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Effects of Aerobic Exercise on Cortisol Stress Reactivity in Response to the Trier Social Stress Test in Inpatients with Major Depressive Disorders: A Randomized Controlled Trial.

ABSTRACT: Physical activity is associated with a favourable (blunted) cortisol stress reactivity in healthy people. However, evidence from experimental study and with psychiatric patients is missing. This study examines whether exercise training impacts on cortisol stress reactivity in inpatients with major depressive disorder (MDD). These new insights are important because the stress reactivity of healthy people and patients with severe symptoms of depression might differ. Methods: The study was designed as a randomized controlled trial (trial registration number: NCT02679053). In total, 25 patients (13 women, 12 men, mean age: 38.1 12.0 years) completed a laboratory stressor task before and after a six-week intervention period. Nine samples of salivary free cortisol were taken before and after the Trier social stress test (TSST). Fourteen participants took part in six weeks of aerobic exercise training, while 11 patients were allocated to the control condition. While the primary outcome of the study was depressive symptom severity, the focus of this paper is on one of the secondary outcomes (cortisol reactivity during the TSST). The impact of aerobic exercise training was examined with a repeated-measures analysis of variance. We also examined the association between change in depression and cortisol response via correlational analysis. Cortisol reactivity did not change from baseline to post-intervention, either in the intervention or the control group. Participation in six weeks of aerobic exercise training was not associated with participants' cortisol reactivity. Moreover, depressive symptom change was not associated with change in cortisol response. Aerobic exercise training was not associated with patients' stress reactivity in this study. Because many patients initially showed a relatively flat/blunted cortisol response curve, efforts might be needed to find out which treatments are most efficient to promote a normalization of HPA axis reactivity.

SUBMITTER: Gerber M

PROVIDER: S-EPMC7291068 | biostudies-literature | 2020 May

REPOSITORIES: biostudies-literature

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Effects of Aerobic Exercise on Cortisol Stress Reactivity in Response to the Trier Social Stress Test in Inpatients with Major Depressive Disorders: A Randomized Controlled Trial.

Gerber Markus M Imboden Christian C Beck Johannes J Brand Serge S Colledge Flora F Eckert Anne A Holsboer-Trachsler Edith E Pühse Uwe U Hatzinger Martin M

Journal of clinical medicine 20200511 5

Physical activity is associated with a favourable (blunted) cortisol stress reactivity in healthy people. However, evidence from experimental study and with psychiatric patients is missing. This study examines whether exercise training impacts on cortisol stress reactivity in inpatients with major depressive disorder (MDD). These new insights are important because the stress reactivity of healthy people and patients with severe symptoms of depression might differ. Methods: The study was designed ...[more]

PMID: 32403243

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Project description:Sympathetic responsiveness to laboratory mental stress is highly variable, making interpretations of its role in stress reactivity challenging. The present study assessed muscle sympathetic nerve activity (MSNA, microneurography) responsiveness to the Trier social stress test (TSST), which employs an anticipatory stress phase, followed by a public speaking and mental arithmetic task. We hypothesized that sympathetic reactivity to the anticipatory phase would offer a more uniform response between individuals due to elimination of confounds (i.e. respiratory changes, muscle movement, etc.) observed during more common stress tasks. Participants included 26 healthy adults (11 men, 15 women, age: 25 ± 6 years, body mass index: 24 ± 3 kg/m2 ). Continuous heart rate (electrocardiogram) and beat-to-beat blood pressure (finger plethysmography) were recorded from all participants, while MSNA recordings were obtained in 20 participants. MSNA burst frequency was significantly reduced during anticipatory stress. During the speech, although burst frequency was unchanged, total MSNA was significantly increased. Changes in diastolic arterial pressure were predictive of changes in MSNA during anticipatory (β = -0.680, P = 0.001), but not the speech (P = 0.318) or mental maths (P = 0.051) phases. Lastly, sympathetic reactivity to anticipatory stress was predictive of subsequent reactivity to both speech (β = 0.740, P = 0.0002) and maths (β = 0.663, P = 0.001). In conclusion, anticipatory social stress may offer a more versatile means of assessing sympathetic reactivity to mental stress in the absence of confounds and appears to predict reactivity to subsequent mental stress paradigms. KEY POINTS: Cardiovascular reactivity to laboratory mental stress is predictive of future health outcomes. However, reactivity of the sympathetic nervous system to mental stress is highly variable. The current study assessed peripheral muscle sympathetic nerve activity in response to the Trier social stress test, a psychosocial stressor that includes anticipatory stress, public speaking and mental arithmetic. Our findings demonstrate that sympathetic neural activity is consistently reduced during anticipatory stress. Conversely, the classically observed inter-individual variability of sympathetic responsiveness was observed during speech and maths tasks. Additionally, sympathetic reactivity to the anticipatory period accurately predicted how an individual would respond to both speech and maths tasks, outlining the utility of anticipatory stress in future research surrounding stress reactivity. Utilization of the Trier social stress test in autonomic physiology may offer an alternative assessment of sympathetic responsiveness to stress with more consistent inter-individual responsiveness and may be a useful tool for further investigation of stress reactivity.

