Plasma brain-derived neurotrophic factor level may contribute to the therapeutic response to eye movement desensitisation and reprocessing in complex post-traumatic stress disorder: a pilot study

We investigated the relationship between plasma levels of brain-derived neurotrophic factor (BDNF) and nerve growth factor (NGF) and responses to eye movement desensitisation and reprocessing (EMDR) in complex post-traumatic stress disorder (complex PTSD). Before and after EMDR, plasma levels of neurotrophic factors and scores in the indices of self-questionnaires were obtained for eight men with complex PTSD. Baseline plasma levels of BDNF and NGF of responders and of non-responders were compared. The plasma BDNF levels of responders were higher than those of non-responders. However, plasma NGF levels did not differ in two groups. Plasma BDNF level might contribute to the therapeutic response to EMDR in trauma-related psychiatric disorders, such as complex PTSD. Complex PTSD is a proposed diagnosis that describes the psychological sequelae of survivors with prolonged, repeated, and interpersonal trauma, including childhood physical abuse, incest, and other forms of family violence. The diagnostic criteria for complex PTSD consist of the functional alterations in six areas: (1) regulation of affect and impulses; (2) attention or consciousness; (3) self-perception; (4) relations with others; (5) somatisation; and (6) system of meaning. Changes in the neural substrates of patients with complex PTSD may reflect the relationship, established in critical developmental phases, between traumatic experiences and neurobiological factors. Recently, a morphometric study showed that patients with childhood abuse-related complex PTSD had more extensive involvements of neural substrates (reduced anterior cingulate and orbitofrontal volumes) than those with classical PTSD (1). Therefore, the deficits in emotional/selfawareness, emotion regulation, social emotional processing and self-referential processing should be emphasised in the assessment of patients with complex PTSD. EMDR is an integrative and comprehensive psychotherapy originally developed to resolve symptoms of psychic trauma. It has been also proposed as a rapid and effective application for treating the core symptoms of complex PTSD (2). In the present study, we assess the potential of levels of neurotrophic factors as biological predictors of EMDR responses in complex PTSD. The diagnoses were confirmed by two psychiatrists using the Structured Interview for Disorders of Extreme Stress (SIDES), which was designed to measure the presence of complex PTSD. Before and after eight-session EMDR, plasma levels of BDNF and NGF were obtained for eight men with complex PTSD. No psychotropic medication was given during the subsequent period of EMDR treatment. However, either 2-mg lorazepam or 10-mg diazepam was allowed for sleep management. The amounts of BDNF and NGF in plasma were measured with enzyme-linked immunosorbent assay (ELISA) kits (Quantikine, R & D Systems, Minneapolis, MN, USA) following the manufacturer’s instructions. The Symptom Checklist-90-Revision (SCL-90-R) was employed to assess the participants’ symptomatic status, because all the symptomatic dimensions of complex PTSD could not be assessed using the