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Guo Z, Xie Z, Wang P, Li S, Xin X, Wang X. The moderating effect of physical activity on the relationship between neutrophil count and depressive symptoms. Sci Rep 2024; 14:12647. [PMID: 38825659 PMCID: PMC11144697 DOI: 10.1038/s41598-024-63432-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Accepted: 05/29/2024] [Indexed: 06/04/2024] Open
Abstract
Variations in immune cell counts can trigger depressive symptoms, while physical activity effectively reduces the risk and severity of depressive symptoms. This study, based on the NHANES database, analyzes the relationship between neutrophil count and depressive symptoms and explores the moderating effect of physical activity on this relationship. Cross-sectional data from the NHANES database were extracted, including immune cell counts, PHQ-9 scores for self-assessment of depressive symptoms, and Global Physical Activity Questionnaire (GPAQ) scores (PA). The interrelations among physical activity, neutrophil count, and depressive symptoms were analyzed. After controlling for confounding factors, neutrophil count was found to have a significant role in identifying depressive symptoms with an odds ratio (OR) [95% Confidence Interval (CI)] = 1.13 [1.02, 1.251]; the moderating effect of physical activity on the impact of neutrophil count on depressive symptoms was statistically significant (coefficient = -0.0028, P < 0.05). Neutrophil count may be a significant factor in identifying depressive symptoms in adults. As an effective moderating factor, physical activity can mitigate the impact of neutrophil count on depressive symptoms to a certain extent.
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Affiliation(s)
- Zhaohui Guo
- Shanghai University of Sport, Shanghai, 200438, China
| | - Zhenwen Xie
- Shanghai University of Sport, Shanghai, 200438, China
| | - Peng Wang
- Shanghai University of Sport, Shanghai, 200438, China
| | - Shufan Li
- Shanghai University of Sport, Shanghai, 200438, China
| | - Xin Xin
- Shanghai University of Sport, Shanghai, 200438, China
| | - Xing Wang
- Shanghai University of Sport, Shanghai, 200438, China.
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2
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Kowalec K, Harder A, Dolovich C, Fitzgerald KC, Salter A, Lu Y, Bernstein CN, Bolton JM, Cutter G, Fisk JD, Gelernter J, Graff LA, Hägg S, Hitchon CA, Levey DF, Lublin FD, McKay KA, Patten S, Patki A, Stein MB, Tiwari HK, Wolinsky JS, Marrie RA. Polygenic liability for anxiety in association with comorbid anxiety in multiple sclerosis. Ann Clin Transl Neurol 2024; 11:1393-1404. [PMID: 38715244 PMCID: PMC11187942 DOI: 10.1002/acn3.52025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Accepted: 02/03/2024] [Indexed: 06/20/2024] Open
Abstract
OBJECTIVE Comorbid anxiety occurs often in MS and is associated with disability progression. Polygenic scores offer a possible means of anxiety risk prediction but often have not been validated outside the original discovery population. We aimed to investigate the association between the Generalized Anxiety Disorder 2-item scale polygenic score with anxiety in MS. METHODS Using a case-control design, participants from Canadian, UK Biobank, and United States cohorts were grouped into cases (MS/comorbid anxiety) or controls (MS/no anxiety, anxiety/no immune disease or healthy). We used multiple anxiety measures: current symptoms, lifetime interview-diagnosed, and lifetime self-report physician-diagnosed. The polygenic score was computed for current anxiety symptoms using summary statistics from a previous genome-wide association study and was tested using regression. RESULTS A total of 71,343 individuals of European genetic ancestry were used: Canada (n = 334; 212 MS), UK Biobank (n = 70,431; 1,390 MS), and the USA (n = 578 MS). Meta-analyses identified that in MS, each 1-SD increase in the polygenic score was associated with ~50% increased odds of comorbid moderate anxious symptoms compared to those with less than moderate anxious symptoms (OR: 1.47, 95% CI: 1.09-1.99). We found a similar direction of effects in the other measures. MS had a similar anxiety genetic burden compared to people with anxiety as the index disease. INTERPRETATION Higher genetic burden for anxiety was associated with significantly increased odds of moderate anxious symptoms in MS of European genetic ancestry which did not differ from those with anxiety and no comorbid immune disease. This study suggests a genetic basis for anxiety in MS.
