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Chen H, Dong G, Li K. Overview on brain function enhancement of Internet addicts through exercise intervention: Based on reward-execution-decision cycle. Front Psychiatry 2023; 14:1094583. [PMID: 36816421 PMCID: PMC9933907 DOI: 10.3389/fpsyt.2023.1094583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2022] [Accepted: 01/13/2023] [Indexed: 02/05/2023] Open
Abstract
Internet addiction (IA) has become an impulse control disorder included in the category of psychiatric disorders. The IA trend significantly increased after the outbreak of the new crown epidemic. IA damages some brain functions in humans. Emerging evidence suggests that exercise exerts beneficial effects on the brain function and cognitive level damaged by IA. This work reviews the neurobiological mechanisms of IA and describes the brain function impairment by IA from three systems: reward, execution, and decision-making. Furthermore, we sort out the research related to exercise intervention on IA and its effect on improving brain function. The internal and external factors that produce IA must be considered when summarizing movement interventions from a behavioral perspective. We can design exercise prescriptions based on exercise interests and achieve the goal of quitting IA. This work explores the possible mechanisms of exercise to improve IA through systematic analysis. Furthermore, this work provides research directions for the future targeted design of exercise prescriptions.
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Affiliation(s)
- Hao Chen
- Department of Sports, Quzhou University, Quzhou, China.,Department of Graduate School of Education, Shandong Sport University, Jinan, China
| | - Guijun Dong
- Department of Sports, Quzhou University, Quzhou, China.,Department of Graduate School of Education, Shandong Sport University, Jinan, China
| | - Kefeng Li
- Department of Medicine, Quzhou College of Technology, Quzhou, China
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2
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Strafella R, Chen R, Rajji TK, Blumberger DM, Voineskos D. Resting and TMS-EEG markers of treatment response in major depressive disorder: A systematic review. Front Hum Neurosci 2022; 16:940759. [PMID: 35992942 PMCID: PMC9387384 DOI: 10.3389/fnhum.2022.940759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Accepted: 06/28/2022] [Indexed: 11/28/2022] Open
Abstract
Electroencephalography (EEG) is a non-invasive method to identify markers of treatment response in major depressive disorder (MDD). In this review, existing literature was assessed to determine how EEG markers change with different modalities of MDD treatments, and to synthesize the breadth of EEG markers used in conjunction with MDD treatments. PubMed and EMBASE were searched from 2000 to 2021 for studies reporting resting EEG (rEEG) and transcranial magnetic stimulation combined with EEG (TMS-EEG) measures in patients undergoing MDD treatments. The search yielded 966 articles, 204 underwent full-text screening, and 51 studies were included for a narrative synthesis of findings along with confidence in the evidence. In rEEG studies, non-linear quantitative algorithms such as theta cordance and theta current density show higher predictive value than traditional linear metrics. Although less abundant, TMS-EEG measures show promise for predictive markers of brain stimulation treatment response. Future focus on TMS-EEG measures may prove fruitful, given its ability to target cortical regions of interest related to MDD.
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Affiliation(s)
- Rebecca Strafella
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada
- Temerty Centre for Therapeutic Brain Intervention, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Robert Chen
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada
- Krembil Research Institute, Toronto Western Hospital, University Health Network, Toronto, ON, Canada
- Division of Neurology, Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - Tarek K. Rajji
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada
- Temerty Centre for Therapeutic Brain Intervention, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Toronto Dementia Research Alliance, University of Toronto, Toronto, ON, Canada
| | - Daniel M. Blumberger
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada
- Temerty Centre for Therapeutic Brain Intervention, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Daphne Voineskos
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada
- Temerty Centre for Therapeutic Brain Intervention, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Krembil Research Institute, Toronto Western Hospital, University Health Network, Toronto, ON, Canada
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- *Correspondence: Daphne Voineskos
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Rodrigues SLDS, Silva JMD, Oliveira MCCD, Santana CMFD, Carvalho KM, Barbosa BJAP. Physical exercise as a non-pharmacological strategy for reducing behavioral and psychological symptoms in elderly with mild cognitive impairment and dementia: a systematic review of randomized clinical trials. ARQUIVOS DE NEURO-PSIQUIATRIA 2021; 79:1129-1137. [PMID: 34877985 DOI: 10.1590/0004-282x-anp-2020-0539] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Accepted: 03/30/2021] [Indexed: 12/30/2022]
Abstract
BACKGROUND Elderly people with dementia may exhibit behavioral and psychological symptoms throughout the course of disease. Non-pharmacological therapies, such as regular physical activity, are considered strategies for managing these symptoms. OBJECTIVE The aim of this study was to investigate whether participation in physical exercise programs is effective in reducing behavioral and neuropsychiatric symptoms in elderly people with Mild Cognitive Impairment (MCI) and dementia. METHODS A literature review was carried out in MEDLINE (PubMed), SciELO, Web of Science, Scopus and SPORTDiscus databases from 2010 to 2020. The eligible studies were randomized clinical trials involving elderly people with mild cognitive impairment or dementia and assessing changes in neuropsychiatric and psychological symptoms as primary or secondary outcomes. The studies had a group with only physical exercise as an intervention compared to a control group. RESULTS Of 175 publications identified in the initial survey, only 7 studies met the eligibility criteria. Four out of 7 studies demonstrated positive effects in reducing behavioral symptoms, while the others did not report differences between gains according to the type of protocol. CONCLUSIONS Moderate to intense aerobic and muscle strengthening exercises may have a potential benefit in the management of behavioral and psychological symptoms in dementia, but studies varied in their conclusions. This review indicates the need for further intervention studies to investigate, as a primary outcome, the absolute effect of physical exercise and its impact on behavioral and psychological symptoms in elderly people with MCI dementia, especially in the early stages of the disease.
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Affiliation(s)
| | | | | | | | | | - Breno José Alencar Pires Barbosa
- Instituto de Medicina Integral Prof. Fernando Figueira, Recife PE, Brazil
- Universidade Federal de Pernambuco, Centro de Ciências Médicas, Área Acadêmica de Neuropsiquiatria, Recife PE, Brazil
- Universidade de São Paulo, Faculdade de Medicina, Departamento de Neurologia, Grupo de Neurologia Cognitiva e do Comportamento, São Paulo SP, Brazil
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4
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Fossati C, Torre G, Vasta S, Giombini A, Quaranta F, Papalia R, Pigozzi F. Physical Exercise and Mental Health: The Routes of a Reciprocal Relation. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182312364. [PMID: 34886090 PMCID: PMC8656946 DOI: 10.3390/ijerph182312364] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/19/2021] [Revised: 11/15/2021] [Accepted: 11/22/2021] [Indexed: 01/18/2023]
Abstract
Sport participation and exercise practice are considered to be beneficial for mental status, yielding an improved mood and better quality of life. On the other hand, good mental fitness is thought to lead to better physical status and sport performance. The key aim of this narrative review is to provide an unstructured overview on the topic with special considerations on the role of mental and physical health to summarize the evidence on their reciprocal influence. While very few papers describe the role of mental health measures in affecting physical performance, more evidence is available concerning the effect of exercise and sport in improving mental health outcomes. Furthermore, there is a consistent role of depressive and anxiety symptoms in influencing the risk of sport injury in either recreational or elite athletes. Moreover, the importance of investigating mental health issues in elite and retired athletes is highlighted. On the basis of the available literature, several biases were found to affect the provided evidence mainly because of the complexity of a proper study design in this field.
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Affiliation(s)
- Chiara Fossati
- Department of Movement, Human and Health Sciences, University of Rome “Foro Italico”, 00135 Rome, Italy; (C.F.); (A.G.); (F.Q.); (F.P.)
| | - Guglielmo Torre
- Department of Orthopaedic and Trauma Surgery, Campus Bio-Medico University of Rome, 00128 Rome, Italy; (S.V.); (R.P.)
- Correspondence:
| | - Sebastiano Vasta
- Department of Orthopaedic and Trauma Surgery, Campus Bio-Medico University of Rome, 00128 Rome, Italy; (S.V.); (R.P.)
| | - Arrigo Giombini
- Department of Movement, Human and Health Sciences, University of Rome “Foro Italico”, 00135 Rome, Italy; (C.F.); (A.G.); (F.Q.); (F.P.)
| | - Federico Quaranta
- Department of Movement, Human and Health Sciences, University of Rome “Foro Italico”, 00135 Rome, Italy; (C.F.); (A.G.); (F.Q.); (F.P.)
| | - Rocco Papalia
- Department of Orthopaedic and Trauma Surgery, Campus Bio-Medico University of Rome, 00128 Rome, Italy; (S.V.); (R.P.)
| | - Fabio Pigozzi
- Department of Movement, Human and Health Sciences, University of Rome “Foro Italico”, 00135 Rome, Italy; (C.F.); (A.G.); (F.Q.); (F.P.)
