Neurotrophic factors are critical regulators of the formation and plasticity of neuronal networks. Brain-derived neurotrophic factor (BDNF) is abundant in the brain and periphery, and is found in both human serum and plasma. Animal studies have demonstrated that stress reduces BDNF expression or activity in the hippocampus and that this reduction can be prevented by treatment with antidepressant drugs. A similar change in BDNF activity occurs in the brain of patients with major depression disorder (MDD). Recently, clinical studies have indicated that serum or plasma BDNF levels are decreased in untreated MDD patients. Antidepressant treatment for at least four weeks can restore the decreased BDNF function up to the normal value. Therefore, MDD is associated with impaired neuronal plasticity. Suicidal behavior can be a consequence of severe impaired neuronal plasticity in the brain. Antidepressant treatment promotes increased BDNF activity as well as several forms of neuronal plasticity, including neurogenesis, synaptogenesis and neuronal maturation. BDNF could also play an important role in the modulation of neuronal networks. Such a neuronal plastic change can positively influence mood or recover depressed mood. These alterations of BDNF levels or neuronal plasticity in MDD patients before and after antidepressant treatment can be measured through the examination of serum or plasma BDNF concentrations. BDNF levels can therefore be useful markers for clinical response or improvement of depressive symptoms, but they are not diagnostic markers of major depression.
Animals ; Antidepressive Agents ; Brain ; Brain-Derived Neurotrophic Factor ; Depression ; Hippocampus ; Humans ; Nerve Growth Factors ; Neurogenesis ; Neuronal Plasticity ; Neurons ; Plasma ; Plastics ; Reference Values

Transcranial direct current stimulation (tDCS) is a non-invasive brain stimulation method that delivers 1–2 mA of current to the scalp. Several clinical studies have been conducted to confirm the therapeutic effect of major depressive disorder (MDD) patients with tDCS. Some studies have shown tDCS's antidepressant effect, while the others showed conflicting results in antidepressant effects. Our aim of this review is to understand the biological bases of tDCS's antidepressant effect and review the results of studies on tDCS's antidepressant effect. For the review and search process of MDD treatment using tDCS, the US National Library of Medicine search engine PubMed was used. In this review, we discuss the biological mechanism of tDCS's antidepressant effect and the existing published literature including meta-analysis, systematic review, control trial, open studies, and case reports of antidepressant effects and cognitive function improvement in patients with MDD are reviewed. We also discuss the appropriate tDCS protocol for MDD patients, factors predictive of response to tDCS treatment, the disadvantages of tDCS in MDD treatment, and side effects.
Brain ; Cognition ; Depressive Disorder, Major* ; Humans ; Methods ; National Library of Medicine (U.S.) ; Scalp ; Search Engine ; Transcranial Direct Current Stimulation*

Brain-derived neurotrophic factor (BDNF) is an important member of the neurotrophic factors, which are critical regulators of the formation and plasticity of neuronal networks. BDNF is abundant in the brain and periphery and it is found in both human serum and plasma. Stressed animals and depressed patients show reduced BDNF expression in the hippocampus and this reduction can be prevented by antidepressant drug treatment. Recent several clinical studies have indicated the decreases of serum or plasma BDNF levels in untreated patients with major depression. These decreases of BDNF can recover after antidepressant treatment. Increasing BDNF after antidepressant treatment could result from improving depressive symptoms, not just from antidepressant treatment. BDNF can play a critical role in the action mechanism of antidepressant treatment. Taken together, major depression may be considered a dysfunction of critical neuronal networks, and the gradual network recovery may induce antidepressant effect. Serum or plasma BDNF levels could indirectly show the above processes of major depression.
Animals ; Brain ; Brain-Derived Neurotrophic Factor ; Depression ; Hippocampus ; Humans ; Nerve Growth Factors ; Neurons ; Plasma ; Plastics