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Affiliation(s)
- Kaarina Kowalec
- Rady Faculty of Health SciencesUniversity of ManitobaWinnipegCanada
- Department of Medical Epidemiology & BiostatisticsKarolinska InstitutetSolnaSweden
| | - Arvid Harder
- Department of Medical Epidemiology & BiostatisticsKarolinska InstitutetSolnaSweden
| | - Casandra Dolovich
- Department of Internal MedicineMax Rady College of Medicine, Rady Faculty of Health Sciences, University of ManitobaWinnipegCanada
| | | | - Amber Salter
- Department of NeurologyUT SouthwesternDallasTexasUSA
| | - Yi Lu
- Department of Medical Epidemiology & BiostatisticsKarolinska InstitutetSolnaSweden
| | - Charles N. Bernstein
- Department of Internal MedicineMax Rady College of Medicine, Rady Faculty of Health Sciences, University of ManitobaWinnipegCanada
| | - James M. Bolton
- Department of PsychiatryMax Rady College of Medicine, Rady Faculty of Health Sciences, University of ManitobaWinnipegCanada
| | - Gary Cutter
- Department of BiostatisticsUniversity of Alabama at BirminghamBirminghamAlabamaUSA
| | - John D. Fisk
- Nova Scotia Health and Departments of Psychiatry, Psychology & Neuroscience, and MedicineDalhousie UniversityHalifaxNova ScotiaCanada
| | - Joel Gelernter
- Department of PsychiatryYale University, School of MedicineNew HavenConnecticutUSA
- Department of PsychiatryVA Connecticut Healthcare SystemNew HavenConnecticutUSA
| | - Lesley A. Graff
- Department of Clinical Health PsychologyMax Rady College of Medicine, Rady Faculty of Health Sciences, University of ManitobaWinnipegCanada
| | - Sara Hägg
- Department of Medical Epidemiology & BiostatisticsKarolinska InstitutetSolnaSweden
| | - Carol A. Hitchon
- Department of RheumatologyMax Rady College of Medicine, Rady Faculty of Health Sciences, University of ManitobaWinnipegCanada
| | - Daniel F. Levey
- Department of PsychiatryYale University, School of MedicineNew HavenConnecticutUSA
- Department of PsychiatryVA Connecticut Healthcare SystemNew HavenConnecticutUSA
| | - Fred D. Lublin
- Icahn School of Medicine at Mount SinaiNew YorkNew YorkUSA
| | - Kyla A. McKay
- Department of Clinical NeuroscienceKarolinska InstitutetSolnaSweden
| | - Scott Patten
- Department of Community Health SciencesCumming School of Medicine, University of CalgaryCalgaryCanada
| | - Amit Patki
- Department of BiostatisticsUniversity of Alabama at BirminghamBirminghamAlabamaUSA
| | - Murray B. Stein
- Department of PsychiatryMax Rady College of Medicine, Rady Faculty of Health Sciences, University of ManitobaWinnipegCanada
- Department of PsychiatryUniversity of California San DiegoLa JollaCaliforniaUSA
| | - Hemant K. Tiwari
- Department of BiostatisticsUniversity of Alabama at BirminghamBirminghamAlabamaUSA
| | - Jerry S. Wolinsky
- Department of NeurologyMcGovern Medical School, The University of Texas Health Science Center at Houston (UTHealth)HoustonTexasUSA
| | - Ruth A. Marrie
- Department of Internal MedicineMax Rady College of Medicine, Rady Faculty of Health Sciences, University of ManitobaWinnipegCanada
- Department of Community Health SciencesMax Rady College of Medicine, Rady Faculty of Health Sciences, University of ManitobaWinnipegCanada
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Ren FF, Hillman CH, Wang WG, Li RH, Zhou WS, Liang WM, Yang Y, Chen FT, Chang YK. Effects of aerobic exercise on cognitive function in adults with major depressive disorder: A systematic review and meta-analysis. Int J Clin Health Psychol 2024; 24:100447. [PMID: 38371396 PMCID: PMC10869919 DOI: 10.1016/j.ijchp.2024.100447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Accepted: 01/30/2024] [Indexed: 02/20/2024] Open
Abstract
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.
