Effects of aerobic exercise on cognitive function in adults with major depressive disorder: A systematic review and meta-analysis

Background

Major Depressive Disorder (MDD) is a highly prevalent psychiatric disorder that impairs the cognitive function of individuals. Aerobic exercise stands out as a promising non-pharmacological intervention for enhancing cognitive function and promoting brain health.While positive impacts of aerobic exercise on executive function in adults with depression have been documented, a comprehensive understanding of its benefits on overall cognitive function, including memory, attention, and processing speed, along with key moderating factors in adults with MDD, remains unexplored. The purpose of the systematic review and meta-analysis was to investigate the effects of aerobic exercise on overall cognitive function in adults with MDD, and to explore whether cognitive sub-domains, aerobic exercise characteristics, and study and sample variables modify the effects of aerobic exercise on cognition.

Methods

Six English electronic databases (Embase, Cochrane Central, Scopus, APA PsycInfo, PubMed, Web of Science) were searched from inception to 2 April 2023. Randomized trials, including adults aged 18 years or above with a diagnosis of clinical depression, of the effects of aerobic exercise on cognitive function in adults with MDD compared to non-aerobic exercise groups were included. A three-level meta-analysis was conducted utilizing a random-effects model in R. The quality of the studies was evaluated using the Physiotherapy Evidence Database (PEDro) scale. The PROSPERO registration number is CRD42022367350.

Results

Twelve randomized trials including 945 adults with MDD were included. Results indicated that aerobic exercise significantly improved overall cognitive function (g = 0.21; 95 % confidence intervals [CI] = 0.07, 0.34), and the sub-domains of memory (g = 0.25; 95 % CI = 0.06, 0.44) and executive function (g = 0.12; 95 % CI = 0.04, 0.20). Significant benefits in cognitive function were found from moderate-to-vigorous (mixed) intensity (g = 0.19; 95 % CI = 0.02, 0.37), aerobic exercise conducted 3 times per week (g = 0.23; 95 % CI = 0.10, 0.38), in sessions < 45 min (g = 0.59; 95 % CI = 0.28, 0.90), and 45-60 min (g = 0.16; 95 % CI = 0.07, 0.26), in aerobic exercise intervention ≤ 12 weeks (g = 0. 26; 95 % CI = 0.08, 0.44).

Limitations

This review only included peer-reviewed English-language studies, which may lead to a language bias. The results of the Egger's test suggested a potential publication bias.

Conclusions

Aerobic exercise is efficacious in improving overall cognitive function and the sub-domains of memory and executive function in adults with major depressive disorder.

[Clinical application of split liver transplantation: a single center report of 203 cases]

Objective: To investigate the safety and therapeutic effect of split liver transplantation (SLT) in clinical application. Methods: This is a retrospective case-series study. The clinical data of 203 consecutive SLT, 79 living donor liver transplantation (LDLT) and 1 298 whole liver transplantation (WLT) performed at the Third Affiliated Hospital of Sun Yat-sen University from July 2014 to July 2023 were retrospectively analyzed. Two hundred and three SLT liver grafts were obtained from 109 donors. One hundred and twenty-seven grafts were generated by in vitro splitting and 76 grafts were generated by in vivo splitting. There were 90 adult recipients and 113 pediatric recipients. According to time, SLT patients were divided into two groups: the early SLT group (40 cases, from July 2014 to December 2017) and the mature SLT technology group (163 cases, from January 2018 to July 2023). The survival of each group was analyzed and the main factors affecting the survival rate of SLT were analyzed. The Kaplan-Meier method and Log-rank test were used for survival analysis. Results: The cumulative survival rates at 1-, 3-, and 5-year were 74.58%, 71.47%, and 71.47% in the early SLT group, and 88.03%, 87.23%, and 87.23% in the mature SLT group, respectively. Survival rates in the mature SLT group were significantly higher than those in the early SLT group (χ2=5.560,P=0.018). The cumulative survival rates at 1-, 3- and 5-year were 93.41%, 93.41%, 89.95% in the LDLT group and 87.38%, 81.98%, 77.04% in the WLT group, respectively. There was no significant difference among the mature SLT group, the LDLT group and the WLT group (χ2=4.016, P=0.134). Abdominal hemorrhage, infection, primary liver graft nonfunction,and portal vein thrombosis were the main causes of early postoperative death. Conclusion: SLT can achieve results comparable to those of WLT and LDLT in mature technology liver transplant centers, but it needs to go through a certain time learning curve.

