SYMPOSIA

Poster Presentations
MADRS and HAM-A scales were assessed before and the day following treatment and then 1 and 3 months after treatment. The MADRS
scores were found to be 28, 10, 5 and 5, while the HAM-A scores were found to be 33, 18, 7 and 6, respectively.
Case 3: A 44 year-old male patient was diagnosed with major depressive disorder since age 15 and received venlafaxine 375 mg/day and
ziprasidone 40 mg/day for five months. An add-on 15 sessions of DLPFC rTMS (20 Hz,110% MT,1000p/d) was applied due to insufficient
medication response. The MADRS and HAM-A scales were assessed before and the day following treatment and then 1 and 3 months after
treatment. The MADRS scores were found to be 29, 9, 6 and 7, while the HAM-A scores were found to be 28, 13, 10 and 8, respectively.
Conclusion: Maintenance of improvement in major depression treatment has been another concern apart from efficacy of current
interventions. rTMS is an effective method as monotherapy and also as add-on treatment of depression. In this study each of three
patients responded favorably to rTMS. In the post-treatment course, significiant improvement was maintained at the 3-month follow-up.
Given its relatively benign side effect profile, long lasting therapeutic effect, and more practical non-invasive application than ECT, we
conclude that rTMS can be considered as an optional treatment before ECT in treatment-resistant depression patients.
Key words: rTMS, resistant depression, treatment, follow-up, maintenance
References:
1. Pell GS, Roth Y, Zangen A.Modulation of cortical excitability induced by repetitive transcranial magnetic stimulation: Influence of timing and geometrical
parameters and underlying mechanisms. Prog Neurobiol. 2010 Nov 5.
2. Bortolomasi M, Minelli A, Fuggetta G, Perini M, Comencini S, Fiaschi A, Manganotti P.Long-lasting effects of high frequency repetitive transcranial magnetic
stimulation in major depressed patients. Psychiatry Res. 2007 Mar 30;150(2):181-6.
3. Hadley D, Anderson BS, Borckardt JJ, Arana A, Li X, Nahas Z et all. Safety, tolerability, and effectiveness of high doses of adjunctive daily left prefrontal repetitive
transcranial magnetic stimulation for treatment-resistant depression in a clinical setting. J ECT. 2011 Mar;27(1):18-25.
Bulletin of Clinical Psychopharmacology 2011;21(Suppl. 2):S175-6
[PP-090] Ref. No: 225
The effects of brain-derived neurotrophic factor Val66Met polymorphism on
executive functioning in patients with obsessive-compulsive disorder
Raşit Tükel 1 , Hakan Gürvit 2 , Berna Özata 1 , Banu Aslantaş Ertekin 1 , Erhan Ertekin 1 , Bengi Baran 2 , Şükriye Akça Kalem 2 ,
Nalan Öztürk 1 , Güher Saruhan Direskeneli 3
1 Istanbul University, Istanbul Faculty of Medicine, Department of Psychiatry, İstanbul, Turkey
2 Istanbul University, Istanbul Faculty of Medicine, Department of Neurology, İstanbul, Turkey
3 Istanbul Faculty of Medicine, Department of Physiology, Istanbul University, İstanbul, Turkey
E-mail: rtukel@gmail.com
Objective: In the present study, we investigated the association between the brain-derived neurotrophic factor (BDNF) Val66Met
polymorphism and performance on tests measuring executive functions in a sample of patients with obsessive-compulsive disorder
(OCD).
Method: A total of 71 patients diagnosed with OCD by the DSM-IV criteria were included in the study. All patients were assessed using the
Yale-Brown Obsessive-Compulsive Scale and the Hamilton Depression Rating Scale. Patients also performed the Wisconsin Card Sorting
Test (WCST), the Trail Making Test part A (TMT A) and part B (TMT B), the Tower of London Test (ToL), the Verbal Fluency Test (semantic and
lexical fluency) and the Stroop Test. Genomic DNA was extracted from whole blood. The single nucleotide polymorphism (G/A) leading
to amino acid substitution at the 66 codon in the BDNF gene (dbSNP number rs6265) was screened by a polymerase chain reaction
and restriction digestion analysis in the DNA samples. The performance of the patients on the neuropsychological tests of executive
functioning was compared between the patients with Val/Val genotype and Met carriers.
Results: Subjects with Val/Val genotype and Met carriers (Met/Met or Val/Met genotypes) did not differ on socio-demographic and clinical
factors, except for the age of onset of the illness, which was earlier in subjects with Val/Val genotype than Met carriers. The performances on the
TMT B and TMT B-A, the Stroop Test, and the two measures of the ToL were found to be significantly lower in the Met-allele carriers, compared
to the Val/Val group. There were no significant differences in the WCST and the Verbal Fluency Test performances between the two groups.
Conclusions: These findings suggest that the BDNF Met allele may be associated with poorer performance on neuropsychological tests
of executive functions in OCD patiens.
Key words: Brain-derived neurotrophic factor, executive functions, obsessive-compulsive disorder, polymorphism
Bulletin of Clinical Psychopharmacology 2011;21(Suppl. 2):S176
S176 Bulletin of Clinical Psychopharmacology, Vol: 21, Supplement: 2, 2011 - www.psikofarmakoloji.org