OBJECTIVES: Schizophrenia is a clinically heterogenous disease with a strong genetic component. Many studies have suggested that brain-derived neurotrophic factor(BDNF) is involved in the pathophysiology of schizophrenia. This study was performed to determine whether there is an association between BDNF Val66Met polymorphism and schizophrenia. METHODS: To identify any genetic predisposition to schizophrenia, we investigated the BDNF Val66Met polymorphism in 106 patients with schizophrenia and 147 normal controls with PCR-RFLP method. Statistical analyses were used to test the association between and BDNF Val66Met genotype and Schizophrenia. RESULTS: No association was found between BDNF Val66Met polymorphism and schizophrenia. No significant differences were found comparing the BDNF genotype distributions according to the age of onset, the number of admission and familial loading in schizophrenia. CONCLUSION: This result indicates that BDNF Val66Met polymorphism is not associated with schizophrenia. However, further studies with a large number of subjects are needed to confirm whether the BDNF gene is related to schizophrenia.
Age of Onset ; Brain-Derived Neurotrophic Factor* ; Genetic Predisposition to Disease ; Genotype ; Humans ; Schizophrenia*

Suicide is a significant public health issue and a major cause of death throughout the world. There are significant evidences that the activity of 3 neurobiological systems has a role in the pathophysiology of suicidal behavior : a deficiency of serotonergic system, a hyperactivity of the hypothalamic-pituitary-adrenal axis, and an excessive release of noradrenaline. These neurobiological abnormalities might correlate with the diathesis of suicide including pessimism and aggression. Dysfunction of the serotonergic system is thought to be associated with disturbances in the regulation of impulsivity and aggression, which may be traitdependent factor. Hyperactivity of the hypothalamo-pituitary-adrenal axis and excessive activity of the noradrenergic system appear to be involved in the response to stressful events, which may be state-dependent factor. In the future, more understanding several aspect of suicidal behavior and the neurobiology of suicide can help detect promising predictors of suicidal behavior and treatment interventions.
Aggression ; Axis, Cervical Vertebra ; Biological Factors* ; Cause of Death ; Disease Susceptibility* ; Impulsive Behavior ; Life Change Events ; Neurobiology ; Norepinephrine ; Public Health ; Serotonin ; Suicide

OBJECTIVES: This study was to compare verbal memory ability among patients with schizophrenia, bipolar manic patients and unipolar depressive patients, and to understand their charicteristics of memory process. METHODS: All subjects were hospitalized patients and had been interviewed by using the Structured Clinical Interview for DSM-IV(SCID). Schizophrenic patients(N=40), bipolar manic patients(N=17), and unipolar depressive patients(N=20) were assessed with K-AVLT for verbal memory and with K-WAIS for verbal IQ. Three groups were compared regarding total immediate recall, delayed recall, delayed recognition, learning curve, memory retention, and retrieval efficiency under controlled verbal IQ. Multiple regression analysis was performed to find which clinical factors have an influence on verbal memory ability. RESULTS: In MANCOVA, differences of verbal memory test scores among the groups were statistically significant(F=1.800, p<.05). In post hoc analysis, Patients with schizophrenia and bipolar mania showed poorer performance in immediate recall, delayed recall, delayed recognition, retrieval efficiency than unipolar depressive patients. And schizophrenics performed poorly in delayed recall, delayed recognition, retrieval efficiency than nonpsychotic affective disorder group, but no difference in total immediate recall, delayed recall, delayed recognition, retrieval efficiency between the schizophrenic group and the psychotic affective group. CONCLUSIONS: These results partially confirm previous reports of verbal memory ability among major psychiatric disorders. Our results showed that psychotic symptoms were related with verbal memory, and longer duration of illness was related with poorer performance in schizophrenia and unipolar depression.
Bipolar Disorder ; Depression ; Depressive Disorder ; Humans ; Learning Curve ; Memory* ; Memory, Short-Term ; Mood Disorders* ; Schizophrenia*

& executive function deficit could be reversible after treatment, and 3) medication might have a benefit in improving the cognitive functions in schizophrenia. Furthermore, the data supports that the better premorbid executive function was, the more favorable was the treatment response in schizophrenic patients. Finally, this study indicates that executive function might be an index of treatment improvement.
Executive Function ; Humans ; Schizophrenia