Acute Exercise Effect on Neurocognitive Function Among Cognitively Normal Late-Middle-Aged Adults With/Without Genetic Risk of AD: The Moderating Role of Exercise Volume and APOE Genotype

BACKGROUND

Acute exercise is a behavior that benefits cognitive function; however, its effect on populations with different risks for Alzheimer's disease (AD) and the role of exercise variance and Apolipoprotein E (APOE) genotype on this effect remains unknown. This study explores the acute exercise effect on behavioral and neurocognitive function, and its potential moderation by exercise intensity and duration and APOE genetic risk.

METHODS

Fifty-one cognitively normal adults (~36% APOE ε4 carriers) performed the Stroop task under a rest condition and 3 exercise conditions while electroencephalographic activity was assessed.

RESULTS

Acute exercise improved cognitive performance assessed through both behavioral and neuroelectrical indices. These benefits were observed regardless of adjustments of intensity and duration at a predetermined exercise volume as well as being evident irrespective of APOE ɛ4 carrier status.

CONCLUSIONS

Acute exercise could be proposed as a lifestyle intervention to benefit neurocognitive function in populations with and without genetic risk of AD. Future exploration should further the precise exercise prescription and also the mechanisms underlying the beneficial effects of acute exercise for neurocognitive function.

CLINICAL TRIALS REGISTRATION NUMBER

NCT05591313.

Effects of Exercise Training on Executive Functioning in Adults with Depression: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

BACKGROUND

Exercise is a promising nonpharmacological intervention to improve executive function (EF). However, results from randomized trials and meta-analyses examining the effects of exercise on working memory in adults with depression are mixed, and the influence of exercise on EF, as well as the key moderators of the relationship, remain inconclusive.

OBJECTIVE

The present systematic review with meta-analysis examined the influence of exercise interventions on EF in adults with depression, and the influence of key moderating variables.

METHODS

Electronic searches were conducted using Embase, Cochrane Central, Scopus, Ovid MEDLINE, PubMed, Web of Science, China National Knowledge Infrastructure, Wanfang Database, and Weipu Database up to 25 June 2022, and updated on 16 January 2023. Randomized controlled trials (RCTs) examining the effects of exercise training on EF in adults with depression were included. A three-level meta-analysis based on a random-effects model was applied in R. Study quality was assessed using the Physiotherapy Evidence Database (PEDro) scale.

RESULTS

A total of 14 RCTs that evaluated 1201 adults with depression were included. The results indicated that exercise significantly improved global EF [g = 0.180; 95% confidence intervals (CI) = 0.038, 0.323], and the subdomains of working memory (g = 0.182; 95% CI = 0.015, 0.350), cognitive flexibility (g = 0.222; 95% CI = 0.048, 0.395), and reasoning/planning (g = 0.889; 95% CI = 0.571, 1.206). In subgroup analyses, significant improvements in EF were only observed for aerobic exercise (g = 0.203; 95% CI = 0.023, 0.382), moderate-to-vigorous intensity exercise (g = 0.200; 95% CI = 0.022, 0.379), exercise performed three or more times per week (g = 0.207; 95% CI = 0.026, 0.388), in sessions ≤ 60 min (g = 0.173; 95% CI = 0.003, 0.343), and in program durations lasting at least 13 weeks (g = 0. 248; 95% CI = 0.034, 0.462).

CONCLUSIONS

This meta-analysis demonstrates the benefits of exercise training for improving EF and the subdomains of working memory, cognitive flexibility, and reasoning/planning in adults with depression. Future randomized clinical trials are warranted to determine the therapeutic effects of exercise training on EF and cognitive symptoms in depressed patients.

Lactobacillus acidophilus NCFM and Lactiplantibacillus plantarum Lp-115 inhibit Helicobacter pylori colonization and gastric inflammation in a murine model

Purpose

To determine the role of Lactobacillus strains and their combinations in inhibiting the colonization of H. pylori and gastric mucosa inflammation.