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5
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Moraes HS, Silveira HS, Oliveira NA, Matta Mello Portugal E, Araújo NB, Vasques PE, Bergland A, Santos TM, Engedal K, Coutinho ES, Schuch FB, Laks J, Deslandes AC. Is Strength Training as Effective as Aerobic Training for Depression in Older Adults? A Randomized Controlled Trial. Neuropsychobiology 2020; 79:141-149. [PMID: 31658460 DOI: 10.1159/000503750] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Accepted: 09/21/2019] [Indexed: 11/19/2022]
Abstract
BACKGROUND This study aimed to compare the effects of aerobic training (AT), strength training (ST) and low-intensity exercise in a control group (CG) as adjunct treatments to pharmacotherapy for major depressive disorder (MDD) in older persons. METHODS Older persons clinically diagnosed with MDD (n = 27) and treated with antidepressants were blindly randomized into three groups: AT, ST and a CG. All patients were evaluated prior to and 12 weeks after the intervention. RESULTS Compared with the CG, the AT and ST groups showed significant reductions in depressive symptoms (treatment -response = 50% decrease in the pre- to postintervention assessment) through the Hamilton Depression Rating Scale (AT group: χ2, p = 0.044) and Beck Depression Inventory (ST group: χ2, p = 0.044). CONCLUSION Adding AT or ST with moderate intensity to the usual treatment promoted a greater reduction of MDD symptoms.
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Affiliation(s)
- Helena S Moraes
- Laboratório de Neurociência do Exercício, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil, .,Programa de Pós-Graduação em Psiquiatria e Saúde Mental, Instituto de Psiquiatria, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil,
| | - Heitor S Silveira
- Laboratório de Neurociência do Exercício, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
| | - Natacha A Oliveira
- Laboratório de Neurociência do Exercício, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
| | | | - Narahyana B Araújo
- Programa de Pós-Graduação em Psiquiatria e Saúde Mental, Instituto de Psiquiatria, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
| | - Paulo E Vasques
- Laboratório de Neurociência do Exercício, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
| | - Astrid Bergland
- Department of Physiotherapy, Faculty of Health Sciences, Oslo and Akershus University College of Applied Sciences, Oslo, Norway
| | - Tony M Santos
- Departamento de Educação Física, Universidade Federal de Pernambuco (UFPE), Recife, Brazil
| | - Knut Engedal
- Norwegian Centre for Aging and Health, Vestfold Health Trust and the University of Oslo, Oslo, Norway
| | - Evandro S Coutinho
- Instituto de Medicina Social da Universidade do Estado do Rio de Janeiro (UERJ), Rio de Janeiro, Brazil
| | - Felipe B Schuch
- Departamento de Métodos e Técnicas Desportivas, Universidade Federal de Santa Maria, Santa Maria, Brazil
| | - Jerson Laks
- Programa de Pós-Graduação em Psiquiatria e Saúde Mental, Instituto de Psiquiatria, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil.,Programa de Pós-Graduação em Biomedicina Translacional, Universidade do Grande Rio (Unigranrio), Duque de Caxias, Brazil
| | - Andrea C Deslandes
- Laboratório de Neurociência do Exercício, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil.,Programa de Pós-Graduação em Psiquiatria e Saúde Mental, Instituto de Psiquiatria, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
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6
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Alghadir AH, Gabr SA. Hormonal Function Responses to Moderate Aerobic Exercise in Older Adults with Depression. Clin Interv Aging 2020; 15:1271-1283. [PMID: 32821089 PMCID: PMC7423410 DOI: 10.2147/cia.s259422] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Accepted: 07/14/2020] [Indexed: 12/02/2022] Open
Abstract
Background Poor daily life physical activities among older people were related to depressive mood especially memory loss. In addition to that, the change in physical ability is significantly associated with the score of depression among older age. Objective The present study aimed to evaluate the effects of a supervised aerobic training program with moderate intensity for 12 weeks on mood profiles and hormonal levels of the hypothalamus-pituitary-adrenal axis (HPA axis) of older adults. Methods A total of 80 individuals of both gender (90 males, 110 females) of ages ranged between 65 and 95 years were recruited for this study. Based upon the profile of mood states (POMS) analysis, the participants were classified into two groups: control group (n=30) and depressive group (n=50). Leisure-time physical activity (LTPA), adrenal hormones such as ACTH, corticosterone (CORT), cortisol, DHEA/S, and cortisol:DHEA/S ratio were measured at baseline and post-intervention of moderate aerobic exercise for 12 weeks. Results Older adults with higher depressive scores showed a remarkable change in the level of adrenal hormones compared to control. There was a significant increase in the level of ACTH, CORT, cortisol, and cortisol:DHEA/S ratio, and decrease in DHEA/S. Compared to females, males showed an improvement in depressive mood score along with an increase in LPTA, DHEA/S and decrease in ACTH, CORT, cortisol, cortisol:DHEA/S ratio following 12 weeks of supervised aerobic training, respectively. Conclusion The findings of this study showed that 12 weeks of supervised exercise interventions are promising non-drug therapeutic strategies in improving depression among older adults. The potential performance in a psychological state occurs physiologically via optimizing the levels of the hormones of the HPA axis.
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Affiliation(s)
- Ahmad H Alghadir
- Rehabilitation Research Chair (RRC), College of Applied Medical Sciences (CAMS), King Saud University, Riyadh, Kingdom of Saudi Arabia
| | - Sami A Gabr
- Rehabilitation Research Chair (RRC), College of Applied Medical Sciences (CAMS), King Saud University, Riyadh, Kingdom of Saudi Arabia
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7
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Gramkow MH, Hasselbalch SG, Waldemar G, Frederiksen KS. Resting State EEG in Exercise Intervention Studies: A Systematic Review of Effects and Methods. Front Hum Neurosci 2020; 14:155. [PMID: 32477081 PMCID: PMC7232557 DOI: 10.3389/fnhum.2020.00155] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Accepted: 04/08/2020] [Indexed: 12/18/2022] Open
Abstract
Background: Exercise has been shown to alter brain plasticity and is explored as a therapeutic intervention in a wide variety of neurological diseases. Electroencephalography (EEG) offers an inexpensive method of studying brain electrocortical activity shortly after exercise and thus offers a way of exploring the influence of exercise on the brain. We conducted a systematic review to summarize the current body of evidence regarding methods of EEG analysis and the reported effects of exercise interventions on EEG. Methods: PubMed, Web of Science and EMBASE were searched for studies investigating resting state EEG in exercise intervention studies carried out in participants >17 years of age and with no history of epilepsy. Further, studies solely investigating event-related potentials as an outcome measure were excluded. Relevant data were extracted, and a risk-of-bias assessment was carried out using the Cochrane risk-of-bias tool. A qualitative synthesis of results was carried out. A protocol for the systematic review was uploaded to https://www.crd.york.ac.uk/PROSPERO/ (ID: CRD42019134570) and the Preferred Reporting Items for Systematic Reviews (PRISMA) statement was followed. Results: Out of 1,993 records screened, 54 studies were included in a final qualitative synthesis with a total of 1,445 participants. Our synthesis showed that studies were mainly carried out using frequency analysis as an analytical method. Generally, findings across studies were inconsistent and few were adjusted for multiple comparisons. Studies were mainly of low quality and usually carried out in small populations, lowering the significance of results reported. Conclusions: Changes in the EEG as a result of an exercise intervention are elusive and difficult to replicate. Future studies should provide biologically sound hypotheses underlying assumptions, include larger populations and use standardized EEG methods to increase replicability. EEG remains an interesting methodology to examine the effects of exercise on the brain.
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Affiliation(s)
- Mathias Holsey Gramkow
- Department of Neurology, Danish Dementia Research Centre, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Steen Gregers Hasselbalch
- Department of Neurology, Danish Dementia Research Centre, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Gunhild Waldemar
- Department of Neurology, Danish Dementia Research Centre, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Kristian Steen Frederiksen
- Department of Neurology, Danish Dementia Research Centre, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
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8
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Keller AS, Leikauf JE, Holt-Gosselin B, Staveland BR, Williams LM. Paying attention to attention in depression. Transl Psychiatry 2019; 9:279. [PMID: 31699968 PMCID: PMC6838308 DOI: 10.1038/s41398-019-0616-1] [Citation(s) in RCA: 106] [Impact Index Per Article: 21.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Revised: 10/08/2019] [Accepted: 10/15/2019] [Indexed: 01/05/2023] Open
Abstract
Attention is the gate through which sensory information enters our conscious experiences. Oftentimes, patients with major depressive disorder (MDD) complain of concentration difficulties that negatively impact their day-to-day function, and these attention problems are not alleviated by current first-line treatments. In spite of attention's influence on many aspects of cognitive and emotional functioning, and the inclusion of concentration difficulties in the diagnostic criteria for MDD, the focus of depression as a disease is typically on mood features, with attentional features considered less of an imperative for investigation. Here, we summarize the breadth and depth of findings from the cognitive neurosciences regarding the neural mechanisms supporting goal-directed attention in order to better understand how these might go awry in depression. First, we characterize behavioral impairments in selective, sustained, and divided attention in depressed individuals. We then discuss interactions between goal-directed attention and other aspects of cognition (cognitive control, perception, and decision-making) and emotional functioning (negative biases, internally-focused attention, and interactions of mood and attention). We then review evidence for neurobiological mechanisms supporting attention, including the organization of large-scale neural networks and electrophysiological synchrony. Finally, we discuss the failure of current first-line treatments to alleviate attention impairments in MDD and review evidence for more targeted pharmacological, brain stimulation, and behavioral interventions. By synthesizing findings across disciplines and delineating avenues for future research, we aim to provide a clearer outline of how attention impairments may arise in the context of MDD and how, mechanistically, they may negatively impact daily functioning across various domains.
