Brain-Derived Neurotrophic Factor, Depression, and Physical Activity: Making the Neuroplastic Connection

Relationship between apathy/post-stroke depression and gait training in patients with stroke

BACKGROUND

We examined the effect of gait training on apathy/post-stroke depression (PSD) in patients with walking disorders after stroke, and the effect of apathy/PSD on gait reacquisition in subacute stroke.

METHODS

Fifty-five participants with gait disorders after stroke underwent gait training for 6 weeks. Outcome measurements included Apathy Scale (AS), Center for Epidemiologic Studies Depression Scale (CES-D), Mini-Mental State Examination, Lower Extremity Function of Stroke Impairment Assessment Set, and Functional Independence Measure-TRANSFER and -WALK scores. These scores of the participants were divided into groups with or without apathy based on AS scores for statistical analysis.

RESULTS

Both groups showed significant differences in all outcomes after gait training. In addition, even if the participants had apathy at baseline, there were no significant differences in outcomes other than AS/CES-D between the two groups after gait training. Logistic regression analysis showed that only Mini-Mental State Examination and Lower Extremity Function of Stroke Impairment Assessment Set scores affected the reacquisition of independent walking (odds ratio: 1.332, P = 0.015; odds ratio: 1.364, P = 0.005, respectively). AS and CES-D scores had no effects on gait reacquisition.

CONCLUSION

Gait training may be beneficial for both physical impairment and psychiatric symptoms in patients with stroke and may prevent poor functional recovery caused by apathy and PSD. As opposed to previous studies that have shown a negative impact of apathy and PSD on functional recovery, our results suggest that apathy/PSD may not negatively affect functional recovery when gait training is conducted in subacute stroke.

Exploring the impact of exercise-induced BDNF on neuroplasticity in neurodegenerative and neuropsychiatric conditions

This review investigates the intricate relationship between exercise, brain-derived neurotrophic factor (BDNF), neuroplasticity, and cognitive function, with a focus on implications for neuropsychiatric and neurodegenerative disorders. A systematic review was conducted by searching various databases for relevant studies that explored the connections between exercise, BDNF, neuroplasticity, and cognitive health. The analysis of eligible studies revealed that exercise increases BDNF levels in the brain, promoting neuroplasticity and enhancing cognitive functions. Furthermore, we discuss the protective effects of exercise against cognitive decline and neurological disorders, suggesting that BDNF plays a critical role in mediating these effects. Regular physical activity not only elevates BDNF levels but also fosters memory and learning, offering important implications for the prevention and treatment of neuropsychiatric and neurodegenerative conditions. Our findings underscore the necessity of incorporating exercise into a healthy lifestyle to optimize brain health. Future research is essential to elucidate the underlying mechanisms of this relationship and to refine exercise interventions for improved cognitive outcomes.

Bibliometric insights into astrocytic roles in depression and treatment

Objective

Depression is a mental disorder that significantly impairs both physical and mental health. Recent studies have shown that reactive astrogliosis have gained significant attention for their involvement in the pathophysiology of depression. However, there is no bibliometric analysis in this research field. This study aims to provide a comprehensive overview of the knowledge structure and research hotspots regarding the role of astrocytes in the mechanisms and treatment of depression through bibliometric analysis. The scope of the literature review encompasses both basic and clinical research.

Methods

Publications related to astrocytes in depression and treatment from 2014 to 2023 were searched in the Web of Science Core Collection (WoSCC) database. VOSviewer, CiteSpace, and the R package "bibliometrix" were used to conduct this bibliometric analysis.

Results

From 2014 to 2023, a total of 1,502 documents from 78 countries on astrocytes in depression and treatment were analyzed from 169 journals, with the most co-cited journals being the Journal of Neuroscience and PNAS. China Medical University was the most productive institution. The analysis identified key authors like Verkhratsky Alexei and Baoman Li, and major co-cited references by Rajkowska and Liddelow. Keywords such as "synaptic plasticity," "astrocytes," and "neuroinflammation" revealed research trends focusing on molecular mechanisms, gut microbiota, and inflammation.

Conclusion

This is the first bibliometric study to comprehensively summarize the research trends and advancements regarding astrocytes in depression and its treatment. Through this bibliometric analysis, we aim to enhance the understanding of the significance of astrocytes in depression research and provide new perspectives and insights for future investigations. We hope that this study will facilitate a broader integration of basic and clinical research, offering novel approaches for the treatment of depression.

Metabolomics in Depression: What We Learn from Preclinical and Clinical Evidences

Depression is one of the predominant common mental illnesses that affects millions of people of all ages worldwide. Random mood changes, loss of interest in routine activities, and prevalent unpleasant senses often characterize this common depreciated mental illness. Subjects with depressive disorders have a likelihood of developing cardiovascular complications, diabesity, and stroke. The exact genesis and pathogenesis of this disease are still questionable. A significant proportion of subjects with clinical depression display inadequate response to antidepressant therapies. Hence, clinicians often face challenges in predicting the treatment response. Emerging reports have indicated the association of depression with metabolic alterations. Metabolomics is one of the promising approaches that can offer fresh perspectives into the diagnosis, treatment, and prognosis of depression at the metabolic level. Despite numerous studies exploring metabolite profiles post-pharmacological interventions, a quantitative understanding of consistently altered metabolites is not yet established. The article gives a brief discussion on different biomarkers in depression and the degree to which biomarkers can improve treatment outcomes. In this review article, we have systemically reviewed the role of metabolomics in depression along with current challenges and future perspectives.

Gut microbiome-gut brain axis-depression: interconnection

OBJECTIVES

The relationship between the gut microbiome and mental health, particularly depression, has gained significant attention. This review explores the connection between microbial metabolites, dysbiosis, and depression. The gut microbiome, comprising diverse microorganisms, maintains physiological balance and influences health through the gut-brain axis, a communication pathway between the gut and the central nervous system.

METHODS

Dysbiosis, an imbalance in the gut microbiome, disrupts this axis and worsens depressive symptoms. Factors like diet, antibiotics, and lifestyle can cause this imbalance, leading to changes in microbial composition, metabolism, and immune responses. This imbalance can induce inflammation, disrupt neurotransmitter regulation, and affect hormonal and epigenetic processes, all linked to depression.

RESULTS

Microbial metabolites, such as short-chain fatty acids and neurotransmitters, are key to gut-brain communication, influencing immune regulation and mood. The altered production of these metabolites is associated with depression. While progress has been made in understanding the gut-brain axis, more research is needed to clarify causative relationships and develop new treatments. The emerging field of psychobiotics and microbiome-targeted therapies shows promise for innovative depression treatments by harnessing the gut microbiome's potential.

CONCLUSIONS

Epigenetic mechanisms, including DNA methylation and histone modifications, are crucial in how the gut microbiota impacts mental health. Understanding these mechanisms offers new prospects for preventing and treating depression through the gut-brain axis.