Methods

Human gastric adenocarcinoma AGS cells were incubated with H. pylori and six probiotic strains (Lactobacillus acidophilus NCFM, L. acidophilus La-14, Lactiplantibacillus plantarum Lp-115, Lacticaseibacillus paracasei Lpc-37, Lacticaseibacillus rhamnosus Lr-32, and L. rhamnosus GG) and the adhesion ability of H. pylori in different combinations was evaluated by fluorescence microscopy and urease activity assay. Male C57BL/6 mice were randomly divided into five groups (uninfected, H. pylori, H. pylori+NCFM, H. pylori+Lp-115, and H. pylori+NCFM+Lp-115) and treated with two lactobacilli strains (NCFM and Lp-115) for six weeks. H. pylori colonization and tissue inflammation statuses were determined by rapid urease test, Hematoxylin-Eosin (HE) staining, immunohistochemistry, and qRT-PCR and ELISA.

Results

L. acidophilus NCFM, L. acidophilus La-14, L. plantarum Lp-115, L. paracasei Lpc-37, L. rhamnosus Lr-32, and L. rhamnosus GG reduced H. pylori adhesion and inflammation caused by H. pylori infection in AGS cells and mice. Among all probiotics L. acidophilus NCFM and L. plantarum, Lp-115 showed significant effects on the H. pylori eradication and reduction of inflammation in-vitro and in-vivo. Compared with the H. pylori infection group, the mRNA and protein expression levels of IL-8 and TNF-α in the six Lactobacillus intervention groups were significantly reduced. The changes in the urease activity (ureA and ureB) for 1-7h in each group showed that L. acidophilus NCFM, L. acidophilus La-14, L. plantarum Lp-115, and L. rhamnosus GG effectively reduced the colonization of H. pylori. We observed a higher ratio of lymphocyte and plasma cell infiltration into the lamina propria of the gastric mucosa and neutrophil infiltration in H. pylori+NCFM+Lp-115 mice. The infiltration of inflammatory cells in lamina propria of the gastric mucosa was reduced in the H. pylori+NCFM+Lp-115 group. Additionally, the expression of IFN-γ was decreased significantly in the NCFM and Lp-115 treated C57BL/6 mice.

Conclusions

L. acidophilus NCFM and L. plantarum Lp-115 can reduce the adhesion of H. pylori and inhibit the gastric inflammatory response caused by H. pylori infection.

Acute effect of breathing exercises on muscle tension and executive function under psychological stress

Introduction

Intensive and long-lasting office work is a common cause of muscular and mental disorders due to workplace stressors. Mindful and slow breathing exercises decrease psychological stress and improve mental health, whereas fast breathing increases neuronal excitability. This study aimed to explore the influence of 5 min of mindful breathing (MINDFUL), slow breathing (SLOW), fast breathing (FAST), and listening to music (MUSIC) on muscle tension and executive function during an intensive psychological task.

Methods

Forty-eight participants (24 men and 24 women) were enrolled. Muscle tension was recorded using surface electromyography, and executive function was assessed using the Stroop Color and Word Test (Stroop Test). The respiration rate (RR), oxygen saturation (SpO₂), end-tidal carbon dioxide (EtCO₂), and the subjects' preferred method were also recorded. During the experiment, participants performed a one-time baseline test (watching a neutral video for 5 min) and then completed 5 min of MUSIC, MINDFUL, SLOW, and FAST in a random sequence. The Stroop Test was performed after each intervention, including the baseline test, and was followed by a 5 min rest before performing the next intervention.

Results

None of the methods significantly influenced muscular activity and performance of the Stroop Test in both men and women, based on the average 5 min values. However, at the fifth minute, men's accuracy rate in the Stroop Test was significantly higher after SLOW than after MUSIC and FAST, and the reaction time after the SLOW was the shortest. SpO₂ was significantly higher during SLOW than during MUSIC, and RR was relatively lower after SLOW than after MUSIC. Most men preferred SLOW, and most women preferred MUSIC, whereas FAST was the most unfavorable method for both men and women.

