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Journal of Clinical and
Basic Psychosomatics BDNF in psychotherapy

implies that changes in neural processes with correlates, which may influence transcriptional activity, as well
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ultimately, in brain chemistry underlie the effects of any as the downstream effectors of BDNF, specifically the
successful therapeutic intervention. TrkB receptor, which responds to BDNF activity and
The increasing arsenal of molecular biological is considered a critical mediator of antidepressant and
techniques developed over the past 60 years has only recently antianxiety effects. 15
been applied to understanding the neuronal mechanisms Each of these factors has been implicated in the brain
of psychotherapy. These techniques have progressed dysfunction associated with both MDD 16,17 and anxiety
from the assessing of neurotransmitters and other small disorders. 18,19 Furthermore, they have been investigated in
molecules, through the determination of proteins both relation to the response to antidepressant pharmacotherapy.
structural and functional, to the measurement of mRNA as This can increase BDNF in the blood (serum, plasma,
an indicator of gene expression, as well as the identification and platelets) in patients with depression after treatment;
of genetic and, most recently, epigenetic factors that might however, differences in the response to antidepressant
influence neuronal function. However, in the past few treatment are also associated with BDNF genotypes. 20
years, there has been an increasing recognition that these This review and commentary aimed to assess the
molecular approaches may be of value in understanding current status of research investigating the role of BDNF
the processes underlying psychotherapies, often with the in the responses of people with anxiety and depression
particular aim of identifying those individuals likely, or to psychotherapy. Both anxiety- and depression-like
likely not, to respond to a particular treatment.
behaviors can be induced by chronic stress, which can also
The targets for investigation of therapeutic mechanisms reduce BDNF levels. Therefore, effective psychotherapy
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have often derived from current understanding of the may also influence BDNF in conjunction with stress
molecular pathology of the relevant disease, in this context reduction, ameliorating the symptoms of depression
the most pertinent of which are anxiety and depression. and anxiety. Psychotherapeutic treatment covers a broad
The neurotransmitter dysfunction thought to be involved range of interventions; in this review, we will focus
in some of the symptoms of these disorders, notably on talking therapies, of which cognitive behavioral
but not exclusively serotonin, provides a source for the therapy (CBT) is the most commonly studied. Other
development of hypotheses to study. Although important therapeutic interventions included are interpersonal,
in pharmacotherapy, such neurotransmitter systems may psychodynamic, and family therapies as well as meditation
not represent the primary pathology of mood disorders and mindfulness-based (MBCT) approaches. All relevant
or explain the pathogenic mechanisms. Other substances studies were indexed in PubMed and Web of Science
fundamental to maintaining the structure and function before April 30, 2024. In total, 135 articles were retrieved
of the healthy brain have attracted interest. One such with the search terms “BDNF CBT; BDNF psychotherapy;
molecule is the brain-derived neurotrophic factor (BDNF). BDNF mindfulness therapy or meditation therapy; BDNF
BDNF is a protein expressed in many organs of the interpersonal therapy; BDNF methylation psychotherapy.”
body, including the brain, where it appears to play an We also reviewed the search terms “BDNF mindfulness
essential role in the growth, maintenance, and survival meditation therapy, BDNF MBCT, BDNF psychodynamic
of neurons through actions at its specific receptor TrkB. psychotherapy” and found that they were all included in the
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Through these mechanisms, it is implicated in learning previous search. Thereafter, the 135 papers were reviewed
and memory processes and their associated dysfunction. individually to determine whether they contained original
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As such, it has been studied in various neurological and data on the association of BDNF protein, genotype, or gene
psychiatric diseases, ranging from Alzheimer’s disease methylation with psychotherapeutic outcome, resulting in
to schizophrenia, with numerous studies investigating the identification of 14 relevant papers (Tables 1 and 2).
its potential involvement in major depressive disorder 2. BDNF and psychotherapy
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(MDD) and anxiety. 11
2.1. Plasma and serum BDNF
Among the various ways of assessing BDNF function,
two features have been particularly valuable in supporting Peripheral BDNF is a readily available measure obtained
research: a common functional polymorphism (rs6265; from blood plasma or serum. These two sources yield very
val66met) in BDNF and the fact that BDNF is measurable different concentrations of BDNF protein: typically, two
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in blood samples, both in low levels in the plasma and orders of magnitude higher in serum due to the release of
higher concentrations in the serum because it is released stored platelet BDNF on coagulation. Unfortunately, many
from platelet stores. Other study targets related to studies and reviews of blood BDNF have not considered
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BDNF activity include DNA methylation sites in BDNF, or discussed this difference, often including plasma and

Volume 3 Issue 1 (2025) 23 doi: 10.36922/jcbp.4461