Nelumbo nucifera Petals Ameliorate Depressive-like Symptom and Cognitive Deficit in Unpredictable Chronic Mild Stress Mouse Model

Background Chronic stress exposure has been widely recognized as a significant contributor to numerous central nervous system (CNS) disorders, leading to debilitating behavioral changes such as anxiety, depression, and cognitive impairments. The prolonged activation of the hypothalamic-pituitary-adrenal (HPA) axis during chronic stress disrupts the neuroendocrine balance and has detrimental effects on neuronal function and survival. Nelumbo nucifera (N. nucifera) Gaertn., commonly known as the lotus flower, is a traditional medicinal plant consumed for its purported benefits on mental and physical well-being. Despite its traditional use, limited scientific evidence supports these claims. Methods The present study explores the effects of N. nucifera, commonly known as the lotus flower, on cognitive performance and stress resilience in a mouse model subjected to unpredictable chronic mild stress (UCMS). Results Daily treatment significantly improved cognitive performance, alleviated depressive-like behaviors, and normalized hypothalamic-pituitary-adrenal (HPA) axis activity, as indicated by a 60.97% reduction in serum corticosterone. At the molecular level, N. nucifera petals also downregulated serum- and glucocorticoid-inducible kinase 1 (SGK1) mRNA expression while upregulating brain-derived neurotrophic factor (BDNF) mRNA expression and cyclic-adenosine monophosphate (cAMP) responsive element-binding protein (CREB) mRNA expression in the hippocampus and frontal cortex. These normalizations are critical, as chronic stress dysregulates HPA axis function, exacerbating behavioral changes. Furthermore, a phytochemical analysis resulted in the isolation of five major compounds, kaempferol (1), trifolin (2), kaempferol-3-neohesperidoside (3), icariside D2 (4), and β-sitosterol (5), each demonstrating significant monoamine oxidase (MAO) inhibitory activity. Conclusions These compelling findings suggest that N. nucifera petals not only alleviate stress-induced mood and cognitive deficits but also offer a promising avenue for modulating the HPA axis and promoting neuroprotection via essential neurotrophic factors and enzymatic pathways. We advocate for its potential as a complementary and alternative medicine for effective stress management. Future investigations should further explore its mechanisms of action and evaluate its clinical applicability in stress-related disorders.

The effects of exercise on anxiety and depression in adults with cancer: A meta-review of meta-analyses

BACKGROUND

This meta-review aimed to synthesize the evidence of the effects of exercise on anxiety and depression symptoms amongst adults with cancer, and cancer-survivors, comparing effects sizes between meta-analysis.

METHODS

Major databases were searched up to February 9, 2024 for meta-analyses evaluating the effects of exercise, using anxiety and/or depression scales. Effect size (ES) values were calculated as standardized differences in the means and expressed as the Standardized Mean Difference (SMD) with the 95% confidence interval (95%CI). A total of eight unique meta-analyses were included.

RESULTS

Among meta-analyses examining both anxiety and depression symptoms overall, a small beneficial effect of exercise was shown [SMD = 0.41 (0.25-0.57); p < 0.0001]. Subgroup analyses revealed that exercise has a small effect on decreasing anxiety [SMD = 0.42 (0.04-0.79); p = 0.027], and depressive symptoms [SMD = 0.38 (0.21-0.56); p < 0.0001]. In addition, aerobic exercise has a moderate effect on reducing depressive symptoms [SMD = 0.54 (0.16-0.93); p = 0.005], whereas resistance exercise has no effect. Subgroup analyses by type of cancer observed a moderate effect on decreasing depressive symptoms in patients with breast cancer [SMD = 0.51 (0.27-0.74); p < 0.0001].

CONCLUSIONS

Exercise (specifically aerobic) should be considered by healthcare professionals as a strategy to treat/manage symptoms of anxiety and depression amongst adults with cancer and cancer-survivors.

Four-way decomposition of the effects of nutrient supplement and physical exercise on depression among older Chinese: a nationwide cross-sectional analysis

BACKGROUND

Studies on the associations between nutrient supplement, physical exercise, and depression among persons 65 years and older in China are still lacking. We aimed to investigate the association between nutrient supplement and depression and to explore the role of physical exercise in this association.

METHODS

A total of 8,427 older Chinese adults from the Chinese Longitudinal Healthy Longevity Survey were included in this study. The Center for Epidemiologic Studies Depression Scale was used to assess participants' depression, and nutrient supplement and physical exercise were evaluated using self-reports. Linear regression and logistic regression were performed to explore the association between nutrient supplement and depression, and a four-way decomposition method was used to explore the effects of nutrient supplement and physical exercise on depression.

RESULTS

A total of 26.2% of participants suffered from depression. Prior to decomposition, multivariable linear regression and logistic regression models showed that older adults who received nutrient supplement had lower depression score (β: -0.704; 95% confidence interval [CI]: -1.004, -0.404) and a lower risk of depression (odds ratio: 0.710; 95% CI: 0.564, 0.894), especially for calcium and multivitamins. Four-way decomposition analysis suggested that physical exercise mediated the associations between nutrient (protein, calcium, iron, zinc, multivitamins, vitamin A/D, docosahexaenoic acid, and others) supplement and depression (all P < 0.05).

CONCLUSIONS

Calcium or multivitamin supplements were associated with inverse depression, and the reason why this association existed could be partly explained by the mediating effect of physical exercise.

Dietary Patterns, Serum BDNF and Fatty Acid Profiles in Physically Active Male Young Adults: A Cluster Analysis Study

Background/Objectives: Although physical activity and balanced diet may increase peripheral brain-derived neurotrophic factor (BDNF) concentration, little is known about whether these factors modify BDNF content in physically active individuals and whether the serum fatty acid (FA) profile is related. This study aimed to evaluate quality of diet, identify specific dietary patterns and assess their influence on BDNF and FA levels in serum. It is hypothesized that there is a correlation between diet quality and the concentrations of BDNF and FA in the serum of physically active male individuals. Methods: Physically active young adult male students at Jozef Pilsudski University of Physical Education in Warsaw (Poland) were enrolled. Dietary patterns were identified with cluster analysis and linear discriminant analysis (LDA) based on responses to a validated food frequency questionnaire, KomPAN® version 1.1. Results: Consumption of beverages, vegetables, milk, wholemeal bread/rolls, fruit and vegetable juices, butter, tinned vegetables and fruits were significant in the LDA model, in which three clusters were distinguished. Cluster 1 was characterized by more frequent consumption of wholemeal bread/rolls, milk, fruits, vegetables, fruit and vegetable juices and sweetened hot beverages and by significantly greater values for the pro-healthy diet index (p < 0.0001) and diet quality index (p < 0.0001) compared to Clusters 2 and 3. The diet of Cluster 2 was of the worst quality, as indicated by the higher values of the not-healthy diet index. Cluster 1 had the tendency for the highest BDNF levels (of the best quality of diet), and a tendency for decreased BDNF concentration with an increased physical activity level was observed. Conclusions: Physical activity, diet quality and BDNF level depend, correlate and interact with each other to provide both optimal physical and mental health.