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Affiliation(s)
- Arielle S Keller
- Graduate Program in Neurosciences, Stanford University, Stanford, CA, USA
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA
| | - John E Leikauf
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA
| | - Bailey Holt-Gosselin
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA
| | - Brooke R Staveland
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA
| | - Leanne M Williams
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA.
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Al-Qahtani AM, Shaikh MAK, Shaikh IA. Exercise as a treatment modality for depression: A narrative review. ALEXANDRIA JOURNAL OF MEDICINE 2019. [DOI: 10.1016/j.ajme.2018.05.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Affiliation(s)
- Awad Mohammed Al-Qahtani
- Department of Family & Community Medicine, Faculty of Medicine, Najran University, Najran, Saudi Arabia
| | | | - Ibrahim Ahmed Shaikh
- Department of Pharmacology, College of Pharmacy, Najran University, Najran, Saudi Arabia
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10
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Villafaina S, Sitges C, Collado-Mateo D, Fuentes-García JP, Gusi N. Influence of depressive feelings in the brain processing of women with fibromyalgia: An EEG study. Medicine (Baltimore) 2019; 98:e15564. [PMID: 31083224 PMCID: PMC6531145 DOI: 10.1097/md.0000000000015564] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Depression is one of the most common mental health problems which affects more than 10% of the global population. The prevalence of this disorder is higher in fibromyalgia patients. However, the influence of the combination of depression and fibromyalgia in the brain processing is poorly understood.To explore the modifications of EEG power spectrum in women with fibromyalgia when depressive feelings are elicited.Twenty eight women with fibromyalgia participated in this cross-sectional study. They were classified as women with depression or women without depression according to the score in the Geriatric Depression Scale. This questionnaire was used to elicit depression symptoms during the EEG recording. Analyses were performed with the standardized LOw Resolution Electric Tomography (sLORETA) software. Power spectrum were compared in the following frequency bands: delta, theta, alpha-1, alpha-2, beta-1, beta-2, and beta-3.Fibromyalgia patients with untreated depression showed a hypoactivation of the left hemisphere when compared with fibromyalgia patients without depression. In addition, when compared fibromyalgia patients without depression and women with both fibromyalgia and depression who were taking antidepressant medications, differences in EEG power spectrum in the studied frequency bands were not found.The current study contributes to the understanding on the influence of the combination of fibromyalgia and depression in the brain activity patterns. Patients with untreated depression showed a hypoactivation of the left hemisphere while eliciting depression symptoms. However, further research is needed, antidepressant medication might reduce the differences between patients with depression and those who do not suffer from depression symptoms.
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Affiliation(s)
- Santos Villafaina
- Physical Activity and Quality of Life Research Group (AFYCAV), Faculty of Sport Science, University of Extremadura
- EXERNET Research Network on Exercise and Health in Special Populations
| | - Carolina Sitges
- Balearic Islands Health Research Institute (IdISBa), Research Institute on Health Sciences (IUNICS), University of Balearic Islands (UIB
| | - Daniel Collado-Mateo
- Physical Activity and Quality of Life Research Group (AFYCAV), Faculty of Sport Science, University of Extremadura
- EXERNET Research Network on Exercise and Health in Special Populations
- Facultad de Educación, Universidad Autónoma de Chile, Talca, Chile
| | | | - Narcis Gusi
- Physical Activity and Quality of Life Research Group (AFYCAV), Faculty of Sport Science, University of Extremadura
- EXERNET Research Network on Exercise and Health in Special Populations
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11
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Beserra AHN, Kameda P, Deslandes AC, Schuch FB, Laks J, Moraes HSD. Can physical exercise modulate cortisol level in subjects with depression? A systematic review and meta-analysis. TRENDS IN PSYCHIATRY AND PSYCHOTHERAPY 2019; 40:360-368. [PMID: 30570106 DOI: 10.1590/2237-6089-2017-0155] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Accepted: 05/03/2018] [Indexed: 01/03/2023]
Abstract
INTRODUCTION Major depressive disorder (MDD) is a prevalent medical illness that is associated with chronic stress. Patients with MDD can show an imbalance in cortisol levels, which can be restored with the remission of symptoms. Physical exercise training has been used as a tool to promote changes in cortisol levels in healthy individuals. However, it is unknown if exercise can produce the same results in individuals with MDD. OBJECTIVE To review evidence of cortisol changes after exercise training in individuals with MDD. METHODS We conducted a search on PubMed, SciELO, LILACS, ISI Web of Knowledge, Scopus, and PsycInfo databases. Random effects meta-analysis was performed and standardized mean difference (SMD) effect size was calculated. Analyses of forest and funnel plots was conducted using Stata v.11.0 software. RESULTS At first, 463 studies were obtained in the search. After completion of the selection procedure, five articles with seven analyses were included. Type of exercise, frequency of training, cortisol measurement, and type of control group were analyzed. There was a reduction of cortisol levels in the exercise group (SMD = -0.65, 95%CI 1.30-0.01). Moreover, sensitivity analysis and subgroup analyses revealed an effect of type (aerobic exercise) and frequency (five times per week) of exercise on reduction of cortisol levels. However, these results should be interpreted cautiously due to the small number of studies and a substantial heterogeneity among them. CONCLUSION Physical exercise promotes a reduction in cortisol levels in individuals with MDD. However, this finding can be influenced by type of exercise, weekly frequency, and type of cortisol measurement.
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Affiliation(s)
- Ana Heloisa Nascimento Beserra
- Instituto de Psiquiatria, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brazil.,Laboratório de Neurociência do Exercício (LaNEx), UFRJ, Rio de Janeiro, RJ, Brazil
| | - Priscila Kameda
- Instituto de Psiquiatria, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brazil.,Laboratório de Neurociência do Exercício (LaNEx), UFRJ, Rio de Janeiro, RJ, Brazil
| | - Andrea Camaz Deslandes
- Instituto de Psiquiatria, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brazil.,Laboratório de Neurociência do Exercício (LaNEx), UFRJ, Rio de Janeiro, RJ, Brazil
| | | | - Jerson Laks
- Instituto de Psiquiatria, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brazil.,Programa de Pós-Graduação em Biomedicina Translacional, Universidade do Grande Rio (Unigranrio), Duque de Caxias, RJ, Brazil
| | - Helena Sales de Moraes
- Instituto de Psiquiatria, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brazil.,Laboratório de Neurociência do Exercício (LaNEx), UFRJ, Rio de Janeiro, RJ, Brazil
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12
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Kaur R, Lin X, Layton A, Hernandez M, Sowers R. Virtual Reality, Visual Cliffs, and Movement Disorders. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2018; 2018:81-84. [PMID: 30440346 DOI: 10.1109/embc.2018.8512246] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
We outline an experimental setup designed to dynamically understand neural responses to visual cliffs while walking. The goal of our work is understanding and mitigating fear of falling, particularly among the elderly. In our setup, an EEG cap monitors a subject's neural activity while the subject is immersed in a virtual world and walking on an instrumented treadmill. The subject's response to visual stimuli is measured by both the EEG cap and by speed and pressure data from the treadmill. Based on this data, we can dynamically alter the landscape in the virtual world. We hope that our setup may be useful in helping subjects develop mechanisms to compensate for significant fear of falling while walking.
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Kaiser AK, Gnjezda MT, Knasmüller S, Aichhorn W. Electroencephalogram alpha asymmetry in patients with depressive disorders: current perspectives. Neuropsychiatr Dis Treat 2018; 14:1493-1504. [PMID: 29928121 PMCID: PMC6001846 DOI: 10.2147/ndt.s137776] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
PURPOSE Electroencephalogram (EEG) alpha asymmetry (AA) in depressive disorders has been of interest over the last few decades, but it continues to remain unclear whether EEG AA can discriminate between healthy and depressive individuals. MATERIALS AND METHODS A systematic literature search for papers addressing EEG AA using the keywords alpha asymmetry, depression, and EEG was performed in PubMed. All studies were checked for sample size, gender, handedness, reference, recording protocol, EEG band range, impedance, type of analysis, drugs, and comorbidity. RESULTS A total of 61 articles were found, of which 44 met our inclusion criteria. They have been consecutively analyzed in respect of methodology and results. Approximately 25% (11/44) of the studies did not mention or ignored handedness, 41% (18/44) of the studies used data with only self-reported handedness, and only 34.1% (15/44) of all studies tested handedness. Only 35% (15/44) of the studies reported pharmacological treatment, and only 35% (15/44) of the studies controlled for medication. A total of 52% (23/44) of the studies reported comorbidity, and only 30% (13/44) of the studies controlled for comorbidity. Only 29.6% (13/44) of the studies reported education. In all, 30.5% (13/44) of the studies analyzed group differences and correlations, while 15.9 (7/44) of the studies used only correlational analyses. A total of 52.3% (23/44) of the studies analyzed only group differences. Alpha range was fixed (8-13 Hz) in 59.1% (26/44) of all studies. Reference to common average was used in seven of 44 studies (15.9%). In all, nine of 44 (20.5%) studies used the midline central position as reference, 22 of 44 (50%) studies used the ear or the mastoid as reference, and four of 44 (9.1%) studies used the nose as reference. CONCLUSION Discriminative power of EEG AA for depressed and healthy controls remains unclear. A systematic analysis of 44 studies revealed that differences in methodology and disregarding proper sampling are problematic. Ignoring handedness, gender, age, medication, and comorbidity could explain inconsistent findings. Hence, we formulated a guideline for requirements for future studies on EEG AA in order to allow for better comparisons.