A 62-year-old woman was evaluated for tinnitis and headache. Magnetic resonance imaging and angiography revealed the coexistence of a tentorial tumor encroaching the junction of the right transverse-sigmoid sinuses, and dural arteriovenous fistulous malformation (AVFM) of the right transverse sinus. AVFM was not manipulated at all during the surgery. The pathology was fibroblastic meningioma. Postoperatively, the dural AVFM completely disappeared on follow-up angiography. The fistulas were occluded also after surgery, even though there was no manipulation of the AVFM. It is suggested that the right dominant transverse-sigmoid sinuses are partially occluded by tentorial meningioma, developing the dural arteriovenous fistula of the right transverse sinus. An acquired origin of the dural AVFM was suggested in this case.
Arteriovenous Malformations/diagnosis ; Arteriovenous Malformations/complications* ; Carotid Artery, External/pathology ; Carotid Artery, Internal/pathology ; Case Report ; Cerebral Angiography ; Dura Mater/pathology ; Female ; Human ; Jugular Veins/pathology ; Magnetic Resonance Imaging ; Meningeal Neoplasms/diagnosis ; Meningeal Neoplasms/complications* ; Meningioma/diagnosis ; Meningioma/complications* ; Middle Age

OBJECTIVE: To examine gender differences in the characteristics of suicidal behavior in South Korea. METHODS: Between August 2003 and December 2006, 344 suicide attempters (116 men, 228 women) participated in this study. The attempters were interviewed using the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I), and the lethality of the attempt was measured using the Lethality Suicide Attempt Rating Scale-II (LSARS-II) and Risk-Rescue Rating Scale (RRRS). RESULTS: Significantly more women than men were admitted to emergency rooms due to attempted suicide during the study period. The male attempters were older and had a higher rate of employment than the females. Depression was the most common psychiatric disorder in both genders. The lesion/toxicity scores of the RRRS indicated that the male suicide attempters used higher doses or more toxic agents than the female attempters. The most common methods of suicide were ingestion and cutting in both sexes. Although there were significant gender differences in the RRRS risk score and RRRS total scores, there was no gender difference in the LSARS-II scores, which suggests that patients of both sexes share a similar ambivalence regarding suicide completion or death. CONCLUSION: Our study should be understood within the context of the specific cultural background of South Korea. We found that males and females use similar methods when attempting suicide and share a similar ambivalence regarding the outcome of the attempt; however, there was a difference in severity of the attempt between the two groups. Our findings may aid in the identification of more effective methods of intervention to prevent suicide.
Axis, Cervical Vertebra ; Depression ; Diagnostic and Statistical Manual of Mental Disorders ; Eating ; Emergency Service, Hospital ; Employment ; Female ; Humans ; Korea ; Male ; Risk Factors ; Suicide ; Suicide, Attempted

OBJECTIVE: This study was conducted to investigate the cognitive factors that can longitudinally predict the response to treatment in patients with schizophrenia. METHODS: The subjects were 49 patients with schizophrenia who were newly hospitalized in an acute psychiatry ward and had not been treated with medication for at least 8 weeks prior to the study. The symptoms and cognitive functions of the patients were evaluated at baseline before treatment (T0), at eight weeks after treatment (T1), and one year after treatment (T2). Clinical symptoms were assessed using the PANSS, and cognitive functions were estimated using the Vigilance Test, Cognitrone Test, Wisconsin Card Sorting Test (WCST), and the Korean version of the Memory Assessment Scales (K-MAS). RESULTS: The patient group showed marked impairments in cognitive function when compared to the normal group, but the patients' clinical symptoms and cognitive functions improved after drug treatment. The patients also showed consistent improvement in verbal and nonverbal memory function as time progressed. Furthermore, there was a significant correlation between clinical symptoms and cognitive functions in the patient group. The cognitive variables that best predicted treatment response and prognosis were total errors on the WCST and immediate list recall component of the K-MAS. It was also shown that the number of total errors on the WCST was a better cognitive predictor than the number of errors in immediate recall. CONCLUSION: The results of the present study show that the neurocognitive functions of patients with schizophrenia can be stabilized with treatment intervention, that treatment response is related to improvement in cognitive function, and that cognitive domains, especially executive function, can predict treatment response and prognosis in patients with schizophrenia.
Cognition ; Executive Function ; Follow-Up Studies* ; Humans ; Memory ; Memory, Short-Term ; Prognosis ; Schizophrenia ; Weights and Measures ; Wisconsin