Effects of physical exercise on Irisin and BDNF concentrations, and their relationship with cardiometabolic and mental health of individuals with Metabolic Syndrome: A Systematic Review

Chronic Non-Communicable Diseases (NCDs), including cardiovascular diseases, cancer, chronic respiratory diseases, and diabetes, are the leading global causes of mortality, accounting for 71 % of deaths annually. Metabolic Syndrome (MS), characterized by hypertension, obesity, insulin resistance, and dyslipidemia, is a significant risk factor for NCDs. Physical inactivity exacerbates these conditions, contributing to poor cardiovascular and mental health outcomes.

OBJECTIVE

To analyze the effects of physical exercise on Irisin and Brain-Derived Neurotrophic Factor (BDNF) concentrations and their relationship with cardiometabolic and mental health of individuals with MS.

METHODS

A systematic review was conducted of articles published between August 2023 and June 2024 in ScienceDirect, PubMed, and SciELO, following PRISMA guidelines. Inclusion criteria encompassed observational studies, clinical trials, and reviews with high methodological quality. The review focused on Irisin, BDNF, physical exercise, and MS.

RESULTS

A total of 584 articles were identified, with 43 selected for detailed analysis. The review highlights that physical exercise significantly impacts Irisin and BDNF levels, which in turn influence metabolic and mental health. Irisin, a myokine secreted during exercise, promotes the conversion of white adipose tissue to brown adipose tissue, enhancing energy expenditure and metabolic health. Elevated Irisin levels are associated with improved cognitive function and mental well-being. BDNF, a neurotrophin, supports neuronal growth and cognitive function. Exercise-induced increases in BDNF levels are linked to enhanced neuroplasticity, reduced anxiety, and improved mood.

CONCLUSION

Understanding the role of Irisin and BDNF in response to physical exercise offers valuable insights for developing strategies to manage and prevent MS and its related mental health issues. Further research is needed to elucidate the molecular mechanisms involved.

Housing Environmental Enrichment, Lifestyles, and Public Health Indicators of Neurogenesis in Humans: A Pilot Study

BACKGROUND

In response to the rising mental health concerns and cognitive decline associated with the human brain's neurogenesis, which continues until the tenth decade of life but declines with age and is suppressed by poor environments, this pilot study investigates how physical environments may influence public health proxy measures of neurogenesis in humans. This pilot study focuses on the residential environment where people spend most of their time and age in place, exploring the dependency of depression, anxiety, and cognitive impairment variations on spatial and lifestyle variables.

METHODS

A total of 142 healthy adults in England completed a survey consisting of PHQ-8, GAD-7, and CFI questionnaires and other questions developed to capture the variance in spatial and lifestyle factors such as time spent at home, house type layout complexity, spaciousness, physical activity, routine and spatial novelty, and perceived loneliness.

RESULTS

Extensive time spent at home has adverse effects on all measures, while multi-storey houses perform better than single-story houses with positive correlations with physical activity and spatial novelty. Separate regression models on the variance in depression, as the most salient dependent variable and reliably associated with neurogenesis, reveal that getting out of the house explains 20.5% of the variance in depression symptoms. At the scale of the house, multi-storey houses explain 16.5% of the variance. Both percentages are closer to the effect of loneliness, which we found to explain 26.6% of the variance in depression.

CONCLUSIONS

The built environment appears to be significantly associated with changes in cognitive function and mental health symptoms associated with neurogenesis. This pilot study shows the equally important effect of physical and social enrichment, offering critically needed insights for neuroarchitecture and brain health research that is interested in public health.

Impact of Physical Activity on Cellular Metabolism Across Both Neurodegenerative and General Neurological Conditions: A Narrative Review

BACKGROUND

Regular physical activity plays a crucial role in modulating cellular metabolism and mitigating the progression of neurodegenerative diseases such as Alzheimer's, Parkinson's, and Multiple Sclerosis.

OBJECTIVE

The objective of this review is to evaluate the molecular mechanisms by which exercise influences cellular metabolism, with a focus on its potential as a therapeutic intervention for neurological disorders.

METHODS

A comprehensive literature review was conducted using peer-reviewed scientific articles, with a focus on the period between 2015 and 2024, to analyze the effects of exercise on mitochondrial function, oxidative stress, and metabolic health.

RESULTS

The findings indicate that exercise promotes mitochondrial biogenesis, enhances oxidative phosphorylation, and reduces reactive oxygen species, contributing to improved energy production and cellular resilience. These metabolic adaptations are associated with delayed disease progression and reduced symptoms in patients with neurodegenerative conditions. Additionally, integrating exercise with nutritional strategies may further enhance therapeutic outcomes by addressing metabolic disturbances comprehensively.

CONCLUSIONS

This review concludes that personalized exercise protocols should be developed to optimize metabolic benefits for patients with neurological diseases, while future research should focus on biomarker development for individualized treatment approaches. These findings highlight the importance of non-pharmacological interventions in managing neurodegenerative diseases.

Physical activity promotes the development of cognitive ability in adolescents: the chain mediating role based on self-education expectations and learning behaviors

Cognitive ability plays a crucial role in adolescents' academic performance and subsequent career development. Although previous studies have demonstrated that physical activity, self-education expectations, and learning behaviors positively affect the cognitive development of adolescents, the extent of their influence and their mediating roles require further elucidation. This study is based on tracking survey data from 2,688 adolescents in Chinese households collected in 2018. Multiple linear regression, Propensity Score Matching, and Quantile regression were employed to analyze the impact and heterogeneity of physical activity on adolescents' cognitive ability. Furthermore, the Bootstrap mediation test was used to explore the mediating roles of self-education expectations and learning behaviors in this process. The results indicate the following: Physical activity significantly promotes adolescents' cognitive ability; for those with poorer cognitive ability, it exerts a greater impact. Moreover, in addition to its direct effects, physical activity indirectly enhances adolescents' cognitive ability through the mediation of three factors (self-education expectations, learning behaviors, self-education expectations and learning behaviors). These discoveries offer significant insights into diverse strategies for developing cognitive ability in adolescents, contributing to both theoretical research and practical interventions.

Associations between phenols, parabens, and phthalates and depressive symptoms: The role of inflammatory markers and bioinformatic insights

Phenols, parabens, and phthalates are commonly found in consumer products, yet there is limited research on their individual and combined effects on depressive symptoms, particularly regarding the role of inflammation in these associations. This study aimed to evaluate these effects and explore potential molecular mechanisms, with a focus on inflammation as a mediator. We conducted a cross-sectional analysis involving 2766 adult participants from the National Health and Nutrition Examination Survey (NHANES) 2013-2016. Urine samples were analyzed for 15 chemicals, including 3 phenols, 2 parabens, and 10 phthalates. Depressive symptoms were assessed using the Patient Health Questionnaire-9 (PHQ-9). Statistical analyses included linear regression, restricted cubic splines, Bayesian Kernel Machine Regression and quantile g-computation models to investigate the relationships between chemical exposures and depressive symptoms. Additionally, mediation analysis was employed to explore the potential role of inflammation (immune cells, CRP, NLR) in these associations. The underlying molecular mechanisms were analyzed using bioinformatic approaches. Notably, BPA, MECPP, MEHHP, MiBP and MBP were found to be positively associated with depressive symptoms among females. Besides, BPA was the most significant positive contributor to the effect in the context of the chemical mixture, while the overall mixture effect was relatively weak. Furthermore, WBC were found to mediate a marginal portion (4 %) of the potential effects of MBP on depressive symptoms. The 15 genes identified are primarily involved in neurotransmission, mood regulation, and stress response. Further research is needed to elucidate the mechanisms underlying the observed associations.