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Affiliation(s)
- Andreas Kurt Kaiser
- Department of Clinical Psychology, Salzburger Landeskliniken Betriebs-GesmbH, Christian-Doppler-Klinik, Paracelsus Medical University, Salzburg, Austria
| | - Maria-Theresa Gnjezda
- Department of Clinical Psychology, Salzburger Landeskliniken Betriebs-GesmbH, Christian-Doppler-Klinik, Paracelsus Medical University, Salzburg, Austria
| | - Stephanie Knasmüller
- Department of Clinical Psychology, Salzburger Landeskliniken Betriebs-GesmbH, Christian-Doppler-Klinik, Paracelsus Medical University, Salzburg, Austria
| | - Wolfgang Aichhorn
- Department of Psychiatry, Salzburger Landeskliniken Betriebs-GesmbH, Christian-Doppler-Klinik, Paracelsus Medical University, Salzburg, Austria
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Yuenyongchaiwat K, Pongpanit K, Hanmanop S. Physical activity and depression in older adults with and without cognitive impairment. Dement Neuropsychol 2018; 12:12-18. [PMID: 29682228 PMCID: PMC5901244 DOI: 10.1590/1980-57642018dn12-010002] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Low physical activity and depression may be related to cognitive impairment in the elderly.
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Affiliation(s)
- Kornanong Yuenyongchaiwat
- Physiotherapy Department, Faculty of Allied Health Sciences, Thammasat University, Rangsit, Pathumthani, 12120, Thailand
| | - Khajonsak Pongpanit
- Physiotherapy Department, Faculty of Allied Health Sciences, Thammasat University, Rangsit, Pathumthani, 12120, Thailand
| | - Somrudee Hanmanop
- Physiotherapy Department, Faculty of Allied Health Sciences, Thammasat University, Rangsit, Pathumthani, 12120, Thailand
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Fay P, Edmond SL, Baron JK, Joshi M. Depression screening by physical therapists: Practices, beliefs, barriers. J Back Musculoskelet Rehabil 2017; 30:1221-1229. [PMID: 28655127 DOI: 10.3233/bmr-169551] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Depression, a common comorbidity encountered in physical therapy (PT) practice, negatively impacts outcomes. There is limited knowledge of PT practice patterns relative to screening for depression. OBJECTIVE Objectives were to describe beliefs regarding depression, and identify practice patterns and perceived barriers regarding screening for depression among APTA Board Certified Orthopedic Clinical Specialist (OCS) PTs. METHODS Surveys were distributed to all PT OCSs in the US; 416 responses were analyzed. Descriptive, univariate and multiple regression analyses were performed. RESULTS Ninety-five percent of respondents believed that depression has a moderate to high influence on PT outcomes, whereas 68% believed a pre-existing diagnosis of depression influences the plan of care. Most believed that 20% or more of their current patients presented with symptoms of depression. Nevertheless, only 18% formally screen for depression during the initial evaluation. Those with formal depression screening education were 2.3 times more likely to screen at initial examination. Common barriers to screening included lack of department policy, limited knowledge and lack of follow-up resources. CONCLUSIONS Formal screening did not occur as frequently as expected, given the belief regarding depression's impact on plan of care and outcomes. Addressing barriers may assist in greater compliance with recommended screening guidelines.
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Affiliation(s)
- Patricia Fay
- Doctoral Programs in Physical Therapy, Rutgers University, Newark, NJ, USA
| | - Susan L Edmond
- Doctoral Programs in Physical Therapy, Rutgers University, Newark, NJ, USA
| | - Julia K Baron
- PHENIX Physical Therapy and Personal Wellness, Issaquah, WA, USA
| | - Michelle Joshi
- Hackensack Meridian Rehabilitation, Point Pleasant, NJ, USA
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Widdowson C, Ganhotra J, Faizal M, Wilko M, Parikh S, Adhami Z, Hernandez ME. Virtual reality applications in assessing the effect of anxiety on sensorimotor integration in human postural control. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2016; 2016:33-36. [PMID: 28268274 DOI: 10.1109/embc.2016.7590633] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Falls are a leading cause of injury and mortality among adults over the age of 65 years. Given the strong relation between fear of falling and fall risk, identification of the mechanisms that underlie anxiety-related changes in postural control may pave the way to the development of novel therapeutic strategies aimed at reducing fall risk in older adults. First, we review potential mechanisms underlying anxiety-mediated changes in postural control in older adults with and without neurological conditions. We then present a system that allows for the simultaneous recording of neural, physiological, and behavioral data in an immersive virtual reality (VR) environment while implementing sensory and mechanical perturbations to evaluate alterations in sensorimotor integration under conditions with high postural threat. We also discuss applications of VR in minimizing falls in older adults and potential future studies.
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Schuch FB, Deslandes AC, Stubbs B, Gosmann NP, Silva CTBD, Fleck MPDA. Neurobiological effects of exercise on major depressive disorder: A systematic review. Neurosci Biobehav Rev 2015; 61:1-11. [PMID: 26657969 DOI: 10.1016/j.neubiorev.2015.11.012] [Citation(s) in RCA: 155] [Impact Index Per Article: 17.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2015] [Revised: 11/02/2015] [Accepted: 11/23/2015] [Indexed: 12/22/2022]
Abstract
Exercise displays promise as an efficacious treatment for people with depression. However, no systematic review has evaluated the neurobiological effects of exercise among people with major depressive disorder (MDD). The aim of this article was to systematically review the acute and chronic biological responses to exercise in people with MDD. Two authors conducted searches using Medline (PubMed), EMBASE and PsycINFO. From the searches, twenty studies were included within the review, representing 1353 people with MDD. The results demonstrate that a single bout of exercise increases atrial natriuretic peptide (ANP), brain natriuretic peptide (BNP), copepetin and growth hormone among people with MDD. Exercise also potentially promotes long-term adaptations of copeptin, thiobarbituric acid reactive species (TBARS) and total mean frequency (TMF). However, there is limited evidence that exercise promotes adaptations on neurogenesis, inflammation biomarkers and brain structure. Associations between depressive symptoms improvement and hippocampus volume and IL-1β were found. Nevertheless, the paucity of studies and limitations presented within, precludes a more definitive conclusion of the underlying neurobiological explanation for the antidepressant effect of exercise in people with MDD. Further trials should utilize appropriate assessments of neurobiological markers in order to build upon the results of our review and further clarify the potential mechanisms associated with the antidepressant effects of exercise.
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Affiliation(s)
- Felipe Barreto Schuch
- Programa de Pós-graduação em Ciências Médicas: Psiquiatria, Universidade Federal do Rio Grande do Sul, 90150090 Porto Alegre, Brazil; Departamento de Psiquiatria, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil.
| | - Andrea Camaz Deslandes
- Programa de Pós-graduação em Ciências do Exercício e do Esporte, Universidade Estadual do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Brendon Stubbs
- Health Service and Population Research Department, Institute of Psychiatry, King's College London, London, UK; Physiotherapy Department, South London and Maudsley NHS Foundation Trust, London, UK
| | - Natan Pereira Gosmann
- Departamento de Psiquiatria, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Cristiano Tschiedel Belem da Silva
- Programa de Pós-graduação em Ciências Médicas: Psiquiatria, Universidade Federal do Rio Grande do Sul, 90150090 Porto Alegre, Brazil; Departamento de Psiquiatria, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Marcelo Pio de Almeida Fleck
- Programa de Pós-graduação em Ciências Médicas: Psiquiatria, Universidade Federal do Rio Grande do Sul, 90150090 Porto Alegre, Brazil; Departamento de Psiquiatria, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
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Jesulola E, Sharpley CF, Bitsika V, Agnew LL, Wilson P. Frontal alpha asymmetry as a pathway to behavioural withdrawal in depression: Research findings and issues. Behav Brain Res 2015; 292:56-67. [DOI: 10.1016/j.bbr.2015.05.058] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2015] [Revised: 05/21/2015] [Accepted: 05/23/2015] [Indexed: 12/28/2022]
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Khazaee-Pool M, Sadeghi R, Majlessi F, Rahimi Foroushani A. Effects of physical exercise programme on happiness among older people. J Psychiatr Ment Health Nurs 2015; 22:47-57. [PMID: 25492721 DOI: 10.1111/jpm.12168] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/22/2014] [Indexed: 11/30/2022]
Abstract
This randomized-controlled trial investigated the effect of physical exercise programme (PEP) on happiness among older adults in Nowshahr, Iran. Results of this study on 120 male and female volunteers showed that an 8-week group physical exercise programme was significantly effective in older adults' happiness. Findings showed that physical exercise programme is so beneficial for increasing older adults' happiness. Physical activity is associated with well-being and happiness. The purpose of this study was to determine the effects of an 8-week long physical exercise programme (PEP) on happiness among older adults in Nowshahr, Iran. This was a randomized control trial study. The participants consisted of a group of 120 male and female volunteers (mean ± SD age: 71 ± 5.86 years) in a convenience sampling among older adults in public parks in Nowshahr, Iran. We randomly allocated them into experimental (n = 60) and control (n = 60) groups. A validated instrument was used to measure well-being and happiness [Oxford Happiness Inventory (OHI)]. Respondents were asked to complete the OHI before and 2 months after implementing PEP. The 8-week PEP was implemented with the intervention group. The statistical analysis of the data was conducted using paired t-test, Fisher's exact test and χ(2). Before the intervention, there was no significant difference in the happiness mean score between the case and control groups; however, after implementing PEP, happiness significantly improved among the experimental group (P = 0.001) and did not improve within the control group (P = 0.79). It can be concluded that PEP had positive effects on happiness among older adults. Planning and implementing of physical activity is so important for older happiness.
