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Effects of Endurance Exercise Modalities on Arterial Stiffness in Patients Suffering from Unipolar Depression: A Randomized Controlled Trial.

ABSTRACT: Background:Psychiatric disorders are associated with a higher prevalence of cardiovascular disease and mortality. Regular exercise has been shown to reduce depressive symptoms and improve arterial stiffness as a biomarker of cardiovascular risk. We aimed to investigate the effects of different exercise modalities on depression severity index and arterial stiffness in patients suffering from unipolar depression. Methods:34 patients suffering from unipolar depression [female: 25, male: 9, age: 37.8, Beck-Depression-Inventory-II (BDI-II) score: 31.0] were enrolled in this two-armed randomized controlled trial. Central hemodynamics, augmentation index at heart rate 75/min (AIx@75) and aortic pulse wave velocity (PWV) were obtained by an oscillometric monitoring device. Maximal bicycle ergometer exercise testing yielded maximal fitness parameters. Patients were assigned to either high-intensity low volume (HILV) or moderate continuous aerobic training (MCT). Both intervention groups trained three times a week during a 4-week intervention period. BDI-II were filled out by the patients before and after the intervention period. Results:We found moderate interaction effects on depression severity reduction [Formula: see text]. HILV showed a 85% beneficial effect in lowering BDI-II scores compared to MCT (HILV: pre: 28.8 (9.5), post: 15.5 (8.5), SMD?=?1.48), MCT: (pre: 33.8 (8.5), post: 22.6 (7.5), SMD?=?1.40). Reduction of AIx@75 was more pronounced after MCT (SMD?=?0.61) compared to HILV (SMD?=?0.08), showing 37% possibly beneficial effects of MCT over HILV. PWV remained unchanged in both training groups. Conclusion:Both training regimes showed large effects on the reduction of depressive symptoms. While HILV was more effective in lowering depression severity, MCT was more effective in additionally lowering peripheral arterial stiffness. Exercise should be considered an important strategy for preventive as well as rehabilitative treatment in depression.

SUBMITTER: Hanssen H

PROVIDER: S-EPMC5786741 | biostudies-literature | 2017

REPOSITORIES: biostudies-literature

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Effects of Endurance Exercise Modalities on Arterial Stiffness in Patients Suffering from Unipolar Depression: A Randomized Controlled Trial.

Hanssen Henner H Minghetti Alice A Faude Oliver O Schmidt-Trucksäss Arno A Zahner Lukas L Beck Johannes J Donath Lars L

Frontiers in psychiatry 20180122

<h4>Background</h4>Psychiatric disorders are associated with a higher prevalence of cardiovascular disease and mortality. Regular exercise has been shown to reduce depressive symptoms and improve arterial stiffness as a biomarker of cardiovascular risk. We aimed to investigate the effects of different exercise modalities on depression severity index and arterial stiffness in patients suffering from unipolar depression.<h4>Methods</h4>34 patients suffering from unipolar depression [female: 25, ma ...[more]

PMID: 29403399

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Project description:BackgroundExercise is accepted as an important contribution to the rehabilitation of patients with cardiovascular disease (CVD). This study aims to better understand the possible causes for lack of consensus and reviews the effects of three exercise modalities (aerobic, resistance and combined exercise) on central hemodynamics, arterial stiffness and cardiac function for better rehabilitation strategies in CVD.MethodsThe electronic data sources, Cochrane Library, MEDLINE, Web of Science, EBSCO (CINAHL), and ScienceDirect from inception to July 2017 were searched for randomized controlled trials (RCTs) investigating the effect of exercise modalities in adult patients with CVD. The effect size was estimated as mean differences (MD) with 95% confidence intervals (CI). Subgroup analysis and meta-regression were used to study potential moderating factors.ResultsThirty-eight articles describing RCTs with a total of 2089 patients with CVD were included. The pooling revealed that aerobic exercise [MD(95%CI) = -5.87 (-8.85, -2.88), P = 0.0001] and resistance exercise [MD(95%CI) = -7.62 (-10.69, -4.54), P<0.00001] significantly decreased aortic systolic pressure (ASP). Resistance exercise significantly decreased aortic diastolic pressure [MD(95%CI) = -4(-5.63, -2.37), P<0.00001]. Aerobic exercise significantly decreased augmentation index (AIx) based on 24-week exercise duration and patients aged 50-60 years. Meanwhile, aerobic exercise significantly improved carotid-femoral pulse wave velocity (cf-PWV) [MD(95%CI) = -0.42 (-0.83, -0.01), P = 0.04], cardiac output (CO) [MD(95% CI) = 0.36(0.08, 0.64), P = 0.01] and left ventricular ejection fraction (LVEF) [MD(95%CI) = 3.02 (2.11, 3.93), P<0.00001]. Combined exercise significantly improved cf-PWV [MD(95%CI) = -1.15 (-1.95, -0.36), P = 0.004] and CO [MD(95% CI) = 0.9 (0.39, 1.41), P = 0.0006].ConclusionsAerobic and resistance exercise significantly decreased ASP, and long-term aerobic exercise reduced AIx. Meanwhile, aerobic and combined exercise significantly improved central arterial stiffness and cardiac function in patients with CVD. These findings suggest that a well-planned regime could optimize the beneficial effects of exercise and can provide some evidence-based guidance for those involved in cardiovascular rehabilitation of patients with CVD.