Lindera aggregata improves intestinal function and alleviates depressive behaviors through the BDNF/TrkB/CREB signaling pathway induced by CUMS in mice

Depression is a common mental illness, which is highly related to intestinal motor dysfunction and causes a global burden of disease. Lindera aggregata (LA), a traditional medicinal herb, has been used to treat gastrointestinal disorders; however, the effect of LA on depression remains unclear. Here, we assessed the impact of LA on chronic unpredictable mild stress (CUMS)-induced depression in mice and explored the related mechanisms. The results showed that LA ameliorated depressive behaviors in mice exposed to CUMS, as evidenced by improved performance in the sucrose preference test, force swimming test, and open field test, as well as increased serum levels of adrenocorticotropic hormone and 5-hydroxytryptamine. In addition, LA increased the serum levels of D-xylose and ghrelin, indicating that LA can promote gastrointestinal motility. Additional studies revealed that LA relieved CUMS-induced hippocampal tissue damage, as shown by hematoxylin and eosin and Nissl staining. LA increased the expression levels of brain-derived neurotrophic factor (BDNF) and promoted the activation of tropomyosin receptor kinase B (TrkB) and cAMP response element-binding (CREB) in the hippocampus of CUMS-exposed mice or in corticosterone-injured HT22 cells. In conclusion, LA can improve CUMS-induced depressive behavior in mice, potentially through hippocampal neuroprotection mediated by the BDNF/TrkB/CREB signaling pathway, which also contributes to improved intestinal function.

Deciphering the role of miRNA-134 in the pathophysiology of depression: A comprehensive review

This study summarizes the significance of microRNA-134 (miRNA-134) in the pathophysiology, diagnosis, and treatment of depression, a disease still under investigation due to its complexity. miRNA-134 is an endogenous short non-coding RNA that can bind to the 3' untranslated region (3'UTR) of miRNA-134, inhibiting gene translation and showing great potential in the regulation of mood, synaptic plasticity, and neuronal function. This study included 15 articles retrieved from four English-language databases: PubMed, Embase, The Cochrane Library, and Web of Science, and three Chinese literature databases: CNKI, Wanfang, and Chinese Science and Technology Periodical Database (VIP).We evaluated each of the 15 articles using the Critical Appraisal Skills Program (CASP) tool.The standard integrates analyzes of genomic, transcriptomic, neuroimaging, and behavioral data analyses related to miRNA-134 and depression. A multidimensional framework based on standardized criteria was used for quality assessment. The main findings indicate that miRNA-134 significantly affects synaptic plasticity and neurotransmitter regulation, in particular the synthesis and release of serotonin and dopamine. miRNA-134 shows high sensitivity and specificity as a biomarker for the diagnosis of depression and has therapeutic potential for the targeted treatment of depression. miRNA-134 plays a crucial role in the pathogenesis of depression, providing valuable insights for early diagnosis and the development of targeted therapeutic strategies. This work highlights the potential of miRNA-134 as a focal point for advancing personalized medicine approaches for depression.

Flibanserin conquers murine depressive pseudodementia by amending HPA axis, maladaptive inflammation and AKT/GSK/STAT/BDNF trajectory: Center-staging of the serotonergic/adrenergic circuitry

Depressive pseudodementia (DPD) is a debilitating cognitive dysfunction that accompanies major and/or frequent depressive attacks. DPD has gained significant research attention owing to its negative effects on the patients' quality of life and productivity. This study tested the procognitive potential of Flibanserin (FBN), the serotonin (5HT) receptor modulator, against propranolol (PRP), as β/5HT1A receptors blocker. Serving this purpose, female Wistar Albino rats were subjected to chronic unpredictable stress (CUS) and subsequently treated with FBN only (3 mg/kg/day, p.o), PRP only (10 mg/kg/day, p.o), or PRP followed by FBN, using the same doses. FBN ameliorated the behavioral/cognitive alterations and calmed the hypothalamic-pituitary-adrenal (HPA) axis storm by reducing the levels of stress-related hormones, viz, corticotropin-releasing hormone (CRH), adrenocorticotropic hormone (ACTH), corticosterone (CORT) parallel to epinephrine (EPI) hyperstimulation. The maladaptive inflammatory response, comprising of interleukin (IL)-1β/6, and tumor necrosis factor (TNF)-α, was consequently blunted. This was contemporaneous to the partial restoration of the protein kinase-B (AKT)/glycogen synthase kinase (GSK)3β/signal transducer and activator of transcription (STAT)-3 survival trajectory and the reinstatement of the levels of brain derived neurotrophic factor (BDNF). Microscopically, FBN repaired the hippocampal architecture and lessened CD68/GFAP immunoreactivity. Pre-administration of PRP partially abolished FBN effect along the estimated parameters, except for 5HT2A receptor expression and epinephrine level, to prove 5HT1A receptor as a fulcrum initiator of the investigated pathway, while its sole administration worsened the underlying condition. Ultimately, these findings highlight the immense procognitive potential of FBN, offering a new paradigm for halting DPD advancement via synchronizing adrenergic/serotonergic circuitry.

Lacticaseibacillus rhamnosus KY16 Improves Depression by Promoting Intestinal Secretion of 5-HTP and Altering the Gut Microbiota

Increasing research suggests a connection between gut microbiota and depressive disorders. Targeted changes to the intestinal flora may contribute to alleviating anxiety and depression. This study aimed to identify probiotics that could attenuate stress-induced abnormal behavior and explore potential mechanisms. The administration of LR.KY16 significantly reduced stress-induced abnormal behaviors and physiological dysfunction. The mechanism may be via regulating the structure of the intestinal microbiota in mice, increasing the abundance of Akkermansia muciniphila, prompting enterochromaffin cells to secrete 5-HTP in the gut, which enters the brain through the bloodstream and promotes the synthesis of 5-HT in the brain, and then activates brain-derived neurotrophic factor (BDNF)/tyrosine kinase receptor B (TrkB) through the 5-HT1A receptor. In addition, LR.KY16 also increased the expression of claudin-7, occludin, and zonula occludens-1 (ZO-1) in the colon, inhibited microglial M1 polarization, and inhibited systemic inflammation.