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Affiliation(s)
- M Khazaee-Pool
- Department of Health Education and Promotion, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
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Carvalho A, Barbirato D, Araujo N, Martins JV, Cavalcanti JLS, Santos TM, Coutinho ES, Laks J, Deslandes AC. Comparison of strength training, aerobic training, and additional physical therapy as supplementary treatments for Parkinson's disease: pilot study. Clin Interv Aging 2015; 10:183-91. [PMID: 25609935 PMCID: PMC4293290 DOI: 10.2147/cia.s68779] [Citation(s) in RCA: 59] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction Physical rehabilitation is commonly used in patients with Parkinson’s disease (PD) to improve their health and alleviate the symptoms. Objective We compared the effects of three programs, strength training (ST), aerobic training (AT), and physiotherapy, on motor symptoms, functional capacity, and electroencephalographic (EEG) activity in PD patients. Methods Twenty-two patients were recruited and randomized into three groups: AT (70% of maximum heart rate), ST (80% of one repetition maximum), and physiotherapy (in groups). Subjects participated in their respective interventions twice a week for 12 weeks. The assessments included measures of disease symptoms (Unified Parkinson’s Disease Rating Scale [UPDRS]), functional capacity (Senior Fitness Test), and EEG before and after 12 weeks of intervention. Results The PD motor symptoms (UPDRS-III) in the group of patients who performed ST and AT improved by 27.5% (effect size [ES]=1.25, confidence interval [CI]=−0.11, 2.25) and 35% (ES=1.34, CI=−0.16, 2.58), respectively, in contrast to the physiotherapy group, which showed a 2.9% improvement (ES=0.07, CI=−0.85, 0.99). Furthermore, the functional capacity of all three groups improved after the intervention. The mean frequency of the EEG analysis mainly showed the effect of the interventions on the groups (F=11.50, P=0.0001). Conclusion ST and AT in patients with PD are associated with improved outcomes in disease symptoms and functional capacity.
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Affiliation(s)
- Alessandro Carvalho
- Centro de Doença de Alzheimer e Outros Transtornos da Velhice, Instituto de Psiquiatria, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil ; Centro de Estudo e Pesquisa do Envelhecimento, Instituto Vital Brazil, Rio de Janeiro, Brazil
| | - Dannyel Barbirato
- Centro de Doença de Alzheimer e Outros Transtornos da Velhice, Instituto de Psiquiatria, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Narahyana Araujo
- Centro de Doença de Alzheimer e Outros Transtornos da Velhice, Instituto de Psiquiatria, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Jose Vicente Martins
- Instituto de Neurologia Deolindo Couto, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Jose Luiz Sá Cavalcanti
- Instituto de Neurologia Deolindo Couto, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Tony Meireles Santos
- Departamento de Educação Física da Universidade Federal de Pernambuco, Pernambuco, Brazil
| | - Evandro S Coutinho
- Departamento de Epidemiologia e Métodos Quantitativos em saúde. Escola Nacional de Saúde Pública-FIOCRUZ, Rio de Janeiro, Brazil
| | - Jerson Laks
- Centro de Doença de Alzheimer e Outros Transtornos da Velhice, Instituto de Psiquiatria, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil ; Centro de Estudo e Pesquisa do Envelhecimento, Instituto Vital Brazil, Rio de Janeiro, Brazil
| | - Andrea C Deslandes
- Centro de Doença de Alzheimer e Outros Transtornos da Velhice, Instituto de Psiquiatria, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
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Abstract
Antidepressants are currently the treatment of choice for major depressive disorder (MDD). Nevertheless, a high percentage of patients do not respond to a first-line antidepressant drug, and combination treatments and augmentation strategies increase the risk of side effects. Moreover, a significant proportion of patients are treatment-resistant. In the last 30 years, a number of studies have sought to establish whether exercise could be regarded as an alternative to antidepressants, but so far no specific analysis has examined the efficacy of exercise as an adjunctive treatment in combination with antidepressants. We carried out a systematic review to evaluate the effectiveness of exercise as an adjunctive treatment with antidepressants on depression. A search of relevant papers was carried out in PubMed/Medline, Google Scholar, and Scopus with the following keywords: "exercise," "physical activity," "physical fitness," "depressive disorder," "depression," "depressive symptoms," "add-on," "augmentation," "adjunction," and "combined therapy." Twenty-two full-text articles were retrieved by the search. Among the 13 papers that fulfilled our inclusion criteria, we found methodological weaknesses in the majority. However, the included studies showed a strong effectiveness of exercise combined with antidepressants. Further analyses and higher quality studies are needed; nevertheless, as we have focused on a particular intervention (exercise in adjunction to antidepressants) that better reflects clinical practice, we can hypothesize that this strategy could be appropriately and safely translated into real-world practice.
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Matta Mello Portugal E, Cevada T, Sobral Monteiro-Junior R, Teixeira Guimarães T, da Cruz Rubini E, Lattari E, Blois C, Camaz Deslandes A. Neuroscience of exercise: from neurobiology mechanisms to mental health. Neuropsychobiology 2014; 68:1-14. [PMID: 23774826 DOI: 10.1159/000350946] [Citation(s) in RCA: 153] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2012] [Accepted: 03/24/2013] [Indexed: 11/19/2022]
Abstract
The neuroscience of exercise is a growing research area that is dedicated to furthering our understanding of the effects that exercise has on mental health and athletic performance. The present study examined three specific topics: (1) the relationship between exercise and mental disorders (e.g. major depressive disorder, dementia and Parkinson's disease), (2) the effects of exercise on the mood and mental health of athletes, and (3) the possible neurobiological mechanisms that mediate the effects of exercise. Positive responses to regular physical exercise, such as enhanced functional capacity, increased autonomy and improved self-esteem, are frequently described in the recent literature, and these responses are all good reasons for recommending regular exercise. In addition, physical exercise may improve both mood and adherence to an exercise program in healthy individuals and might modulate both the performance and mental health of athletes. Exercise is associated with the increased synthesis and release of both neurotransmitters and neurotrophic factors, and these increases may be associated with neurogenesis, angiogenesis and neuroplasticity. This review is a call-to-action that urges researchers to consider the importance of understanding the neuroscience of physical exercise and its contributions to sports science.
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Tavares BB, Moraes H, Deslandes AC, Laks J. Impact of physical exercise on quality of life of older adults with depression or Alzheimer's disease: a systematic review. TRENDS IN PSYCHIATRY AND PSYCHOTHERAPY 2014; 36:134-9. [DOI: 10.1590/2237-6089-2013-0064] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
INTRODUCTION: Physical exercise has been associated with improvement of quality of live (QoL), but its effect among the elderly with depression and Alzheimer's disease (AD) is still unclear. This systematic review evaluated randomized and controlled studies about the effect of physical exercise on QoL of older individuals with a clinical diagnosis of depression and AD.METHODS:We searched PubMed, ISI, SciELO and Scopus from December 2011 to June 2013 using the following keywords: physical exercise, quality of life, elderly, depression, Alzheimer's disease. Only six studies met inclusion criteria: two examined patients with AD and four, patients with depression.RESULTS: The studies used different methods to prescribe exercise and evaluate QoL, but all had high quality methods. Findings of most studies with individuals with depression suggested that exercise training improved QoL, but studies with patients with AD had divergent results.CONCLUSIONS: Although different methods were used, results suggested that physical exercise is an effective non-pharmacological intervention to improve the QoL of elderly individuals with depression and AD. Future studies should investigate the effect of other factors, such as the use of specific scales for the elderly, controlled exercise prescriptions and type of control groups.
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Deslandes A. The biological clock keeps ticking, but exercise may turn it back. ARQUIVOS DE NEURO-PSIQUIATRIA 2013; 71:113-8. [PMID: 23392323 DOI: 10.1590/s0004-282x2013000200011] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/06/2012] [Accepted: 07/24/2012] [Indexed: 11/22/2022]
Abstract
Aging is an inevitable process that is associated to loss of functional capacities in several body systems, like the cardiovascular, the skeletal muscle mass, the osteoarticular and the neuro-immune-endocrine systems. Changes appear due to interactions between genetic factors and way of life, such as diet and sedentary life style. This review shows evidence from the past twenty years concerning the importance of physical exercise to reduce the deleterious effects of aging, regarding the improvement in functional performance, the prevention of diseases and increased longevity. Moreover, physical exercise improves the cognitive function and the mood. Aerobic and strength training collaborate with the prevention and treatment of mental diseases, which are mostly prevalent in older adults, like major depression, dementia and Parkinson's disease. Several mechanisms of neurobiological action are proposed to explain how exercise can actually reduce the effects of aging.