Conclusion

Brief breathing exercises did not substantially affect muscle tension under psychological stress. SLOW demonstrated greater potential for sustaining executive function in men, possibly via its superior respiration efficiency on SpO₂ and inhibition of RR.

Women's Respiratory Movements during Spontaneous Breathing and Physical Fitness: A Cross-Sectional, Correlational Study

BACKGROUND

Abdominal/diaphragmatic breathing exercises are popular worldwide and have been proven to be beneficial for physical performance. Is abdominal motion (AM) during spontaneous breathing correlated with physical fitness? The present study aimed to answer this question.

METHODS

434 women (aged 20-59) were enrolled and participated in respiration tests using two respiration belts (one was tied at the height of the xiphoid and another at the navel) to detect AM and thoracic motion (TM). They also performed physical fitness tests to measure body size, muscular strength, muscular power, muscular endurance, balance, flexibility, reaction time, and cardiorespiratory endurance.

RESULTS

All the correlation coefficients between respiratory movements (AM, TM, AM + TM, AM/(AM + TM)) and physical fitness outcomes were less than 0.4/-0.4. Only AM and muscular power (countermovement jump height) had a weak correlation, with a correlation coefficient close to 0.4 in the 20-29-year age group (r_s = 0.398, p = 0.011, n = 40).

CONCLUSIONS

Women's respiratory movements during spontaneous breathing were not correlated with physical fitness. Future studies may focus on the relationship between AM and countermovement jump height in young women with a larger sample size and using ultrasound to directly test the excursion of the diaphragm.

Effects of Acute High-Intensity Interval Exercise and High-Intensity Continuous Exercise on Inhibitory Function of Overweight and Obese Children

This study aimed to examine whether a single bout each of high-intensity interval exercise (HIIE) and high-intensity continuous exercise (HICE) could improve inhibitory functions of overweight and obese children, and which mode of exercise was more beneficial. Seventy-two overweight and obese children, with (26.02 ± 1.05 kg/m²), aged 10-14 years (11.56 ± 1.03 years), were randomly assigned to three groups. The HIIE group completed a 30-min treadmill exercise session (5-min warm up, 20-min HIIE, and 5-min cool-down). The HICE group performed 30 min of rope skipping, while the control (CON) group watched a designated cartoon on a tablet computer for the same duration. Reaction time and number of errors in the Stroop test were determined before and after the intervention. The difference between pre- and post-test reaction time scores was higher in the HIIE and HICE groups than in the CON group, while the pre- and post-test difference in the number of errors was similar between groups. Overall, it is likely that both acute HIIE and HICE were similarly efficient in facilitating cognitive and inhibitory functions of children with overweight and obesity conditions, supporting the benefits of acute high-intensity exercise probability for cognitive functions of children in general, as well as of the population with overweight and obesity conditions.

Relationship Between CNVs and Immune Cells Infiltration in Gastric Tumor Microenvironment

Gastric cancer (GC) is a highly fatal and common malignancy of the digestive system. Recent therapeutic advancements have significantly improved the clinical outcomes in GC, but due to the unavailability of suitable molecular targets, a large number of patients do not respond to the immune checkpoint inhibitors (ICI) therapy. To identify and validate potential therapeutic and prognostic targets of gastric cancer, we used the “inferCNV” R package for analyzing single-cell sequencing data (GSE112302) of GC and normal epithelial cells. First, by using LASSO, we screened genes that were highly correlated with copy number variations (CNVs). Therefrom, five gene signature (CPVL, DDC, GRTP1, ONECUT2, and PRSS21) was selected by cross-validating the prognosis and risk management with the GC RNA-seq data obtained from GEO and TCGA. Moreover, the correlation analyses between CNVs of these genes and immune cell infiltration in gastric cancer identified CPVL as a potential prognostic marker. Finally, CPVL showed high expression in gastric cancer samples and cell lines, then siRNA-mediated silencing of CPVL expression in gastric cancer cells showed significant proliferation arrest in MGC803 cells. Here, we conclude that CNVs are key regulators of the immune cells infiltration in gastric TME as well as cancer development, and CPVL could potentially be used as a prognostic and therapeutic marker in gastric cancer.