Exploratory studies of the antidepressant effect of Cordyceps sinensis polysaccharide and its potential mechanism

Cordyceps sinensis, a traditionally prized medicinal fungus, contains polysaccharides as one of its main bioactive constituents, known for their significant immunomodulatory properties. In this study, we systematically investigated the composition and structure of Cordyceps sinensis polysaccharide, followed by an evaluation of its therapeutic effect on depression using a chronic restraint stress-induced depression model. The polysaccharide CSWP-2, extracted via hot water, precipitated with ethanol, and purified using DEAE-cellulose column chromatography from Cordyceps sinensis, is primarily composed of glucose, mannose, and galactose, with α-1,4-D-glucan as its major structural component. Behavioral tests, immunological profiling, metabolomics, and gut microbiota analyses indicated a notable ameliorative effect of CSWP-2 on depressive-like symptoms in mice. Furthermore, the action of CSWP-2 may be attributed to the modulation of the gut microbiome's abundance and its metabolic impacts, thereby transmitting signals to the host immune system and exerting immunomodulatory activity, ultimately contributing to its antidepressant effects.

Low-carbohydrate diet as a nutritional intervention in a major depression disorder: focus on relapse prevention

OBJECTIVES

Mood disorders are trending to be among the leading causes of years lived with disability. Despite multiple treatment options, around 30% patients with major depressive disorder (MDD) develop treatment resistant depression (TRD) and fail to respond to current pharmacological therapies. This study aimed to explore the potential benefits of nutritional treatment strategies, along with their molecular mechanisms of action, focusing especially on low-carbohydrate diet (LCHD), ketogenic diet (KD) and other strategies based on carbohydrates intake reduction.

METHODS

A comprehensive literature review was conducted to determine the impact of LCHD on alleviating depressive symptoms in patients with MDD, along with an explanation of its mode of action.

RESULTS

The study revealed significant impact of nutritional interventions based on restriction in carbohydrate intake such as LCHD, KD or sugar-sweetened beverages (SSB) exclusion on anxiety or depression symptoms reduction, mood improvement and lower risk of cognitive impairment or depression. The efficacy of these approaches is further substantiated by their underlying molecular mechanisms, mainly brain-derived neurotrophic factor (BDNF) which is a potential key target of sugar restriction diets in terms of neuroplasticity.

DISCUSSION

Healthcare professionals may consider implementing LCHD strategies for MDD and TRD patients to modify the disease process, maintain euthymia, and prevent depressive episode relapses. Ranging from the exclusion of SSB to the adherence to rigorous LCHD regimens, these nutritional approaches are safe, straightforward to implement, and may confer benefits for well-being and relapse prevention in this specific patient population.

Efficacy and safety of add-on sarcosine in patients with major depressive disorder: A randomized controlled trial

The main hurdles with current therapies for major depressive disorder (MDD) include lack of efficacy, therapeutic latency, and adverse drug reactions. Add-on therapy to conventional antidepressants may result in better therapeutic outcomes to overcome these obstacles. Sarcosine (N-methyl glycine), an endogenous amino acid that acts by modulating the NMDA receptor, is available as a dietary supplement. So, the present study was planned to evaluate the efficacy and safety of add-on sarcosine to SSRIs in MDD. In the present randomized, double-blind clinical trial (NCT04975100), 60 eligible participants with MDD were randomly assigned to either the test group (SSRI + sarcosine) or the control group (SSRI + placebo). Clinical and biochemical parameters like MADRS, CGI, serum BDNF, and serum glycine were assessed at baseline and eight weeks. The mean reduction in MADRS score was significant in both the control (-8.7, 95% CI: -11.0 to -6.4, p < 0.001) and the test group (-13.3, 95% CI: -14.9 to -11.7, p < 0.001), but the change in the test group was significantly greater (-4.6, 95% CI: -7.5 to -1.7, p = 0.003). The test group had a significantly higher response rate (p = 0.007) and remission rate (p = 0.038) compared to the control group. There was a significant increase in serum BDNF in both groups; however, the change in the test group was significantly higher than in the control group (p = 0.041). Similarly, the test group had a significantly higher increase in serum glycine than the control group (p < 0.001). Sarcosine may be considered an efficacious and safe add-on therapy to standard SSRIs in the management of MDD. ClinicalTrial.gov IdentifierNCT04975100.

Antidepressant effects of selective adenosine receptor antagonists targeting the A1 and A2A receptors administered jointly with NMDA receptor ligands: behavioral, biochemical and molecular investigations in mice

BACKGROUND

The objective of the study was to ascertain the antidepressant potential of the co-administration of NMDA receptor ligands and selective adenosine A1 and A2A receptor antagonists.

METHODS

The forced swim test (FST) and spontaneous locomotor activity test were carried out in adult male naïve mice. Before the behavioral testing, animals received DPCPX (a selective adenosine A1 receptor antagonist, 1 mg/kg) or istradefylline (a selective adenosine A2A receptor antagonist, 0.5 mg/kg) in combination with L-701,324 (a potent NMDA receptor antagonist, 1 mg/kg), D-cycloserine (a partial agonist at the glycine recognition site of NMDA receptor, 2.5 mg/kg), CGP 37849 (a competitive NMDA receptor antagonist, 0.3 mg/kg) or MK-801 (a non-competitive NMDA receptor antagonist, 0.05 mg/kg). Additionally, serum BDNF level and the mRNA level of the Adora1, Comt, and Slc6a15 genes in the murine prefrontal cortex were determined.

RESULTS

The obtained results showed that DPCPX and istradefylline administered jointly with NMDA receptor ligands (except for DPCPX + D-cycloserine combination) produced an antidepressant effect in the FST in mice without enhancement in spontaneous motility of animals. An elevation in BDNF concentration was noted in the D-cycloserine-treated group. Adora1 expression increased with L-701,324, DPCPX + D-cycloserine, and DPCPX + CGP 37849, while D-cycloserine, CGP 37849, and MK-801 led to a decrease. Comt mRNA levels dropped with DPCPX + L-701,324, istradefylline + L-701,324/CGP 37849 but increased with D-cycloserine, MK-801, CGP 37849 and DPCPX + MK-801/ CGP 37849. Slc6a15 levels were reduced by D-cycloserine, DPCPX + L-701,324 but rose with DPCPX + CGP 37849/MK-801 and istradefylline + D-cycloserine/MK-801/CGP 37849.

CONCLUSION

Our study suggests that selective antagonists of adenosine receptors may enhance the antidepressant efficacy of NMDA receptor ligands highlighting a potential synergistic interaction between the adenosinergic and glutamatergic systems. Wherein, A2A receptor antagonists are seen as more promising candidates in this context. Given the intricate nature of changes in BDNF levels and the expression of Adora1, Comt, and Slc6a15 seen after drug combinations exerting antidepressant properties, further research and integrative approaches are crucial understand better the mechanisms underlying their antidepressant action.

