Serum brain-derived neurotrophic factor in relation to craving and duration of abstinence in patients with heroin dependence-A case-control study.

BACKGROUND AND OBJECTIVES: Addiction is a chronic disorder that comes with emotional and financial burdens. Several neurobiological factors were correlated to opiate-use disorder which is brain-derived neurotrophic factor (BDNF). BDNF has been found to be involved in long-term potentiation of synaptic strength, a mechanism that is thought to motivate both natural adaption mechanisms as well as the development of addictive behavior. In this study, we aimed to address the relation between BDNF serum level and heroin craving and the effect of duration of abstinence on them. METHODS: A case study was conducted on 80 subjects from Kasr Al-Ainy Psychiatry and Addiction Treatment Hospital with a history of heroin dependence and were divided into two groups: Group A had 40 active heroin-dependent subjects while in Group B, 40 subjects with 1-year heroin abstinence. Severity of addiction was assessed by the addiction severity index, heroin craving was measured by Brief Substance Craving Scale and serum BDNF level was investigated using an enzyme-linked immunosorbent assay. RESULTS: The findings show that active heroin users had significantly higher serum BDNF which is associated with high heroin craving in comparison to the abstinent group. CONCLUSIONS AND SCIENTIFIC SIGNIFICANCE: This study revealed a significant positive correlation between serum BDNF levels and craving in active heroin users versus 1-year abstinent subjects. It is the first study to address the relationship between craving and serum BDNF level in a 1-year abstinent participants. These findings help to determine the brain alterations associated with illness and recovery in heroin dependence.

Late versus Early Onset Depression in Elderly Patients: Vascular Risk and Cognitive Impairment.

BACKGROUND: Three-quarters of patients with major depressive disorder have late-onset depression. Late-onset depression is more often associated with cognitive impairment than earlyonset depression and evidences showed a relationship between vascular factors and late-life depression. OBJECTIVES: To compare cognitive functions between late-onset (&ge;60 years) and early-onset (<60 years) depression in elderly patients and to highlight the effect of vascular risk factors in elderly patients with late and early onset depression. METHODS: This was a cross sectional, case control study with consecutive referral done on eighty elderly patients with depression who were recruited from Geriatric Outpatient Clinic of Psychiatry and Addiction Prevention Hospital, Al Kasr Al-Ainy, Cairo University. They were divided into two groups according to the age of onset of depression: Late Onset Depression (LOD) group and Early Onset Depression (EOD) group. They were cognitively assessed using ACE III, Framingham risk score for vascular risk assessment. RESULTS: Late onset group had worse performance than early onset group regarding memory, verbal fluency, language, visuospatial abilities and had more vascular risk. CONCLUSION: Elderly patients with late onset depression had higher severity of depression as well as they were more cognitively affected regarding memory, verbal fluency, language, and visuospatial abilities. Vascular risk factors especially hypertension and diabetes mellitus were higher elderly patients with late onset depression and affects the severity of depression and degree of cognitive impairment.