Aquatic Exercise for Health Promotion: A 31-Year Bibliometric Analysis

The present study aimed to review the research literature on aquatic exercise for health promotion using bibliometric methods and CiteSpace software. The number of studies related to this topic are constantly expanding, with the USA, Brazil, and Australia the centers of this research. Most published papers fall within Sports Science, but the disciplines of Physiology, Psychology, and Rehabilitation were also found to be dominant domains for this literature. The seven most prolific authors were from Brazil or Spain. The most frequently cited references focused on sub-topics of physiology, biochemistry, physical fitness, psychological health, cardiovascular disease, and joint disease. New research trends have shifted to the promotion of cardiovascular health in clinical populations (stroke, overweight, hypertension, endothelium dysfunctional, obese, inflammation, antioxidant, heart failure). Overall, this review found that research hot spots and trends in this realm have focused on improving cardiovascular health with aquatic exercise.

Effects of Chinese Mind-Body Exercises on Executive Function in Middle-Aged and Older Adults: A Systematic Review and Meta-Analysis

Chinese mind-body exercises (CMBEs) are positively associated with executive function (EF), but their effects on EF, from synthesized evidence using systematic and meta-analytic reviews, have not been conducted. Therefore, the present systematic review with meta-analysis attempted to determine whether CMBEs affect EF and its sub-domains, as well as how exercise, sample, and study characteristics moderate the causal relationship between CMBEs and EF in middle-aged and older adults. Seven electronic databases were searched for relevant studies published from the inception of each database through June 2020 (PubMed, Web of Science, Embase, Cochrane Controlled Trials Register, Wanfang, China National Knowledge Infrastructure, and Weipu). Randomized controlled trials with at least one outcome measure of CMBEs on EF in adults of mean age ≥ 50 years with intact cognition or mild cognitive impairment (MCI) and with or without chronic diseases were included. A total of 29 studies (N = 2,934) ultimately were included in this study. The results indicated that CMBEs improved overall EF (Standardized Mean Differences = 0.28, 95% CI 0.12, 0.44), as well as its sub-domains of working memory and shifting. The beneficial effects of CMBEs on EF occurred regardless of type (Tai Chi, Qigong), frequency of group classes (≤2 time, 3-4 time, ≥5 times), session time (≤45 min, 46-60 min), total training time (≥150 to ≤300 min, >300 min), and length of the CMBEs (4-12 week, 13-26 week, and >26 week), in addition to that more frequent participation in both group classes and home practice sessions (≥5 times per week) resulted in more beneficial effects. The positive effects of CMBEs on EF were also demonstrated, regardless of participants mean age (50-65 years old, >65 years old), sex (only female, both), and cognitive statuses (normal, MCI, not mentioned), health status (with chronic disease, without chronic disease), as well as training mode (group class, group class plus home practice) and study language (English, Chinese). This review thus suggests that CMBEs can be used as an effective method with small to moderate and positive effects in enhancing EF, and that more frequent group classes and home practice sessions may increase these effects. However, certain limitations, including strictly design studies, limited ES (effect size) samples for specific variables, and possible biased publications, required paying particular attention to, for further exploring the effects of CMBEs on EF.

A ceRNA network and a potential regulatory axis in gastric cancer with different degrees of immune cell infiltration

Immune cell infiltration is an important indicator of whether tumor patients will benefit from immunotherapy. Gastric cancer is one of the most common tumors in the world, and new indicators of immunotherapy are urgently needed. The aim of this study was to construct ceRNA networks in gastric cancer with different degrees of immune cell infiltration. We analyzed the expression profiles of different gastric cancer with different degrees of immune cell infiltration retrieved from The Cancer Genome Atlas (TCGA) database and found differentially expressed lncRNAs, mRNAs, and miRNAs. A ceRNA regulatory network of gastric cancer with different degrees of immune cell infiltration was constructed using functional annotation, RNA‐RNA interaction prediction, correlation analysis, survival analysis, and other comprehensive bioinformatics methods. The interaction and correlation between ceRNAs were verified using experiments on tumor tissues and cell lines. Cell line experiments showed a potential RP11‐1094M14.8/miR‐1269a/CXCL9 axis that was consistent with the ceRNA theory. qRT‐PCR results showed that RP11‐1094M14.8 knockdown significantly reduced the expression of CXCL9, and RP11‐1094M14.8 overexpression had the opposite effect. The results of clinical analysis of gastric cancer samples showed that RP11‐1094M14.8 and CXCL9 were highly expressed in hot tumors, and CXCL9 was positively correlated with a better prognosis for patients. The constructed novel ceRNA network and the potential regulatory axis may provide a comprehensive understanding of the potential mechanisms of development in gastric cancer with different degrees of immune cell infiltration. The RP11‐1094M14.8/miR‐1269a/CXCL9 axis may serve as a potential immune‐therapeutic target for gastric cancer with different degrees of immune cell infiltration.