From gut to brain: unveiling probiotic effects through a neuroimaging perspective-A systematic review of randomized controlled trials

The gut-brain axis, a bidirectional communication network between the gastrointestinal system and the brain, significantly influences mental health and behavior. Probiotics, live microorganisms conferring health benefits, have garnered attention for their potential to modulate this axis. However, their effects on brain function through gut microbiota modulation remain controversial. This systematic review examines the effects of probiotics on brain activity and functioning, focusing on randomized controlled trials using both resting-state and task-based functional magnetic resonance imaging (fMRI) methodologies. Studies investigating probiotic effects on brain activity in healthy individuals and clinical populations (i.e., major depressive disorder and irritable bowel syndrome) were identified. In healthy individuals, task-based fMRI studies indicated that probiotics modulate brain activity related to emotional regulation and cognitive processing, particularly in high-order areas such as the amygdala, precuneus, and orbitofrontal cortex. Resting-state fMRI studies revealed changes in connectivity patterns, such as increased activation in the Salience Network and reduced activity in the Default Mode Network. In clinical populations, task-based fMRI studies showed that probiotics could normalize brain function in patients with major depressive disorder and irritable bowel syndrome. Resting-state fMRI studies further suggested improved connectivity in mood-regulating networks, specifically in the subcallosal cortex, amygdala and hippocampus. Despite promising findings, methodological variability and limited sample sizes emphasize the need for rigorous, longitudinal research to clarify the beneficial effects of probiotics on the gut-brain axis and mental health.

Hominis Placenta modulates PTSD-like behaviors in SPSS-induced PTSD mice: Regulating energy metabolism and neuronal activity

The symptoms of post-traumatic stress disorder (PTSD) include re-experiencing trauma, avoidance behaviors, negative alterations in cognition and mood. However, the underlying molecular mechanisms are unclear. Dysfunction of hypothalamic-pituitary-adrenal axis (HPA-axis) and dysregulation of glutamatergic and GABAergic systems were shown during PTSD. Therefore, regulating hormonal change or glutamate energy metabolism are considered as a therapeutic approach to alleviate this condition. Herbal medicine may be effective in treating PTSD due to its ability to target multiple underlying mechanisms with various compounds. Hominis placenta (HP) is a traditional medicine widely used in East Asia for various conditions. However, the effect on PTSD has not been clarified. We aimed to investigate the effects of HP treatment in single-prolonged stress with shock (SPSS)-induced PTSD mice and explore its possible mechanisms. HP treatment at ST36 acupoints, combined with herbal medicine and acupuncture point stimulation, was applied three times/week for 2 weeks. HP treatment effectively alleviated anxiety and cognitive decline in SPSS-induced PTSD mice, as detected by Open field and the Y-maze test. Additionally, HP decreased the corticosterone levels and proinflammatory cytokines in the serum, modulated brain energy metabolism, and inhibited glutamate excitotoxicity, while regulating neuronal activity through modulating brain-derived neurotrophic factor (BDNF) levels, as demonstrated by western blot and immunohistochemistry, and flow cytometry analyses. These findings reveal that HP treatment effectively alleviates PTSD-like behaviors by regulating energy metabolism and neuronal activity though modulation of the HPA-axis and BDNF levels in PTSD mice, indicating that HP treatment is a promising therapeutic approach for PTSD.

Graph convolutional network with attention mechanism improve major depressive depression diagnosis based on plasma biomarkers and neuroimaging data

BACKGROUND

The absence of clinically-validated biomarkers or objective protocols hinders effective major depressive disorder (MDD) diagnosis. Compared to healthy control (HC), MDD exhibits anomalies in plasma protein levels and neuroimaging presentations. Despite extensive machine learning studies in psychiatric diagnosis, a reliable tool integrating multi-modality data is still lacking.

METHODS

In this study, blood samples from 100 MDD and 100 HC were analyzed, along with MRI images from 46 MDD and 49 HC. Here, we devised a novel algorithm, integrating graph neural networks and attention modules, for MDD diagnosis based on inflammatory cytokines, neurotrophic factors, and Orexin A levels in the blood samples. Model performance was assessed via accuracy and F1 value in 3-fold cross-validation, comparing with 9 traditional algorithms. We then applied our algorithm to a dataset containing both the aforementioned protein quantifications and neuroimages, evaluating if integrating neuroimages into the model improves performance.

RESULTS

Compared to HC, MDD showed significant alterations in plasma protein levels and gray matter volume revealed by MRI. Our new algorithm exhibited superior performance, achieving an F1 value and accuracy of 0.9436 and 94.08 %, respectively. Integration of neuroimaging data enhanced our novel algorithm's performance, resulting in an improved F1 value and accuracy, reaching 0.9543 and 95.06 %.

LIMITATIONS

This single-center study with a small sample size requires future evaluations on a larger test set for improved reliability.

CONCLUSIONS

In comparison to traditional machine learning models, our newly developed MDD diagnostic model exhibited superior performance and showed promising potential for inclusion in routine clinical diagnosis for MDD.

Effects of COVID-19 lockdown on children´s sleep quality, physical activity, screen time, and diet

Introduction

Background: this study aimed to assess how the COVID-19 lockdown (March to June 2020) affected children's sleep quality, physical activity, screen time, and nutrition. Material and methods: the survey consisted of 479 children from the SENDO project, a pediatric cohort in Spain, aged 4-5 years. The BEAR questionnaire was used to evaluate sleep quality. Hierarchical models with two-level clustering were used to account for intra-cluster correlation between siblings, and the difference regression method was used to study the association between changes in screen consumption and physical activity and changes in sleep quality. Results: the results showed an increase in the consumption of homemade pastries and snacks. Sleep quality worsened significantly during confinement, with a mean score on the BEAR scale of 0.52 before, 1.43 during, and 1.07 after confinement. Although sleep quality improved significantly after the end of confinement, it remained worse than before. The average daily screen time increased from 1.13 hours before confinement to 2.65 hours during confinement. Physical activity decreased during confinement, with the mean number of hours per day decreasing from 1.27 to 0.79. Children who spent more time on screens during confinement had worse sleep quality, as indicated by their higher scores on the BEAR scale. We used the difference regression method to identify a statistically significant association between the increased screen time for leisure hours and the worsening of children's sleep quality during confinement. Conclusion: we observed a significant relationship between confinement and reduced sleep quality. Although the end of the lockdown led to a slight improvement, the average BEAR scale score remained higher post-confinement, suggesting that the consequences of the lockdown may persist over time.

CCR3 knockdown attenuates prolonged underwater operations-induced cognitive impairment via alleviating microglia-mediated neuroinflammation

Maintaining cognitive integrity is crucial during underwater operations, which can significantly impact work performance and risk severe accidents. However, the cognitive effects of underwater operations and their underlying mechanism remain elusive, posing great challenges to the medical protection of professionals concerned. Here, we found that a single underwater operation session affects cognition in a time-dependent model. Prolonged exposure elicits significant cognitive impairment and hippocampal dysfunction, accompanied by increased neuroinflammation. Furthermore, RNA sequencing (RNA-seq) analysis revealed the involvement of neuroinflammation and highlighted the critical role of CCR3. Knockdown of CCR3 significantly rescued cognitive impairment and hippocampal dysfunction and reversed the upregulation of pro-inflammatory cytokines, by switching the activated microglia from a pro-inflammatory to a neuroprotective phenotype. Taken together, these results highlighted the time-dependent effects of a single underwater operation session on cognitive function. Knocking down CCR3 can attenuate neuroinflammation by regulating polarization of activated microglia, thereby alleviating prolonged underwater operations-induced cognitive impairment.