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Affiliation(s)
- Fei-Fei Ren
- Department of Physical Education, Beijing Language and Culture University, Beijing, China
| | - Charles H. Hillman
- Department of Psychology, Northeastern University, Boston, MA, USA
- Department of Physical Therapy, Movement, and Rehabilitation, Northeastern University, Boston, MA, USA
| | - Wei-Guang Wang
- Department of Physical Education, Beijing Language and Culture University, Beijing, China
| | - Ruei-Hong Li
- Department of Physical Education and Sport Sciences, National Taiwan Normal University, Taipei, Taiwan
| | - Wen-Sheng Zhou
- Department of Physical Education, Jiangsu Second Normal University, Jiangsu, China
| | - Wen-Ming Liang
- Life Sciences Center, Vilnius University, Vilnius, Lithuania
| | - Yong Yang
- Laboratory of Kinesiology and Rehabilitation, School of Physical Education and Sport, Chaohu University, Anhui, China
| | - Feng-Tzu Chen
- Department of Kinesiology, National Tsing Hua University, Hsinchu, Taiwan
| | - Yu-Kai Chang
- Department of Physical Education and Sport Sciences, National Taiwan Normal University, Taipei, Taiwan
- Social Emotional Education and Development Center, National Taiwan Normal University, Taipei, Taiwan
- Institute for Research Excellence in Learning Science, National Taiwan Normal University, Taipei, Taiwan
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Gunzler DD, De Nadai AS, Miller D, Ontaneda D, Briggs FB. Long-term trajectories of ambulatory impairment in multiple sclerosis. Mult Scler 2023; 29:1282-1295. [PMID: 37503861 PMCID: PMC10528275 DOI: 10.1177/13524585231187521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/29/2023]
Abstract
BACKGROUND Ambulatory impairment is a common and complex manifestation of multiple sclerosis (MS), and longitudinal patterns are not well understood. OBJECTIVE To characterize longitudinal walking speed trajectories in a general MS patient population and in those with early disease (⩽ 5 years from onset), identify subgroups with similar patterns, and examine associations with individual attributes. METHODS Using a retrospective cohort study design, latent class growth analysis was applied to longitudinal timed 25-foot walk (T25-FW) data from 7683 MS patients, to determine T25-FW trajectories. Associations were evaluated between trajectory assignment and individual attributes. Analyses were repeated for 2591 patients with early disease. RESULTS In the general patient population, six trajectories were discerned, ranging from very minimal to very high impairment at baseline, with variability in impairment accrual. The clusters with moderate to very high walking impairment were associated with being female, older and Black American, longer symptom duration, progressive course, and depressive symptoms. In the early disease subset, eight trajectories were discerned that included two subgroups that rapidly accrued impairment. CONCLUSION We identified novel subgroups of MS patients will distinct long-term T25-FW trajectories. These results underscore that socially disadvantaged and economically marginalized MS patients are the most vulnerable for severe ambulatory impairment.
