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Abstract
Exercise is considered as one of the therapeutic options. in many major treatment guidelines for depression In terms of the underlying neurobiological mechanisms, it has been suggested that the antidepressive effects of exercise can be explained by the increased hippocampal volume associated with an increased level of brain-derived neurotrophic factor (BDNF). However, there have been no significant effects of exercise on cognitive functions in depression. Exercise has been used based on substantial evidence in the context of its therapeutic efficacy in depression. In personalized medicine, various potential mediators for the relationship between exercise and depressive symptoms should be controlled. Since it has been consistently reported that exercise has no significant therapeutic effects on cognitive domains in depression, it is necessary that the efficacy of exercise on cognitive domains should be evaluated with rigorous methodology. Furthermore, it has been suggested that exercise has potentially positive effects in the prevention of depression. Despite the controversies regarding supporting evidence, it is concluded that exercise may be regarded as a “safe and broad-spectrum antidepressant” and used in the context of “prevention and treatment of depression.”
REFERENCES
1). Sackeim HA. The definition and meaning of treatment-resistant depression. J Clin Psychiatry. 2001; 62(Suppl 16):10–17.
2). Deakin J, O'Loughlin C. STAR∗D: a summary and UK perspective. J Psychopharmacol. 2009; 23:605–612.
3). Papakostas G. ‘At this point, any new treatment that makes it to the finish line is a huge win.' Time. 2017; 190:34–39.
4). Cooney GM, Dwan K, Greig CA, Lawlor DA, Rimer J, Waugh FR, et al. Exercise for depression. Cochrane Database Syst Rev. 2013; 9:CD04366.
5). National Collaborating Centre for Mental Health and National Institute for Health and Clinical Excellence. Depression: The treatment and management of depression in adults (updated edition). Leicester and London: The British Psychological Society and The Royal College of Psychiatrists;2010.
6). Spijker J, Bockting CLH, Meeuwissen JAC, van Vliet IM, Em-melkamp PMG, Hermens MLM, et al. Multidisciplinary guideline for depression: Guideline for the diagnosis, treatment, and counseling of adult patients with major depressive disorder. 3rd revision. Utrecht: Trimbos-instituut;2013.
7). Ravindran AV, Balneaves LG, Faulkner G, Ortiz A, McIntosh D, Morehouse RL, et al. Canadian network for mood and anxiety treatments (CANMAT) 2016 clinical guidelines for the management of adults with major depressive disorder: section 5. complementary and alternative medicine treatments. Can J Psychiatry. 2016; 61:576–587.
8). Park SC, Oh HS, Oh DH, Jung SA, Na KS, Lee HY, et al. Evidence-based, non-pharmacological treatment guideline for depression in Korea. J Korean Med Sci. 2014; 29:12–22.
9). Cosgrove L, Shaughnessy AF, Wheeler EE, Austad KE, Kirsch I, Bursztajn HJ. The American Psychiatric Association's guideline for major depressive disorder: a commentary. Psychother Psychosom. 2012; 81:186–188.
10). Qaseem A, Barry MJ, Kansagara D. Clinical Guidelines Committee of the American College of Physicians. Nonpharmacologic versus pharmacologic treatment of adult patients with major depressive disorder: A clinical practice guideline from the American College of Physicians. Ann Intern Med. 2016; 164:350–359.
11). Schuch FB, Deslandes AC, Stubbs B, Gosmann NP, Silva CT, Fleck MP. Neurobiological effects of exercise on major depressive disorder: a systemic review. Neurosci Biobehav Rev. 2016; 61:1–11.
12). Gujral S, Aizenstein H, Reynolds CF 3rd, Butters MA, Erickson KI. Exercise effects on depression: possible neural mechanisms. Gen Hosp Psychiatry. 2017; 49:2–10.
13). Sahay A, Hen R. Adult hippocampal neurogenesis in depression. Nat Neurosci. 2007; 10:1110–1115.