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Affiliation(s)
- Andrea Deslandes
- Exercise Neuroscience Laboratory, Universidade Gama Filho, Rio de Janeiro, RJ, Brazil.
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Hecht D. The neural basis of optimism and pessimism. Exp Neurobiol 2013; 22:173-99. [PMID: 24167413 PMCID: PMC3807005 DOI: 10.5607/en.2013.22.3.173] [Citation(s) in RCA: 62] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2013] [Revised: 09/18/2013] [Accepted: 09/21/2013] [Indexed: 12/12/2022] Open
Abstract
Our survival and wellness require a balance between optimism and pessimism. Undue pessimism makes life miserable; however, excessive optimism can lead to dangerously risky behaviors. A review and synthesis of the literature on the neurophysiology subserving these two worldviews suggests that optimism and pessimism are differentially associated with the two cerebral hemispheres. High self-esteem, a cheerful attitude that tends to look at the positive aspects of a given situation, as well as an optimistic belief in a bright future are associated with physiological activity in the left-hemisphere (LH). In contrast, a gloomy viewpoint, an inclination to focus on the negative part and exaggerate its significance, low self-esteem as well as a pessimistic view on what the future holds are interlinked with neurophysiological processes in the right-hemisphere (RH). This hemispheric asymmetry in mediating optimistic and pessimistic outlooks is rooted in several biological and functional differences between the two hemispheres. The RH mediation of a watchful and inhibitive mode weaves a sense of insecurity that generates and supports pessimistic thought patterns. Conversely, the LH mediation of an active mode and the positive feedback it receives through its motor dexterity breed a sense of confidence in one's ability to manage life's challenges, and optimism about the future.
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Affiliation(s)
- David Hecht
- Institute of Cognitive Neuroscience, University College London, London, WC1N 3AR, United Kingdom
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Abstract
BACKGROUND Depression is a common and important cause of morbidity and mortality worldwide. Depression is commonly treated with antidepressants and/or psychological therapy, but some people may prefer alternative approaches such as exercise. There are a number of theoretical reasons why exercise may improve depression. This is an update of an earlier review first published in 2009. OBJECTIVES To determine the effectiveness of exercise in the treatment of depression in adults compared with no treatment or a comparator intervention. SEARCH METHODS We searched the Cochrane Depression, Anxiety and Neurosis Review Group's Controlled Trials Register (CCDANCTR) to 13 July 2012. This register includes relevant randomised controlled trials from the following bibliographic databases: The Cochrane Library (all years); MEDLINE (1950 to date); EMBASE (1974 to date) and PsycINFO (1967 to date). We also searched www.controlled-trials.com, ClinicalTrials.gov and the WHO International Clinical Trials Registry Platform. No date or language restrictions were applied to the search.We conducted an additional search of the CCDANCTR up to 1st March 2013 and any potentially eligible trials not already included are listed as 'awaiting classification.' SELECTION CRITERIA Randomised controlled trials in which exercise (defined according to American College of Sports Medicine criteria) was compared to standard treatment, no treatment or a placebo treatment, pharmacological treatment, psychological treatment or other active treatment in adults (aged 18 and over) with depression, as defined by trial authors. We included cluster trials and those that randomised individuals. We excluded trials of postnatal depression. DATA COLLECTION AND ANALYSIS Two review authors extracted data on primary and secondary outcomes at the end of the trial and end of follow-up (if available). We calculated effect sizes for each trial using Hedges' g method and a standardised mean difference (SMD) for the overall pooled effect, using a random-effects model risk ratio for dichotomous data. Where trials used a number of different tools to assess depression, we included the main outcome measure only in the meta-analysis. Where trials provided several 'doses' of exercise, we used data from the biggest 'dose' of exercise, and performed sensitivity analyses using the lower 'dose'. We performed subgroup analyses to explore the influence of method of diagnosis of depression (diagnostic interview or cut-off point on scale), intensity of exercise and the number of sessions of exercise on effect sizes. Two authors performed the 'Risk of bias' assessments. Our sensitivity analyses explored the influence of study quality on outcome. MAIN RESULTS Thirty-nine trials (2326 participants) fulfilled our inclusion criteria, of which 37 provided data for meta-analyses. There were multiple sources of bias in many of the trials; randomisation was adequately concealed in 14 studies, 15 used intention-to-treat analyses and 12 used blinded outcome assessors.For the 35 trials (1356 participants) comparing exercise with no treatment or a control intervention, the pooled SMD for the primary outcome of depression at the end of treatment was -0.62 (95% confidence interval (CI) -0.81 to -0.42), indicating a moderate clinical effect. There was moderate heterogeneity (I² = 63%).When we included only the six trials (464 participants) with adequate allocation concealment, intention-to-treat analysis and blinded outcome assessment, the pooled SMD for this outcome was not statistically significant (-0.18, 95% CI -0.47 to 0.11). Pooled data from the eight trials (377 participants) providing long-term follow-up data on mood found a small effect in favour of exercise (SMD -0.33, 95% CI -0.63 to -0.03).Twenty-nine trials reported acceptability of treatment, three trials reported quality of life, none reported cost, and six reported adverse events.For acceptability of treatment (assessed by number of drop-outs during the intervention), the risk ratio was 1.00 (95% CI 0.97 to 1.04).Seven trials compared exercise with psychological therapy (189 participants), and found no significant difference (SMD -0.03, 95% CI -0.32 to 0.26). Four trials (n = 300) compared exercise with pharmacological treatment and found no significant difference (SMD -0.11, -0.34, 0.12). One trial (n = 18) reported that exercise was more effective than bright light therapy (MD -6.40, 95% CI -10.20 to -2.60).For each trial that was included, two authors independently assessed for sources of bias in accordance with the Cochrane Collaboration 'Risk of bias' tool. In exercise trials, there are inherent difficulties in blinding both those receiving the intervention and those delivering the intervention. Many trials used participant self-report rating scales as a method for post-intervention analysis, which also has the potential to bias findings. AUTHORS' CONCLUSIONS Exercise is moderately more effective than a control intervention for reducing symptoms of depression, but analysis of methodologically robust trials only shows a smaller effect in favour of exercise. When compared to psychological or pharmacological therapies, exercise appears to be no more effective, though this conclusion is based on a few small trials.
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Affiliation(s)
- Gary M Cooney
- Royal Edinburgh Hospital, NHS LothianDivision of PsychiatryEdinburghMidlothianUKEH9 1ED
| | - Kerry Dwan
- University of LiverpoolInstitute of Child HealthAlder Hey Children's NHS Foundation TrustEaton RoadLiverpoolEnglandUKL12 2AP
| | | | - Debbie A Lawlor
- University of BristolMRC Centre for Causal Analyses in Translational Epidemiology, School of Social and Community MedicineCanynge HallWhiteladies RdBristolAvonUKBS6
| | - Jane Rimer
- NHS LothianUniversity Hospitals DivisionEdinburghScotlandUK
| | - Fiona R Waugh
- Victoria Hostpital KirkcaldyGeneral Surgery, NHS FifeHayfield RoadKirkcaldyFifeUKKY2 5AH
| | - Marion McMurdo
- University of DundeeCentre for Cardiovascular and Lung Biology, Division of Medical SciencesNinewells Hospital and Medical SchoolDundeeUK
| | - Gillian E Mead
- University of EdinburghCentre for Clinical Brain SciencesRoom S1642, Royal InfirmaryLittle France CrescentEdinburghUKEH16 4SA
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Silveira H, Moraes H, Oliveira N, Coutinho ESF, Laks J, Deslandes A. Physical exercise and clinically depressed patients: a systematic review and meta-analysis. Neuropsychobiology 2013; 67:61-8. [PMID: 23295766 DOI: 10.1159/000345160] [Citation(s) in RCA: 173] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2012] [Accepted: 10/08/2012] [Indexed: 11/19/2022]
Abstract
OBJECTIVE The aim of this meta-analysis is to evaluate the effect of aerobic training and strength training as a treatment for depression in patients diagnosed with major depressive disorder. METHODS PubMed (Medline), ISI knowledge (Institute for Scientific Information), SciELO (Scientific Electronic Library) and Scopus databases were consulted from January 1970 to September 2011. Data were collected on variables as follows: total number of patients (pre- and postintervention), age, randomized (yes or no), diagnostic criteria, assessment instruments, and the percentage of remission and treatment response. Subsequently, we collected information on time intervention, intensity, duration, frequency, method of training (aerobic training and strength training) and type of supervision. Standardized mean differences were used for pooling continuous variables as endpoint scores. Binary outcomes, such as proportion of remission (no symptoms) and at least 50% reduction of initial scores (response), were pooled using relative risks. Random effects models were used that take into account the variance within and between studies. RESULTS Ten articles were selected and subdivided by their interventions, controlled training modality and levels of intensity. As there was no statistically significant difference between the two types of intervention (strength or aerobic training), we combined data which finally showed a 0.61 (95% CI: -0.88 to -0.33) standard deviation reduction in the intervention group compared to the control group. When the analysis was restricted only to those studies that used the Hamilton scale (n = 15), we observed a reduction of 3.49 points compared with the control group. CONCLUSION Despite the heterogeneity of the studies, the present meta-analysis concluded that physical exercise improves the response to treatment, especially aerobic training. However, the efficacy of exercise in the treatment of depression was influenced by age and severity of symptoms.