The role of dietary intake of live microbes in the association between leisure-time physical activity and depressive symptoms: a population-based study

Current research has shown promising associations between factors such as diet, total physical activity, and mental health outcomes, acknowledging the intricate interplay between these variables. However, the role of dietary intake of live microbes, coupled with leisure-time physical activity (LTPA), in their relationship to depressive symptoms necessitates further exploration. The present study examined a cohort of 25 747 individuals who participated in the National Health and Nutrition Examination Survey between the years 2007 and 2018. Patient's Health Questionnaire (PHQ-9) was employed, whereby individuals scoring ≥ 10 were classified as exhibiting symptoms of depression. LTPA status was reported by the Global Physical Activity Questionnaire and calculated by metabolic equivalent-minutes/week. Foods consumed by participants were evaluated by live microbes per gram, which were categorized into three groups: low, medium, and high. After controlling for all covariates, findings indicated that LTPA was negatively associated with depressive symptoms (OR (95% confidence interval (CI): 0.983 (0.976, 0.990), p < 0.001). Participating in more LTPA was positively correlated with consuming all three levels of dietary live microbes (low, β (95% CI): 0.086 (0.063, 0.109); medium, β (95% CI): 0.009 (0.007, 0.012); high, β (95% CI): 0.002 (0.001, 0.002)). Moreover, taking more foods with medium live microbes was associated with lower depressive likelihood (OR (95% CI): 0.931(0.882, 0.982), p = 0.010). Intake of medium and high levels of live microbes mediated the association between LTPA and depressive symptoms by 4.15% and 0.83%, respectively. Dietary intake of foods containing medium and high levels of live microbes may be a mediator of LTPA's negative association with depressive symptoms.

The Role of Estrogen across Multiple Disease Mechanisms

Estrogen is a significant hormone that is involved in a multitude of physiological and pathological processes. In addition to its pivotal role in the reproductive system, estrogen is also implicated in the pathogenesis of a multitude of diseases. Nevertheless, previous research on the role of estrogen in a multitude of diseases, including Alzheimer's disease, depression, cardiovascular disease, diabetes, osteoporosis, gastrointestinal diseases, and estrogen-dependent cancers, has concentrated on a single disease area, resulting in a lack of comprehensive understanding of cross-disease mechanisms. This has brought some challenges to the current treatment methods for these diseases, because estrogen as a potential therapeutic tool has not yet fully developed its potential. Therefore, this review aims to comprehensively explore the mechanism of estrogen in these seven types of diseases. The objective of this study is to describe the relationship between each disease and estrogen, including the ways in which estrogen participates in regulating disease mechanisms, and to outline the efficacy of estrogen in treating these diseases in clinical practice. By studying the role of estrogen in a variety of disease mechanisms, it is hoped that a more accurate theoretical basis and clinical guidance for future treatment strategies will be provided, thus promoting the effective management and treatment of these diseases.

The Correlation between Motor Skill Proficiency and Academic Performance in High School Students

The intricate relationship between physical health and cognitive development has been a focal point of multidisciplinary research, suggesting that motor skill proficiency could influence academic outcomes. This study aimed to investigate the correlation between motor control, mobility, stability-measured by the Functional Movement Screen (FMS)-and academic performance among high school students. Conducted with 201 participants from a public high school in Spain, this descriptive non-experimental research divided students into high and low academic performance groups based on their average grade scores, with the median used as the criterion for distinction. The FMS was utilized to assess fundamental motor skills, and academic performance was verified across mathematics, language, science, and physical education subjects. The findings revealed a significant positive relationship between the FMS scores and academic achievement (r = 0.691; p < 0.001), indicating that students with higher motor skill proficiency had higher academic achievement. This correlation persisted across the various subjects, highlighting the potential benefits of integrating physical education and motor skill development into educational strategies. The study's results suggest that educational policies should advocate for comprehensive physical education programs to foster both physical well-being and academic improvement, thereby promoting a holistic educational model that enhances student performance across disciplines.

Exercise as medicine! Physical activity mitigated the impact of the COVID-19 pandemic on depressive symptoms in adults with depression

We investigated the longitudinal association between physical activity (PA) and symptoms of depression and anxiety in people with depression during the COVID-19 pandemic. We used data from baseline (June 2020) to wave 3 (June 2021) of the PAMPA Cohort, an ambispective cohort with adults in south Brazil. The Hospital Anxiety and Depression Scale assessed depressive and anxiety symptoms in all waves. Participants reported frequency (minutes), type (aerobic, strength, combined), and place (out of home, at home) of physical activity at baseline. Generalized linear models were used to investigate the interaction between time and PA, adjusting for possible confounding variables. Subjective memory decline was assessed using multivariate Cox proportional hazard regression models to obtain adjusted hazard ratio (HR) and respective 95% confidence interval (CI). Participants (n = 424) with self-reported clinically diagnosed depression were included. We observed a non-linear increase trajectory of depression during the first year of the COVID-19 pandemic. PA was associated with a slower trajectory of depressive (slope: -1.89; 95%CI: -3.34, -0.43 points) but not anxiety (slope: -1.33; 95%CI: -2.93, 0.25 points) symptoms during the COVID-19 pandemic. Participants who continued physically active from pre-pandemic in wave 1 showed a lower risk of subjective memory decline during follow-up than those who persisted inactive in the same period (HR: 0.52; 95%CI: 0.30, 0.89). PA attenuated the impact of the COVID-19 pandemic on depressive symptoms in adults living with depression in south Brazil. Regularity of physical activity was associated with fewer depression and anxiety symptoms and a lower risk of subjective memory decline.

Comparing the effect of fluoxetine, escitalopram, and sertraline, on the level of BDNF and depression in preclinical and clinical studies: a systematic review

Brain-derived neurotrophic factor (BDNF) dysfunction is one of the most important mechanisms underlying depression. It seems that selective serotonin reuptake inhibitors (SSRIs) improve depression via affecting BDNF level. In this systematic review, for the first time, we aimed to review the effect of three SSRIs including fluoxetine, escitalopram, and sertraline, on both depression and BDNF level in preclinical and clinical studies. PubMed electronic database was searched, and 193 articles were included in this study. After reviewing all manuscripts, only one important difference was found: subjects. We found that SSRIs induce different effects in animals vs. humans. Preclinical studies showed many controversial effects, while human studies showed only two effects: improvement of depression, with or without the improvement of BDNF. However, most studies used chronic SSRIs treatment, while acute SSRIs were not effectively used and evaluated. In conclusion, it seems that SSRIs are reliable antidepressants, and the improvement effect of SSRIs on depression is not dependent to BDNF level (at least in human studies).

