Neurotrophic factors and the regulation of CREB as a marker and putative predictor of treatment response in major depression

Neuroplasticity has become a well recognized concept in major depression with the transcription factor CREB and its activation by phosphorylation playing a key role (1). However, so far there are no studies in vivo in patients during antidepressant treatment. Therefore, we investigated CREB phosphorylation in peripheral lymphocytes of 14 patients with major depression during antidepressive medication and of 13 patients during exclusive psychotherapy (IPT) and associated clinical response (HAMD) with the effect on this biological parameter. We hypothesize that activation of CREB is associated with clinical improvement.

We found that increase in CREB phosphorylation is significantly associated with clinical improvement regardless of the kind of therapy applied. In an ongoing study we further investigate whether or not an increase in CREB phosphorylation early during therapy meets criteria for a predictive value.

Thus, for the first time, we demonstrated that measuring CREB phosphorylation in peripheral blood lymphocytes is efficient as biological „blood test“ parameter to at least follow clinical response. As there was no difference between the treatment groups the increase in CREB phosphorylation is rather an effect of clinical improvement than of medication.

Hinze-Selch et al. Nervenheilkunde 2002, 21:497–501