14). Mahar I, Bambico FR, Mechawar N, Nobrega JN. Stress, serotonin and hippocampal neurogenesis in relation to depression and antidepressant effects. Neurosci Biobehav Rev. 2014; 38:173–192.
15). Singh MK, Gotlib IH. The neuroscience of depression: implications for assessment and intervention. Behav Res Ther. 2014; 62:60–73.
16). Schuch FB, Dunn AL, Kanitz AC, Delevatti RS, Fleck MP. Moderators of response in exercise treatment for depression: a systemic review. J Affect Disord. 2016; 20:40–49.
17). Erickson KI, Miller DL, Roecklein KA. The aging hippocampus: interaction between exercise, depression, and BDNF. Neuroscientist. 2012; 18:82–97.
18). Erickson KI, Leckle RL, Weinstein AM. Physical activity, fitness, and gray matter volume. Neurobiol Aging. 2014; 35(Suppl 2):S20-S28.
19). Voss MW, Vivar C, Kramer AF, van Praag H. Bridging animal and human models of exercise-induced brain plasticity. Trends Cogn Sci. 2013; 17:525–544.
20). Russo-Neustadt AA, Beard RC, Huang YM, Cotman CW. Physical activity and antidepressant treatment potentiate the expression of specific brain-derived neurotrophic factor transcripts in the rat hippocampus. Neuroscience. 2000; 101:305–312.
21). Garza AA, Ha TG, Garcia C, Chen MJ, Russo-Neustadt AA. Exercise, antidepressant treatment and BDNF mRNA expression in the aging brain. Pharmacol Biochem Behav. 2004; 77:209–220.
22). Vaynman S, Ying Z, Gomez-Pinilla F. Hippocampal BDNF mediates the efficacy of exercise on synaptic plasticity and cognition. Eur J Neurosci. 2004; 20:2580–2590.
23). Nichol KE, Poon WW, Parachikova AI, Cribbs DH, Glabe CG, Cotman CW. Exercise alters the immune profile in Tg2576 Alzheimer mice toward a response coincident with improved cognitive performance and decreased amyloid. J Neuroinflammation. 2008; 5:13.
24). Zoladz JA, Pilc A, Majerczak J, Grandys M, Zapart-Bukowska J, Duda K. Endurance training increases plasma brain-derived neurotrophic factor concentration in young health men. J Physiol Pharmacol. 2008; 59(Suppl 7):119–132.
25). Kvam S, Kleppe CL, Nordhus IH, Hovland A. Exercise as a treatment for depression: a metaanalysis. J Affect Disord. 2016; 202:67–86.
26). Schuch FB, Vancampfort D, Richards J, Rosenbaum S, Ward FB, Stubbs B. Exercise as a treatment for depression: a metaanalysis adjusting for publication bias. J Psychiatr Res. 2016; 77:42–51.
27). Schuch FB, Vancamport D, Rosenbaum S, Richards J, Ward PB, Veronese N, et al. Exercise for depression in older adults: a metaanalysis of randomized controlled trials adjusting for publication bias. Rev Bras Psiquiatr. 2016; 38:247–254.
28). Krogh J, Nordentoft M, Sterne JA, Lawlor DA. The effect of exercise in clinically depressed adults: systematic review and metaanalysis of randomized controlled trials. J Clin Psychiatry. 2011; 72:529–538.
29). Blumenthal JA, Babyak MA, Doraiswamy PM, Watkins L, Hoffman BM, Barbour KA, et al. Exercise and pharmacotherapy in the treatment of major depressive disorder. Psychosom Med. 2007; 69:587–596.
30). Blumenthal JA, Sherwood A, Babyak MA, Watkins LL, Smith PJ, Hoffman BM, et al. Exercise and pharmacological treatment of depressive symptoms in patients with coronary heart disease: results from the UPBEAT (understanding the prognostic benefits of exercise and antidepressant therapy) study. J Am Coll Cardiol. 2012; 60:1053–1063.