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Affiliation(s)
- Heitor Silveira
- Center for Alzheimer's Disease and Related Disorders, Institute of Psychiatry, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil.
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Malchow B, Reich-Erkelenz D, Oertel-Knöchel V, Keller K, Hasan A, Schmitt A, Scheewe TW, Cahn W, Kahn RS, Falkai P. The effects of physical exercise in schizophrenia and affective disorders. Eur Arch Psychiatry Clin Neurosci 2013; 263:451-67. [PMID: 23873090 DOI: 10.1007/s00406-013-0423-2] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2013] [Accepted: 07/08/2013] [Indexed: 01/23/2023]
Abstract
Affective and non-affective psychoses are severe and frequent psychiatric disorders. Amongst others, they not only have a profound impact on affected individuals through their symptomatology, but also regarding cognition, brain structure and function. Cognitive impairment influences patients' quality of life as well as their ability to work and being employed. While exercise therapy has been implemented in the treatment of psychiatric conditions since the days of Kraepelin and Bleuler, the underlying mechanisms have never been systematically studied. Since the early 1990s, studies emerged examining the effect of physical exercise in animal models, revealing stimulation of neurogenesis, synaptogenesis and neurotransmission. Based on that body of work, clinical studies have been carried out in both healthy humans and in patient populations. These studies differ with regard to homogenous study samples, sample size, type and duration of exercise, outcome variables and measurement techniques. Based on their review, we draw conclusions regarding recommendations for future research strategies showing that modern therapeutic approaches should include physical exercise as part of a multimodal intervention programme to improve psychopathology and cognitive symptoms in schizophrenia and affective disorders.
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Affiliation(s)
- Berend Malchow
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University Munich, Nußbaumstraße 7, 80336, Munich, Germany.
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Mura G, Carta MG. Physical activity in depressed elderly. A systematic review. Clin Pract Epidemiol Ment Health 2013; 9:125-35. [PMID: 24009640 PMCID: PMC3758953 DOI: 10.2174/1745017901309010125] [Citation(s) in RCA: 80] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2013] [Revised: 06/06/2013] [Accepted: 06/07/2013] [Indexed: 12/25/2022]
Abstract
Background: exercise may reduce depressive symptoms both in healthy aged populations and in old patients diagnosed with MDD, but few specific analysis were conducted on the efficacy of exercise as an adjunctive treatment with antidepressants, which may be probably more useful in clinical practice, considered the high prevalence of treatment resistant depression in late life, the low cost and safety of physical activity interventions. Objective: to establish the new findings on the effectiveness of exercise on depression in elderlies, with particular focus on the efficacy of the exercise as an adjunctive treatment with antidepressants drug therapy. Method: the search of significant articles was carried out in PubMed/Medline with the following key words: “exercise”, “physical activity”, “physical fitness”, “depressive disorder”, “depression”, “depressive symptoms”, “late life”, “old people”, and “elderly”. Results: 44 papers were retrieved by the search. Among the 10 included randomized controlled trials, treatment allocation was adequately conceived in 4 studies, intention-to-treat analysis was performed in 6 studies, but no study had a double-blinded assessment. We examined and discussed the results of all these trials. Conclusion: in the last 20 years, few progresses were done in showing the efficacy of exercise on depression, due in part to the persistent lack of high quality research, in part to clinical issues of management of depression in late life, in part to the difficult to establish the real effectiveness of exercise on depressive symptoms in elderlies. However, there are some promising findings on physical activity combined with antidepressants in treatment resistant late life depression.
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Affiliation(s)
- Gioia Mura
- Department of Public Health and Clinical and Molecular Medicine, University of Cagliari, Italy
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Mokhtari M, Nezakatalhossaini M, Esfarjani F. The Effect of 12-Week Pilates Exercises on Depression and Balance Associated with Falling in the Elderly. ACTA ACUST UNITED AC 2013. [DOI: 10.1016/j.sbspro.2013.01.246] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Eyre HA, Papps E, Baune BT. Treating depression and depression-like behavior with physical activity: an immune perspective. Front Psychiatry 2013; 4:3. [PMID: 23382717 PMCID: PMC3562851 DOI: 10.3389/fpsyt.2013.00003] [Citation(s) in RCA: 73] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2012] [Accepted: 01/07/2013] [Indexed: 12/18/2022] Open
Abstract
The increasing burden of major depressive disorder makes the search for an extended understanding of etiology, and for the development of additional treatments highly significant. Biological factors may be useful biomarkers for treatment with physical activity (PA), and neurobiological effects of PA may herald new therapeutic development in the future. This paper provides a thorough and up-to-date review of studies examining the neuroimmunomodulatory effects of PA on the brain in depression and depression-like behaviors. From a neuroimmune perspective, evidence suggests PA does enhance the beneficial and reduce the detrimental effects of the neuroimmune system. PA appears to increase the following factors: interleukin (IL)-10, IL-6 (acutely), macrophage migration inhibitory factor, central nervous system-specific autoreactive CD4+ T cells, M2 microglia, quiescent astrocytes, CX3CL1, and insulin-like growth factor-1. On the other hand, PA appears to reduce detrimental neuroimmune factors such as: Th1/Th2 balance, pro-inflammatory cytokines, C-reactive protein, M1 microglia, and reactive astrocytes. The effect of other mechanisms is unknown, such as: CD4+CD25+ T regulatory cells (T regs), CD200, chemokines, miRNA, M2-type blood-derived macrophages, and tumor necrosis factor (TNF)-α [via receptor 2 (R2)]. The beneficial effects of PA are likely to occur centrally and peripherally (e.g., in visceral fat reduction). The investigation of the neuroimmune effects of PA on depression and depression-like behavior is a rapidly developing and important field.
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Affiliation(s)
- Harris A Eyre
- Discipline of Psychiatry, School of Medicine, University of Adelaide Adelaide, SA, Australia ; School of Medicine and Dentistry, James Cook University Townsville, QLD, Australia
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Gomes AM, Rocha-e-Silva M. Exercise and its interactions with various aspects of man and animal lives. ACTA ORTOPEDICA BRASILEIRA 2012; 20:356-66. [PMID: 24453632 PMCID: PMC3861955 DOI: 10.1590/s1413-78522012000600009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/18/2012] [Accepted: 07/30/2012] [Indexed: 08/30/2023]
Abstract
To review recently published papers in the Brazilian Scientific press on the general subject of physical exercise. All articles published in 2010/2011 found through the keyword exercise were collected from 11 Brazilian Journals. They were hand filtered to exclude all but original research papers. They were grouped according to subject categories and subcategories. A brief summary of all included articles was produced, comparing similar articles between them. The most commonly found interactions refer to exercise vs. the cardiovascular system, metabolism and the locomotor system, in this order. The volume of scientific research in the field is high and of sufficient quality to justify highlighting.
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Neto FL, Borges G, Torres-Sanchez S, Mico JA, Berrocoso E. Neurotrophins role in depression neurobiology: a review of basic and clinical evidence. Curr Neuropharmacol 2012; 9:530-52. [PMID: 22654714 PMCID: PMC3263450 DOI: 10.2174/157015911798376262] [Citation(s) in RCA: 106] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2010] [Revised: 08/18/2010] [Accepted: 08/09/2010] [Indexed: 01/02/2023] Open
Abstract
Depression is a neuropsychiatric disorder affecting a huge percentage of the active population especially in developed countries. Research has devoted much of its attention to this problematic and many drugs have been developed and are currently prescribed to treat this pathology. Yet, many patients are refractory to the available therapeutic drugs, which mainly act by increasing the levels of the monoamines serotonin and noradrenaline in the synaptic cleft. Even in the cases antidepressants are effective, it is usually observed a delay of a few weeks between the onset of treatment and remission of the clinical symptoms. Additionally, many of these patients who show remission with antidepressant therapy present a relapse of depression upon treatment cessation. Thus research has focused on other possible molecular targets, besides monoamines, underlying depression. Both basic and clinical evidence indicates that depression is associated with
several structural and neurochemical changes where the levels of neurotrophins, particularly of brain-derived neurotrophic factor (BDNF), are altered. Antidepressants, as well as other therapeutic strategies, seem to restore these levels. Neuronal atrophy, mostly detected in limbic structures that regulate mood and cognition, like the hippocampus, is observed in depressed patients and in animal behavioural paradigms for depression. Moreover, chronic antidepressant treatment enhances adult hippocampal neurogenesis, supporting the notion that this event underlies antidepressants effects. Here we review some of the preclinical and clinical studies, aimed at disclosing the role of neurotrophins in the pathophysiological
mechanisms of depression and the mode of action of antidepressants, which favour the neurotrophic/neurogenic hypothesis.