Functional characterization of short-type peptidoglycan recognition proteins (PGRPs) from silkworm Bombyx mori in innate immunity

Peptidoglycan recognition proteins (PGRPs) are members of an important class of pattern recognition receptors in insects that can specifically recognize peptidoglycan (PGN) in bacterial cell walls and participate in immune regulation and bacterial clearance. Although the role of PGRPs in regulating the innate immune response in Drosophila melanogaster has been studied, little is known regarding PGRPs in Lepidoptera species. In this study, five short (S)-type Bombyx mori PGRPs (BmPGRPs) were cloned, expressed, and evaluated for their function in innate immunity. B. mori larvae that were injected with the gram-positive bacterium Bacillus megaterium or the gram-negative bacterium Escherichia coli exhibited a rapid and significant upregulation in S-type BmPGRP expression. The results showed that the five evaluated BmPGRPs have significant agglutination activity toward E. coli and B. megaterium and more notable amidase activity toward meso-diaminopimelic acid peptidoglycan (DAP-PGN). Furthermore, only in the presence of BmPGRP-S5 did B. mori larval hemocytes exhibit significant phagocytosis against E. coli and B. megaterium.

An ML protein from the silkworm Bombyx mori may function as a key accessory protein for lipopolysaccharide signaling

Lipopolysaccharide (LPS) is a common component of the outermost cell wall in Gram-negative bacteria. In mammals, LPS serves as an endotoxin that can be recognized by a receptor complex of TLR4 (Toll-like receptor 4) and MD-2 (myeloid differentiation-2) and subsequently induce a strong immune response to signal the release of tumor necrosis factor (TNF). In Drosophila melanogaster, no receptors for LPS have been identified, and LPS cannot activate immune responses. Here, we report a protein, BmEsr16, which contains an ML (MD-2-related lipid-recognition) domain, may function as an LPS receptor in the silkworm Bombyx mori. We showed that antibacterial activity in the hemolymph of B. mori larvae was induced by Escherichia coli, peptidoglycan (PGN) and LPS and that the expression of antimicrobial peptide genes was also induced by LPS. Furthermore, both the expression of BmEsr16 mRNA in the fat body and the expression of BmEsr16 protein in the hemolymph were induced by LPS. Recombinant BmEsr16 bound to LPS and lipid A, as well as to PGN, lipoteichoic acid, but not to laminarin or mannan. More importantly, LPS-induced immune responses in the hemolymph of B. mori larvae were blocked when the endogenous BmEsr16 protein was neutralized by polyclonal antibody specific to BmEsr16. Our results suggest that BmEsr16 may function as a key accessory protein for LPS signaling in B. mori.

Chiral resolution, absolute configuration, and bioactivity of a new racemic asarone derivative from the rhizome of Acorus tatarinowii

A new asarone-derived racemate (1) was isolated from the rhizome of Acorus tatarinowii. The structure of 1 was established by comprehensive spectroscopic analyses, and it was successfully resolved by chiral HPLC, demonstrating that it is racemic. The absolute configurations of 1a [(-)-acortatarone A] and 1b [(+)-acortatarone A] were determined using quantum chemical calculations. Compounds 1a and 1b were the first cases of asarone derivatives with the 5,7-dialkyl-6-aryl-8-oxabicyclo[3.2.1]oct-3-en-2-one core. The α-glucosidase inhibitory and acetylcholinesterase (AChE) inhibitory activities of 1 were evaluated, and it exhibited α-glucosidase inhibitory activity with potency close to that of the positive control (acarbose).