Peripheral Brain-Derived Neurotrophic Factor Changes and Clinical Response to Electroconvulsive Therapy and Repetitive Transcranial Magnetic Stimulation in Major Depressive Disorder: A Systematic Review.
12 affiliations
- 1Psychiatry, Universidad internacional Valencia, Valencia, ESP.
- 2Psychiatry, Corporación Universitaria Remington, Medellín, COL.
- 3Psychiatry and Behavioral Sciences, Hospital Mental de Antioquia María Upegui, Medellin, COL.
- 4Psychiatry, Hospital Interdisciplinario Psicoasistencial José Tiburcio Borda, Buenos Aires, ARG.
- 5Psychiatry and Forensic Medicine, Universidad de Buenos Aires, Buenos Aires, ARG.
- 6Psychiatry and Behavioral Sciences, Universidad Maimónides, Buenos Aires, ARG.
- 7Psychiatry, E.S.E. (Empresa Social del Estado) Hospital Carisma, Medellín, COL.
- 8Child and Adolescent Psychiatry, Universidad El Bosque, Bogotá, COL.
- 9Psychiatry, Clinica Samein, Medellín, COL.
- 10Psychiatry and Behavioral Sciences, EIA University, Medellín, COL.
- 11College of Medicine, Universidad Nacional De Colombia, Bogotá, COL.
- 12Psychiatry and Behavioral Sciences, Corporación Universitaria Remington, Medellín, COL.
Abstract
Major depressive disorder (MDD) is a leading contributor to the global burden of disease, and a substantial proportion of patients experience inadequate responses to conventional treatments. Brain-derived neurotrophic factor (BDNF), a key regulator of neuronal survival and synaptic plasticity, has been investigated as a potential biomarker of antidepressant response. However, its clinical relevance following brain stimulation remains uncertain. This systematic review evaluated changes in peripheral BDNF concentrations and their association with clinical outcomes following electroconvulsive therapy (ECT) and repetitive transcranial magnetic stimulation (rTMS) in adults with MDD. The review followed Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) 2020 guidelines, and searches were conducted in PubMed/MEDLINE (Medical Literature Analysis and Retrieval System Online), PsycINFO, and LILACS (Latin America and the Caribbean Literature on Health Sciences). Study selection and data extraction were independently performed by two reviewers, with disagreements resolved through consensus or consultation with a third reviewer. Eleven studies met the eligibility criteria, including two randomized controlled trials and nine non-randomized investigations. Due to substantial clinical and methodological heterogeneity, a meta-analysis was not performed, and findings were synthesized narratively. Peripheral BDNF responses varied across interventions, biological matrices, and sampling intervals. While many studies reported increased serum or plasma BDNF following ECT, others documented substantial clinical improvement without corresponding biomarker changes. Evidence following rTMS was less consistent, with insufficient data to establish a reliable association between BDNF changes and antidepressant response. Overall, peripheral BDNF changes did not consistently parallel clinical improvement, and current evidence does not support their use as a standalone biomarker of antidepressant response. Further adequately powered studies with standardized biomarker measurements and longitudinal clinical assessments are warranted.
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BibTeX
@article{galindo2026peripheral,
title = {{Peripheral Brain-Derived Neurotrophic Factor Changes and Clinical Response to Electroconvulsive Therapy and Repetitive Transcranial Magnetic Stimulation in Major Depressive Disorder: A Systematic Review.}},
author = {Christian David Galindo and Guillermo Jemar and Isabel Carolina Osorio and Andres Lopez and Mariana Uribe Zapata and Laura Gonzalez Perez and Sebastian D Villamil Montejo and Luis Antonio Carvajal Angarita},
journal = {Cureus},
year = {2026},
month = nov,
doi = {10.7759/cureus.119286},
url = {https://europepmc.org/article/MED/42999924},
note = {CC BY},
}
RIS
TY - JOUR
TI - Peripheral Brain-Derived Neurotrophic Factor Changes and Clinical Response to Electroconvulsive Therapy and Repetitive Transcranial Magnetic Stimulation in Major Depressive Disorder: A Systematic Review.
AU - Christian David Galindo
AU - Guillermo Jemar
AU - Isabel Carolina Osorio
AU - Andres Lopez
AU - Mariana Uribe Zapata
AU - Laura Gonzalez Perez
AU - Sebastian D Villamil Montejo
AU - Luis Antonio Carvajal Angarita
PY - 2026
DA - 2026/11/07
JO - Cureus
DO - 10.7759/cureus.119286
UR - https://europepmc.org/article/MED/42999924
AB - Major depressive disorder (MDD) is a leading contributor to the global burden of disease, and a substantial proportion of patients experience inadequate responses to conventional treatments. Brain-derived neurotrophic factor (BDNF), a key regulator of neuronal survival and synaptic plasticity, has been investigated as a potential biomarker of antidepressant response. However, its clinical relevance following brain stimulation remains uncertain. This systematic review evaluated changes in peripheral BDNF concentrations and their association with clinical outcomes following electroconvulsive therapy (ECT) and repetitive transcranial magnetic stimulation (rTMS) in adults with MDD. The review followed Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) 2020 guidelines, and searches were conducted in PubMed/MEDLINE (Medical Literature Analysis and Retrieval System Online), PsycINFO, and LILACS (Latin America and the Caribbean Literature on Health Sciences). Study selection and data extraction were independently performed by two reviewers, with disagreements resolved through consensus or consultation with a third reviewer. Eleven studies met the eligibility criteria, including two randomized controlled trials and nine non-randomized investigations. Due to substantial clinical and methodological heterogeneity, a meta-analysis was not performed, and findings were synthesized narratively. Peripheral BDNF responses varied across interventions, biological matrices, and sampling intervals. While many studies reported increased serum or plasma BDNF following ECT, others documented substantial clinical improvement without corresponding biomarker changes. Evidence following rTMS was less consistent, with insufficient data to establish a reliable association between BDNF changes and antidepressant response. Overall, peripheral BDNF changes did not consistently parallel clinical improvement, and current evidence does not support their use as a standalone biomarker of antidepressant response. Further adequately powered studies with standardized biomarker measurements and longitudinal clinical assessments are warranted.
SN - 2168-8184
ER -