Fluoxetine enhances Brain Derived Neurotropic Factor Serum Concentration and Cognition in Patients with Vascular...

Selective serotonin reuptake inhibitors (SSRIs) improve cognition in patients with stroke and increase the expression of brain-derived neurotrophic factor (BDNF) in the rat hippocampus. However, the effects of SSRIs on cognition and BDNF level in vascular dementia (VaD) patients are largely unknown. We performed an open-label study to investigate the effects of fluoxetine, a selective serotonin reuptake inhibitor, on mini-mental state examination (MMSE) score and serum BDNF level in VaD patients. Fifty VaD patients were randomly allocated to receive fluoxetine (20 mg/d; n = 25) or no fluoxetine (control group; n = 25) for 12 weeks. Both groups received secondary prevention of stroke. Baseline serum BDNF level correlated with MMSE score (r = 0.326, p = 0.021). MMSE score increased in the fluoxetine group (15.1 ± 3.0 at baseline vs. 16.1 ± 2.9 at week 12, p = 0.0004) but not in the control group (15.7 ± 2.6 vs. 15.8 ± 2.7, p = 0.566). Serum BDNF level increased in the fluoxetine group (21.2 ± 3.2 ng/ml at baseline vs. 25.7 ± 4.0 ng/ml at week 12, p < 0.001) but not in the control group (21.4 ± 5.8 ng/ml vs. 21.5 ± 6.9 ng/ml, p = 0.921). In the fluoxetine group, the increase in serum BDNF level correlated with the increase in MMSE score (r = 0.413, p = 0.04). The utility of SSRIs during cognitive recovery of VaD patients requires further investigation. BDNF may play an important role in cognitive recovery. (Trial registration: chictr.org, Identifier: ChiCTR-TRC-12002247).