31). Button KS, Turner N, Campbell J, Kessler D, Kuyken W, Lewis G, et al. Moderators of response to cognitive behavioural therapy as an adjunct to pharmacotherapy for treatment-resistant depression in primary care. J Affect Disord. 2015; 174:272–280.
32). Donker T, Batterham PJ, Warmerdam L, Bennett K, Bennett A, Cui-jpers P, et al. Predictors and moderators of response to internet delivered interpersonal psychotherapy and cognitive behavior therapy for depression. J Affect Disord. 2013; 151:343–351.
33). Ozomaro U, Wahlestedt C, Nemeroff CB. Personalized medicine in psychiatry: problems and promises. BMC Med. 2013; 11:132.
34). Papakostas GI, Fava M. Predictors, moderators, and mediators (correlates) of treatment outcome in major depressive disorder. Dialogues Clin Neurosci. 2008; 10:439–451.
35). Insel T, Cuthbert B, Garvey M, Heinssen R, Pine DS, Quinn K, et al. Research domain criteria (RDoC): toward a new classification framework for research on mental disorders. Am J Psychiatry. 2010; 167:748–751.
36). Wallace ML, Frank E, Kraemer HC. A novel approach for developing and interpreting treatment moderator profiles in randomized clinical trials. JAMA Psychiatry. 2013; 70:1241–1247.
37). Brondino N, Rochetti M, Fusar-Poli L, Codrons E, Correale L, Vando-ni M, et al. A systemic review of cognitive effects of exercise in depression. Acta Psychiatr Scand. 2017; 135:285–295.
38). Hoffman BM, Blumenthal JA, Babyak MA, Smith PJ, Rogers SD, Doraiswamy PM, et al. Exercise fails to improve neurocognition in depressed middle-aged and older adults. Med Sci Sports Exerc. 2008; 40:1344–1352.
39). Greer TL, Grannemann BD, Chansard M, Karim AI, Trivedi MH. Dose-dependent changes in cognitive function with exercise augmentation for major depression: results from the TREAD study. Eur Neuropsychopharmacol. 2015; 25:248–256.
40). Wroolie TE, Williams KE, Keller J, Zappert LN, Shelton SD, Kenna HA, et al. Mood and neuropsychological changes in women with midlife depression treated with escitalopram. J Clin Psychopharmacol. 2006; 26:361–366.
41). Greer TL, Furman JL, Trivedi MH. Evaluation of the benefits of exercise on cognition in major depressive disorder. Gen Hosp Psychiatry. 2017; 49:19–25.
42). Harvey SB, Øverland S, Hatch SL, Weesely S, Mykletun A, Hotopf M. Exercise and the prevention of depression: results of the HUNT cohort study. Am J Psychiatry. 2018; 175:28–36.
43). Simon G. Should psychiatrists write the exercise prescription for depression? Am J Psychiatry. 2018; 175:2–3.
44). Weinstein AA, Koehmstedt C, Kop WJ. Mental health consequences of exercise withdrawal: a systemic review. Gen Hosp Psychiatry. 2017; 49:11–18.
45). Mausbach BT, Chattillion EA, Moore RC, Roepke SK, Depp CA, Roesch S. Activity restriction and depression in medical patients and their caregivers: a metaanalysis. Clin Psychol Rev. 2011; 31:900–908.
46). Jacobson NS, Martell CR, Dimidjian S. Behavioral activation treatment for depression: returning to contextual roots. Clin Psychol. 2001; 8:255–270.
Fig. 1.
Modeling for the associations among exercise, BDNF, and depression.17,18) BDNF : Brain-derived neurotrophic factor.
Table 1.
Moderators of response in exercise treatment for depression, proposed by Schuch et al.16)
| Specific moderator | |
|---|---|
| Clinical factor | Somatic symptoms |
| State anxiety | |
| Global functioning | |
| Psychological factor | Life satisfaction |
| Self-esteem | |
| Social factor | Social support |
| Marital status | |
| Biological factor | Brain-derived neurotrophic factor∗ |
| Tumor necrosis factor-α∗ | |
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