Clinical Psychopharmacology and Neuroscience Papers in Press available online.

Brain-derived neurotrophic factor and high sensitive C-reactive protein in bipolar disorder and major depressive disorder: the practical usage as a discriminatory tool
Shima Shahyad 1,*, Gholam Reza Kheirabadi 2, Gila Pirzad Jahromi 1, Muhammad massali 1
1Neuroscience Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran, 2Behavioral Sciences Research Center, Department of Psychiatry, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
Background: Brain-derived neurotrophic factor (BDNF) and high sensitive C-reactive protein (hs-CRP) have been previously reported to play roles in depression and bipolar disorder(BD). However, the probable discriminatory properties of these biologic markers are less investigated. We aimed to assess the serum BDNF and hs-CRP levels among Iranian patients with unipolar depressive disorder and BD during a depressive episode and investigate the optimum cut-off point for differential diagnosis of BD and MDD.
Methods: We recruited 30 patients with MDD, 30 with BD in depressive mood and 30 healthy comparators from March 2020 to October 2020. Blood sample was taken from each participant to measure BDNF and hs-CRP levels. We also used receiver operating characteristic(ROC) curve analysis to find an optimal cut-off point for differentiating unipolar depression from bipolar depression according to pre-defined variables.
Results: The mean age of total study population was 37.3±5 years (males:49%). BDNF was significantly lower in patients with BD in depressive episode, followed by MDD subjects and healthy controls 541.0±601.0 pg/ml vs. 809.5±433.3 pg/ml vs. 1482.1±519.8, respectively, P< 0.001). The area under curve (AUC) of ROC curve analysis for BD with depression versus MDD was 0.704 (95% confidence interval (CI): 0.564-0.844, P= 0.007). We also found that the BDNF cut-off value of 504 could appropriately distinguished BD during a depressive episode from MDD (sensitivity:73%, specificity:70%). No significant association were identified in terms of hs-CRP levels.
Conclusion: Patients suffering from BD with depressive mood had lowest BDNF levels compared to MDD or healthy adults and this biomarker could play a practical role differentiating MDD from BD. Several studies are required confirming our outcomes.
Accepted Manuscript [Submitted on 2021-07-29, Accepted on 2021-11-04]