Project description:BackgroundThis study aimed to determine whether individual differences in resilience interacted with those in alcohol consumption habits in situations involving exposure to psychosocial stressors (Trier Social Stress Test-Online; TSST-OL). Additionally, we investigated whether individuals exhibiting resilience in their psychological scale scores showed biological responses that could be interpreted as resilience in stressful situations, such as the TSST-OL. We hypothesized that there would be no association between drinking habits and stress responses in the high-resilience group. Furthermore, high drinking habits would be associated with high stress responses in the low-resilience group.MethodsWe recruited 22 and 20 individuals from the high and low-resilience groups, respectively, from among those who completed the online survey comprising the Alcohol Use Disorders Identification Test (AUDIT) and resilience scales; we excluded individuals with AUDIT scores of 15 or higher, and divided them by the median total resilience scale score. During the TSST-OL, self-rated stress measurement and saliva sample collection were performed seven times. Frozen samples were collected at the Tokyo site, and salivary hormonal (cortisol and dehydroepiandrosterone) levels were measured after transport in frozen state. Finally, 36 participants were included in the analysis of self-rated stress and cortisol levels.ResultsWe observed the typical subjective stress responses to the TSST-OL. People with higher psychological scale scores for resilience traits showed significantly higher salivary cortisol levels than those with lower scores. Due to deficiencies in the survey and experimental design, the classification criteria were changed and an exploratory analysis was performed to investigate the interaction of individual differences in resilience and drinking habits. In contrast to our expectation, those with low resilience scores showed stress responses, regardless of their drinking habits. Furthermore, those with high resilience and drinking habits showed a specific insensitivity to salivary cortisol levels. Their self-rated stress scores were similar to those of other groups.ConclusionsOur study showed the applicability of the TSST-OL in the Japanese population, the individual relationship between psychological resilience measures and biological stress responses, and a specific insensitivity in the salivary cortisol response as a result of individual differences in high resilience and drinking habits.

Project description:BackgroundThe Trier Social Stress Test (TSST) is one of the most widely used laboratory-based psychological stress paradigms. Previous studies have shown that males have a more robust cortisol response than females in the TSST. However, the effects of sample size, speech topic, and interaction between sex and speech topic on cortisol responses in TSST remain elusive. Our goal was to evaluate these influencing factors in the TSST using salivary cortisol reactivity as an objective measure.MethodsWe collected TSST research articles in Web of Science, PubMed, PsycNet, and CNKI. We only included TSST studies that had measures of salivary cortisol both before and after task completion. A total of 65 articles involving 76 sub-studies met our inclusion criteria, with a total of 5171 participants (2040 females and 3131 males). The effects of sample sizes were assessed to determine if results of studies with various sample sizes were stable. We performed multivariate meta-regression to determine the effects of speech topic, sex, and the interaction between sex and speech topic after controlling their confounding effects. Subgroup analysis of sex was conducted to detect inter-group differences. We further evaluated the baseline and peak salivary cortisol concentrations for males and females independently to detect the sources of sex differences.ResultsThe average effect size (i.e., Cohen's d) of salivary cortisol reactivity was 0.93, 95% CI = 0.82 to 1.04, p < .001. The small studies produced larger variations in the reported effect sizes than the large-sample studies (r = -0.24, p = .041). A sample size of 40 was necessary to provide sufficient statistical power to detect significant changes of salivary cortisol in TSST. Speech topics, sex, and sex-speech topic interaction could predict salivary cortisol responses (F(df1 = 3, df2 = 72) = 11.98, p < .001) and explained 42.68% of the total experimental variation. Sex was the only significant contributing factor (p < .00025) in the regression model. Salivary cortisol responses in males were significantly higher than in females (Q B = 42.89, df = 1, p < .001). Further, significant differences between males and females were detected at baseline (t = -2.03, df = 74, p = .046) and peak (t = -4.96, df = 74, p < .001).ConclusionsThe TSST effectively induces stress response as measured by salivary cortisol change. Forty samples is the minimum sample size for detecting the robust salivary cortisol responses. We confirmed that males have more robust salivary cortisol reactivity than females in TSST. Speech topics that we tested did not significantly contribute to differences in salivary cortisol responses. No significant interaction between sex and speech topic on salivary cortisol responses was detected.

Dataset Information

Effects of Aerobic Exercise on Cortisol Stress Reactivity in Response to the Trier Social Stress Test in Inpatients with Major Depressive Disorders: A Randomized Controlled Trial.

Publications

Effects of Aerobic Exercise on Cortisol Stress Reactivity in Response to the Trier Social Stress Test in Inpatients with Major Depressive Disorders: A Randomized Controlled Trial.

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