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Affiliation(s)
- Douglas D. Gunzler
- Department of Population and Quantitative Health Sciences,
Case Western Reserve University School of Medicine, Cleveland, OH, USA
- Center for Health Care Research and Policy, School of
Medicine, Case Western Reserve University, Cleveland, OH, USA
| | | | - Deborah Miller
- The Mellen Center for Multiple Sclerosis and Research,
Department of Neurology, Neurological Institute, Cleveland Clinic Foundation,
Cleveland, OH, USA
- Cleveland Clinic Lerner College of Medicine of Case
Western Reserve University, Cleveland, OH, USA
| | - Daniel Ontaneda
- The Mellen Center for Multiple Sclerosis and Research,
Department of Neurology, Neurological Institute, Cleveland Clinic Foundation,
Cleveland, OH, USA
- Cleveland Clinic Lerner College of Medicine of Case
Western Reserve University, Cleveland, OH, USA
| | - Farren B.S. Briggs
- Department of Population and Quantitative Health Sciences,
Case Western Reserve University School of Medicine, Cleveland, OH, USA
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5
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Marrie RA. The Barancik lecture: Comorbidity in multiple sclerosis-Looking backward, looking forward. Mult Scler 2023; 29:1049-1056. [PMID: 37125430 PMCID: PMC10413784 DOI: 10.1177/13524585231167740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 03/11/2023] [Accepted: 03/19/2023] [Indexed: 05/02/2023]
Abstract
Comorbidity is highly prevalent in people with multiple sclerosis (MS) throughout their disease course. In the last 15 years, our understanding of the association between comorbidity and outcomes such as relapses, disability progressive, health-related quality of life, health care use, and mortality has grown substantially. The broad adverse impacts of comorbidity on these outcomes point to the need to prevent and treat comorbidity effectively in people with MS. This requires having the necessary tools to evaluate comorbidity, an understanding of how MS affects management of comorbidity now, testing of interventions tailored to people with MS, and determining the best models of care to optimize comorbidity management.
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Affiliation(s)
- Ruth Ann Marrie
- Department of Internal Medicine, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada/Department of Community Health Sciences, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
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6
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Hu C, Dewey BE, Mowry EM, Fitzgerald KC. Deep gray matter substructure volumes and depressive symptoms in a large multiple sclerosis cohort. Mult Scler 2023:13524585221148144. [PMID: 36691798 DOI: 10.1177/13524585221148144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
BACKGROUND Consistent findings on underlying brain features or specific structural atrophy patterns contributing to depression in multiple sclerosis (MS) are limited. OBJECTIVE To investigate how deep gray matter (DGM) features predict depressive symptom trajectories in MS patients. METHODS We used data from the MS Partners Advancing Technology and Health Solutions (MS PATHS) network in which standardized patient information and outcomes are collected. We performed whole-brain segmentation using SLANT-CRUISE. We assessed if DGM structures were associated with elevated depressive symptoms over follow-up and with depressive symptom phenotypes. RESULTS We included 3844 participants (average age: 46.05 ± 11.83 years; 72.7% female) of whom 1905 (49.5%) experienced ⩾1 periods of elevated depressive symptoms over 2.6 ± 0.9 years mean follow-up. Higher caudate, putamen, accumbens, ventral diencephalon, thalamus, and amygdala volumes were associated with lower odds of elevated depressive symptoms over follow-up (odds ratio (OR) range per 1 SD (standard deviation) increase in volume: 0.88-0.94). For example, a 1 SD increase in accumbens or caudate volume was associated with 12% or 10% respective lower odds of having a period of elevated depressive symptoms over follow-up (for accumbens: OR: 0.88; 95% confidence interval (CI): 0.83-0.93; p < 0.001; for caudate: OR: 0.90; 95% CI: 0.85-0.96; p = 0.003). CONCLUSION Lower DGM volumes were associated with depressive symptom trajectories in MS.
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Affiliation(s)
- Chen Hu
- Division of Neuroimmunology and Neurological Infections, Departments of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Blake E Dewey
- Division of Neuroimmunology and Neurological Infections, Departments of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Ellen M Mowry
- Division of Neuroimmunology and Neurological Infections, Departments of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Kathryn C Fitzgerald
- Division of Neuroimmunology and Neurological Infections, Departments of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA/Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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