Effects of fluoxetine on brain-derived neurotrophic factor serum concentration and cognition in patients with vascular dementia

Background: Selective serotonin reuptake inhibitors improve cognition in patients with stroke and increase the expression of brain-derived neurotrophic factor (BDNF) in the rat hippocampus. However, the effects of selective serotonin reuptake inhibitors on cognition and serum BDNF levels in patients with vascular dementia are largely unknown. We performed an open-label study to investigate the effects of fluoxetine, a selective serotonin reuptake inhibitor, on cognition and serum BDNF levels in patients with vascular dementia. Methods: Fifty patients with vascular dementia were randomly allocated to receive fluoxetine (20 mg/day; n=25) or no fluoxetine (control group; n=25) for 12 weeks. Both groups received secondary prevention of stroke. Serum BDNF level, Mini-Mental State Examination (MMSE) score, Ten-Point Clock Drawing score, and Digit Span Test and Verbal Fluency Test scores were measured at baseline and at week 12 in the both groups. Results: The baseline serum BDNF level correlated significantly with the MMSE score. MMSE score, Ten-Point Clock Drawing score, and serum BDNF level increased significantly in the fluoxetine group but not in the control group. The increase in serum BDNF level correlated with the increase in MMSE score in the fluoxetine group. Conclusion: Fluoxetine may potentially improve cognition in patients with vascular dementia and requires further investigation. BDNF may play an important role in cognitive recovery.