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Affiliation(s)
- Fani L Neto
- Instituto de Histologia e Embriologia, Faculdade de Medicina e IBMC, Universidade do Porto, 4200-319, Porto, Portugal
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Ribeiro LHM, Neri AL. Exercícios físicos, força muscular e atividades de vida diária em mulheres idosas. CIENCIA & SAUDE COLETIVA 2012; 17:2169-80. [DOI: 10.1590/s1413-81232012000800027] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2011] [Accepted: 01/09/2012] [Indexed: 11/22/2022] Open
Abstract
O objetivo foi investigar as relações entre força muscular nos membros inferiores e nos superiores, prática de exercícios físicos e atividades de vida diária em mulheres idosas recrutadas na comunidade. Um mil quinhentas e trinta e oito idosas com idade média = 72,07 ± 5,46, renda familiar média = 3,59 ± 3,96 SM, sem déficit cognitivo sugestivo de demência. Foram submetidas a medidas de força de preensão manual e velocidade de marcha; a itens de autorrelato sobre prática regular de exercícios físicos; de desempenho de 13 atividades avançadas de vida diária (AAVD) de natureza social (ex: trabalhar, viajar e frequentar igreja) e de 3 atividades instrumentais de vida diária (AIVD) manejar dinheiro, fazer compras e usar transporte, 1.538 idosas com idade média = 72,07 ± 5,46, renda familiar média = 3,59 ± 3,96 SM, sem déficit cognitivo sugestivo de demência. Foram preditivos de pior desempenho em atividades de vida diária (AVD): baixa força muscular (OR = 2,48 para comprometimento da preensão e da marcha e 1,66 para comprometimento em qualquer dos critérios), baixa renda (OR = 2,46 e 2,45 para < 1 e para 1,1 a 3,0 SM) e sedentarismo (OR 2,08). A funcionalidade de mulheres idosas é afetada pelo envelhecimento fisiológico e por condições contextuais e de estilo de vida.
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Knott V, Thompson A, Shah D, Ilivitsky V. Neural expression of nicotine's antidepressant properties during tryptophan depletion: an EEG study in healthy volunteers at risk for depression. Biol Psychol 2012; 91:190-200. [PMID: 22743591 DOI: 10.1016/j.biopsycho.2012.06.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2012] [Revised: 06/06/2012] [Accepted: 06/06/2012] [Indexed: 01/09/2023]
Abstract
Nicotine amelioration of serotonergically mediated mood dysregulation may contribute to the comorbidity between cigarette smoking and depression, a disorder which is associated with aberrant activation and hemispheric asymmetry in frontal and posterior cortical regions. This randomized, double-blind study in 20 healthy volunteers with a positive family history of depression examined the effects of transdermal nicotine on mood and EEG changes accompanying transient reductions in serotonin induced by acute tryptophan depletion (ATD). Increased self-ratings of depressed mood and elevation in left frontal high alpha power (decreased activation) were evidenced with ATD (vs. balanced mixture) in participants treated with the placebo but not the nicotine treated group. Nicotine alone increased vigor and posterior high alpha bilaterally, and during ATD it prevented the reduction in left frontal high alpha that was evident in the placebo patch group. These findings indicate that in depression prone individuals, nicotine acts to stabilize the mood lowering and associated frontal functional asymmetry elicited by an acute decrease in brain serotonin.
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Affiliation(s)
- Verner Knott
- University of Ottawa Institute of Mental Health Research, Ottawa, ON, Canada.
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Yerokhin V, Anderson-Hanley C, Hogan MJ, Dunnam M, Huber D, Osborne S, Shulan M. Neuropsychological and neurophysiological effects of strengthening exercise for early dementia: a pilot study. AGING NEUROPSYCHOLOGY AND COGNITION 2011; 19:380-401. [PMID: 22136405 DOI: 10.1080/13825585.2011.628378] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
Abstract
Research demonstrates a positive effect of aerobic exercise on cognitive functioning in older adults. Unfortunately, aerobic exercise is often contraindicated for older adults due to cardiovascular and functional limitations. Low-intensity strengthening exercise may offer a practical alternative, but the neuropsychological benefits and potential neurophysiological mechanisms are less well understood. The current study evaluated the effects of a 10-week strengthening exercise intervention on cognitive functioning and EEG in a sample of 13 older adults with early dementia, and 9 normative controls. Results revealed beneficial effects of strengthening exercise on verbal memory coupled with frontal beta and delta power asymmetries and N200 amplitude asymmetry. Results point to increased cognitive efficiency following 10 weeks of strengthening exercise. The findings suggest it is feasible to conduct a strengthening intervention with early dementia patients, and to gather neuropsychological and neurophysiological data to evaluate outcomes. Strengthening exercise may serve as a useful alternative to aerobic exercise.
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Affiliation(s)
- Vadim Yerokhin
- Healthy Aging & Neuropsychology Laboratory, Union College, Schenectady, NY 12308, USA
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Carvalho A, Moraes H, Silveira H, Ribeiro P, Piedade RAM, Deslandes AC, Laks J, Versiani M. EEG frontal asymmetry in the depressed and remitted elderly: is it related to the trait or to the state of depression? J Affect Disord 2011; 129:143-8. [PMID: 20870292 DOI: 10.1016/j.jad.2010.08.023] [Citation(s) in RCA: 67] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2010] [Accepted: 08/26/2010] [Indexed: 11/29/2022]
Abstract
BACKGROUND Over the last 30 years, frontal EEG asymmetry has been investigated with regards to the study of emotion, motivation, and psychopathology. METHOD We analyzed the frontal alpha asymmetry, depressive symptoms with a Beck Depression Inventory (BDI) and quality of life with a Short Form Health Survey-36® (SF-36®) in depressed (n=12), remitted (n=8) and non-depressed (n=7) elderly subjects. We also evaluated the correlation between the frontal EEG asymmetry and physical and mental aspects of SF-36®. RESULTS The groups showed no difference regarding the frontal alpha asymmetry (F=0.37; p=0.69). Moreover, there was no significant correlation between frontal asymmetry and quality of life (mental and physical aspects). CONCLUSION The results showed no evidence of a relationship between frontal asymmetry, quality of life and depression in the elderly. Future studies on frontal asymmetry should carefully consider the effects of age.
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Affiliation(s)
- Alessandro Carvalho
- Center for Alzheimer Disease and Related Disorders (CDA), Institute of Psychiatry (IPUB), Universidade Federal do Rio de Janeiro, Brazil.
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Vasques PE, Moraes H, Silveira H, Deslandes AC, Laks J. Acute exercise improves cognition in the depressed elderly: the effect of dual-tasks. Clinics (Sao Paulo) 2011; 66:1553-7. [PMID: 22179158 PMCID: PMC3164403 DOI: 10.1590/s1807-59322011000900008] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2011] [Accepted: 05/19/2011] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE The goal of this study was to assess the acute effect of physical exercise on the cognitive function of depressed elderly patients in a dual-task experiment. INTRODUCTION Physical exercise has a positive effect on the brain and may even act as a treatment for major depressive disorder. However, the effects of acute cardiovascular exercise on cognitive function during and after one session of aerobic training in elderly depressive patients are not known. METHODS Ten elderly subjects diagnosed with major depressive disorder performed neuropsychological tests during and after a moderate physical exercise session (65-75%HR(max)). A Digit Span Test (Forward and Backward) and a Stroop Color-Word Test were used to assess cognitive function. The elderly participants walked on an electric treadmill for 30 minutes and underwent the same cognitive testing before, during, immediately after, and 15 minutes after the exercise session. In the control session, the same cognitive testing was conducted, but without exercise training. RESULTS The results of the Digit Span Test did not change between the control and the exercise sessions. The results of the Stroop Color-Word Test improved after physical exercise, indicating a positive effect of exercise on cognition. CONCLUSIONS These data suggest that the cognitive functions of depressed elderly persons, especially attention and inhibitory control, are not impaired during and after an acute session of physical exercise. In contrast, the effect of dual-tasks showed beneficial results for these subjects, mainly after exercise. The dual-task may be a safe and useful tool for assessing cognitive function.
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Affiliation(s)
- Paulo Eduardo Vasques
- Center for Alzheimer’s Disease and Related Disorders, Institute of Psychiatry, Federal University of Rio de Janeiro, Brazil.
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The effect of acute effort on EEG in healthy young and elderly subjects. Eur J Appl Physiol 2010; 111:67-75. [PMID: 20809229 DOI: 10.1007/s00421-010-1627-z] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/17/2010] [Indexed: 10/19/2022]
Abstract
The effects of physical exercise on mental health have been extensively investigated, mainly in older people. Recent studies have looked into the acute effect of exercise on the brain using standardized low-resolution brain electromagnetic tomography (sLORETA). We assessed EEG power and mood changes after 20 min of aerobic exercise in elderly (N = 10) and young (N = 19) healthy individuals. Both groups showed improvement in total mood disturbance (TMD) post exercise (young: P = 0.03; elderly: P = 0.02). Only the young group showed significant improvement in anger (P = 0.05) and vigor (P = 0.006). Comparison pre versus post-exercise for each group separately revealed significant changes in the young group (an increase in alpha, beta-1 and beta-2 activity in Brodmann areas 24, 33 and 23, respectively). However, the elderly group did not show significant changes. An inverse correlation was found between alpha asymmetry and STAI (rs = -0.50; P = 0.029) in the young group. On the other hand, a significant correlation between beta-1 activity and TMD was observed in the elderly group (rs = 0.67; P = 0.045). We conclude that acute exercise can have distinct effects on brain activity and mood variables in young individuals when compared with elderly adults. However, additional studies are necessary to further investigate the role of exercise intensity in these results.
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