Iraj Salehi1, Seyed Mohammad Hosseini1, Mohammad Haghighi1, Leila Jahangard1, Hafez Bajoghli2, Markus Gerber3, Uwe Pühse3, Edith Holsboer-Trachsler4, Serge Brand5. 1. Research Center For Behavioral Disorders and Substances Abuse, Hamadan University of Medical Sciences, Hamadan, Iran. 2. Iranian National Center for Addiction Studies (INCAS), Tehran University of Medical Sciences, Tehran, Iran. 3. Department of Sport, Exercise and Health, Sport Science Section, University of Basel, Basel, Switzerland. 4. Psychiatric Clinics of the University of Basel, Center for Affective, Stress and Sleep Disorders (ZASS), Basel, Switzerland. 5. Department of Sport, Exercise and Health, Sport Science Section, University of Basel, Basel, Switzerland; Psychiatric Clinics of the University of Basel, Center for Affective, Stress and Sleep Disorders (ZASS), Basel, Switzerland. Electronic address: serge.brand@upkbs.ch.
Abstract
BACKGROUND: To treat patients suffering from major depressive disorder (MDD), research has focused on electroconvulsive therapy (ECT) and aerobic exercise training (AET). Brain derived neurotrophic factor (BDNF) seems to be key in MDD. The aims of the present study were therefore two-fold, to investigate in a three-arm interventional study the differential effects of ECT, ECT plus AET, and AET alone in patients suffering from TR-MDD on 1. depressive symptoms and 2. plasma BDNF (pBDNF). METHODS: 60 patients with MDD (mean age: 31 years; 31.6% female patients) were randomly assigned either to the ECT, ECT + AET, or AET condition. The AET condition consisted of treadmill exercise for 45 min, three times a week. Both depression severity and pBDNF levels were assessed at baseline and 4 weeks later. All patients were further treated with an SSRI standard medication. RESULTS:pBDNF levels increased over time in all three study conditions, though, highest increase was observed in the ECT + EAT condition, and lowest increase was observed in the AET condition. Depressive symptoms decreased in all three conditions over time, though, strongest decrease was observed in the ECT + AET condition. The combination of ECT + AET led to significantly greater remission rates than in either the ECT or AET alone conditions. BDNF levels were not associated with symptoms of depression. CONCLUSIONS: The pattern of results suggests that ECT, AET and particularly their combination are promising directions for the treatment of patients suffering from MDD, and that it remains unclear to what extent pBDNF is key and a reliable biomarker for MDD.
RCT Entities:
BACKGROUND: To treat patients suffering from major depressive disorder (MDD), research has focused on electroconvulsive therapy (ECT) and aerobic exercise training (AET). Brain derived neurotrophic factor (BDNF) seems to be key in MDD. The aims of the present study were therefore two-fold, to investigate in a three-arm interventional study the differential effects of ECT, ECT plus AET, and AET alone in patients suffering from TR-MDD on 1. depressive symptoms and 2. plasma BDNF (pBDNF). METHODS: 60 patients with MDD (mean age: 31 years; 31.6% female patients) were randomly assigned either to the ECT, ECT + AET, or AET condition. The AET condition consisted of treadmill exercise for 45 min, three times a week. Both depression severity and pBDNF levels were assessed at baseline and 4 weeks later. All patients were further treated with an SSRI standard medication. RESULTS: pBDNF levels increased over time in all three study conditions, though, highest increase was observed in the ECT + EAT condition, and lowest increase was observed in the AET condition. Depressive symptoms decreased in all three conditions over time, though, strongest decrease was observed in the ECT + AET condition. The combination of ECT + AET led to significantly greater remission rates than in either the ECT or AET alone conditions. BDNF levels were not associated with symptoms of depression. CONCLUSIONS: The pattern of results suggests that ECT, AET and particularly their combination are promising directions for the treatment of patients suffering from MDD, and that it remains unclear to what extent pBDNF is key and a reliable biomarker for MDD.
Authors: Annamari Sorri; Kaija Järventausta; Olli Kampman; Kai Lehtimäki; Minna Björkqvist; Kati Tuohimaa; Mari Hämäläinen; Eeva Moilanen; Esa Leinonen Journal: Brain Behav Date: 2018-10-01 Impact factor: 2.708