Project description:Study objectivesInsomnia increases the risk of negative disease trajectory, relapse, and suicide in patients with depression. We aimed at investigating the effects of a single bout of aerobic exercise, performed after 02:00 pm, on the subsequent night's sleep in patients with depression.MethodsThe study was designed as a two-arm parallel-group, randomized, outcome assessor-blinded, controlled, superiority trial. Patients between 18 and 65 years of age with a primary diagnosis of unipolar depression were included. The intervention was a single 30-minute bout of moderate aerobic exercise. The control group sat and read for 30 minutes. The primary outcome was sleep efficiency measured by polysomnography. Secondary outcomes were other polysomnographic variables, subjective sleep quality, daytime sleepiness, mood states, and adverse events.ResultsNinety-two patients were randomized to the exercise (N = 46) or control group (N = 46). There were no clinically relevant differences at baseline. Intent-to-treat analysis ANCOVA of follow-up sleep efficiency, adjusted for baseline levels and minimization factors, did not detect a significant effect of the allocation (β = -0.93, p = 0.59). There was no evidence for significant differences between both groups in any other objective or subjective sleep outcomes, daytime sleepiness, or adverse events. The intervention had an immediate positive effect on mood states, including depressiveness (β = -0.40, p = 0.003).ConclusionsThis is the first trial to study the effects of a single bout of aerobic exercise on sleep in patients with depression to the best of our knowledge. Aerobic exercise had no effect on sleep efficiency but had a strong beneficial effect on mood and did not increase adverse outcomes. These results add to the growing body of evidence that, contrary to sleep hygiene recommendations, exercise after 02:00 pm is not detrimental for sleep.Clinical trial registrationClinicaltrials.gov, https://clinicaltrials.gov/ct2/show/NCT03673397. Protocol registered on September 17, 2018.

Project description:Affect experienced during an exercise session is supposed to predict future exercise behavior. However, empirical evidence reveals high variability in affective response to different exercise modalities. Thus, the purpose of the present study was to compare acute affective response and its variation during three different endurance exercise modalities: (a) moderate-intensity continuous exercise (MICE), (b) vigorous-intensity continuous exercise (VICE), and (c) high-intensity interval exercise (HIIE). Using the dual-mode theory as a theoretical framework, cognitive and interoceptive factors were considered as potential predictors of in-task affective response. In a within-subject design, 40 insufficiently active healthy participants (aged from 20 to 40 years) attended three sessions per exercise modality on a cycle ergometer. Affective valence (measured by the Feeling Scale), two cognitive factors (perceived competence and awareness of interoceptive cues), and one interoceptive factor (heart rate) were assessed before, during, and after each exercise session. Mixed models with three levels (subject, exercise session, and time point) revealed more positive affective valence during MICE compared with VICE (p < 0.001) and HIIE (p < 0.01), while there was no significant difference between the latter two. Levene's test results showed the highest variability of in-task affective valence during VICE (ps < 0.01). Regarding the course across the session, MICE was associated with a constant slight increase in affective valence from pre- to post-exercise (p < 0.05), whereas VICE and HIIE caused a decline in pleasure, followed by an affective rebound immediately after exercise termination (ps < 0.01). The highest importance of cognitive and interoceptive factors for in-task affective valence was observed in VICE (ps < 0.05). The current findings provide support for the tenets of the dual-mode theory, however, indicating that there may be differences in the affect-intensity relationship between continuous and interval exercise. In conclusion, the study results concerning previously insufficiently active individuals extend the knowledge of how exercise can positively shape affective well-being depending on exercise modality and psychophysiological influences. This knowledge enables public health practitioners to design more individualized activity recommendations, thereby improving the subjective experience of exercise.

Project description:Objective: To identify changes in skeletal muscle microRNA expression after endurance exercise and associate the identified microRNAs with mRNA and protein expression to disease-specific pathways in polymyositis (PM) and dermatomyositis (DM) patients.Methods: Following a parallel clinical trial design, patients with probable PM or DM, exercising less than once a week, and on stable medication for at least one month were randomized into two groups at Karolinska University Hospital: a 12-week endurance exercise group (n = 12) or a non-exercised control group (n = 11). Using an Affymetrix microarray, microRNA expression was determined in paired muscle biopsies taken before and after the exercise intervention from 3 patients in each group. Ingenuity pathway analysis with a microRNA target filter was used to identify microRNA transcript targets. These targets were investigated at the mRNA (microarray) and protein (mass spectrometry) levels in patients.Results: Endurance exercise altered 39 microRNAs. The microRNAs with increased expression were predicted to target transcripts involved in inflammatory processes, metabolism, and muscle atrophy. Further, these target transcripts had an associated decrease in mRNA expression in exercised patients. In particular, a decrease in the NF-?B regulator IKBKB was associated with an increase in its target microRNA (miR-196b). At the protein level, there was an increase in mitochondrial proteins (AK3, HIBADH), which were associated with a decrease in microRNAs that were predicted to regulate their expression.Conclusion: Improvement in disease phenotype after exercise is associated with increasing microRNAs that target and downregulate immune processes at the transcript level, as well as decreasing microRNAs that target and upregulate mitochondrial content at the protein level. Therefore, microRNAs may improve disease by decreasing immune responses and increasing mitochondrial biogenesis.Trial registration: ClinicalTrials.gov NCT01184625.

Dataset Information

Effects of Endurance Exercise Modalities on Arterial Stiffness in Patients Suffering from Unipolar Depression: A Randomized Controlled Trial.

Publications

Effects of Endurance Exercise Modalities on Arterial Stiffness in Patients Suffering from Unipolar Depression: A Randomized Controlled Trial.

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