDNF exons may be important for the diagnosis of depression with sleep disorders,but it may not be used for the evaluation of curative effect of modified electroconvulsive therapy.(3)the average methylation rate of 15 CpG loci in I region of BDNF promoter is correlated with the body weight and block factor score in Hamilton depression scale factor,which is significant for depression symptom classification and accurate diagnosis and treatment. |
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