Potential Plausible Role of Stem Cell for Treating Depressive Disorder: a Retrospective Review

Depression poses a significant threat to global physical and mental health, impacting around 3.8% of the population with a rising incidence. Current treatment options primarily involve medication and psychological support, yet their effectiveness remains limited, contributing to high relapse rates. There is an urgent need for innovative and more efficacious treatment modalities. Stem cell therapy, a promising avenue in regenerative medicine for a spectrum of neurodegenerative conditions, has recently garnered attention for its potential application in depression. While much of this work remains preclinical, it has demonstrated considerable promise. Identified mechanisms underlying the antidepressant effects of stem cell therapy encompass the stimulation of neurotrophic factors, immune function modulation, and augmented monoamine levels. Nonetheless, these pathways and other undiscovered mechanisms necessitate further investigation. Depression fundamentally manifests as a neurodegenerative disorder. Given stem cell therapy's success in addressing a range of neurodegenerative pathologies, it opens the door to explore its application in depression treatment. This exploration may include repairing damaged nerves directly or indirectly and inhibiting neurotoxicity. Nevertheless, significant challenges must be overcome before stem cell therapies can be applied clinically. Successful resolution of these issues will ultimately determine the feasibility of incorporating stem cell therapies into the clinical landscape. This narrative review provides insights into the progress of research, potential avenues for exploration, and the prevailing challenges in the implementation of stem cell therapy for treatment of depression.

The Role of Physical Activity in Adjunctive Nursing Management of Neuro-Degenerative Diseases among Older Adults: A Systematic Review of Interventional Studies

Neurodegenerative diseases such as dementia and Parkinson's disease pose significant challenges to older adults globally. While pharmacological treatments remain primary, increasing evidence supports the role of non-pharmacological strategies like physical activity in managing these conditions. This systematic review critically evaluates the effectiveness of Nursing based physical activity interventions in improving cognitive function, physical functioning, mobility, and overall quality of life among older adults with neurodegenerative diseases. We conducted a comprehensive search across PubMed, EMBASE, Web of Science, CENTRAL, and other relevant databases, focusing on randomized controlled trials and observational studies that examined the impact of structured physical activity. Our findings from nineteen studies involving 1673 participants indicate that interventions ranging from aerobic exercises, resistance training, to mind-body exercises like Tai Chi and yoga have beneficial effects. Specifically, physical activity was consistently found to enhance cognitive performance, increase mobility, and improve balance and daily living activities, contributing to a better quality of life. However, these benefits vary depending on the type, intensity, and duration of the activity performed. Despite promising results, limitations such as small sample sizes, study heterogeneity, and short-term follow-up periods call for more robust, long-term studies to solidify these findings. This review underscores the potential of tailored physical activity programs as adjunctive therapy in the comprehensive management of neurodegenerative diseases among the elderly population.

Serum indoleamine 2, 3-dioxygenase and tryptophan-2, 3-dioxygenase: potential biomarkers for the diagnosis of major depressive disorder

OBJECTIVE

The objective of this study was to observe the changes in the levels of indoleamine 2, 3-dioxygenase (IDO) and tryptophan-2, 3-dioxygenase (TDO) in patients with major depressive disorder (MDD) and investigate their potential role as novel biomarkers for diagnosing MDD.

METHODS

A total of 55 MDD patients and 55 healthy controls (HC) were enrolled in the study. The severity of MDD was assessed using the 24-item Hamilton Depression Rating Scale (HAMD-24) before and after treatment. The serum concentrations of IDO and TDO were measured at baseline and after treatment. The correlations between the serum levels of IDO and TDO and HAMD-24 scores were evaluated using Pearson's correlation test. Receiver operating characteristic (ROC) curve analysis was used to evaluate the area under the curve (AUC) of serum levels of IDO and TDO for discriminating MDD patients from HC.

RESULTS

The serum IDO and TDO concentrations were significantly higher in patients with MDD at baseline than in healthy controls, and decreased significantly after 2 weeks or 1 month of treatment. The levels of IDO and TDO were significantly positively correlated with HAMD-24 scores. Furthermore, the AUC values for IDO and TDO were 0.999 and 0.966, respectively.

CONCLUSION

The study suggests that serum IDO and TDO may serve as novel biomarkers for diagnosing MDD. These findings may lead to a better understanding of the pathogenesis of MDD and the development of new therapeutic targets.

Targeting the postsynaptic scaffolding protein PSD-95 enhances BDNF signaling to mitigate depression-like behaviors in mice

Signaling mediated by brain-derived neurotrophic factor (BDNF), which is supported by the postsynaptic scaffolding protein PSD-95, has antidepressant effects. Conversely, clinical depression is associated with reduced BDNF signaling. We found that peptidomimetic compounds that bind to PSD-95 promoted signaling by the BDNF receptor TrkB in the hippocampus and reduced depression-like behaviors in mice. The compounds CN2097 and Syn3 both bind to the PDZ3 domain of PSD-95, and Syn3 also binds to an α-helical region of the protein. Syn3 reduced depression-like behaviors in two mouse models of stress-induced depression; CN2097 had similar but less potent effects. In hippocampal neurons, application of Syn3 enhanced the formation of TrkB-Gαi1/3-PSD-95 complexes and potentiated downstream PI3K-Akt-mTOR signaling. In mice subjected to chronic mild stress (CMS), systemic administration of Syn3 reversed the CMS-induced, depression-associated changes in PI3K-Akt-mTOR signaling, dendrite complexity, spine density, and autophagy in the hippocampus and reduced depression-like behaviors. Knocking out Gαi1/3 in hippocampal neurons prevented the therapeutic effects of Syn3, indicating dependence of these effects on the TrkB pathway. The findings suggest that compounds that induce the formation of PSD-95-TrkB complexes have therapeutic potential to alleviate depression.

Evaluating the effect of exercise-based interventions on functioning in people with transdiagnostic depressive symptoms: A systematic review of randomised controlled trials

BACKGROUND

Depressive symptoms are associated with various conditions and can exacerbate the outcome of somatic diseases. Transdiagnostic symptom-based approaches provide treatment flexibility, and exercise has demonstrated benefits beyond clinical symptoms. This work aimed to synthesise and establish the effects of exercise-based interventions on global functioning and quality of life in adults with transdiagnostic depressive symptoms, as well as their impact on clinical symptoms.

METHODS

A systematic review was conducted following PRISMA guidelines. PubMed, Scopus and PsycINFO databases were searched from inception to April 2023. Eligibility criteria included randomised controlled trials involving adults with transdiagnostic depressive symptoms who received exercise-based interventions and provided details of the interventions. Comparators included treatment as usual or other active control groups. The Cochrane quality assessment tool was used for quality assessment.

RESULTS

Fifteen articles involving 2064 participants were included. Data on study design, sample, intervention characteristics, and outcomes were extracted. Several trials demonstrated the expected positive effects of exercise on functioning (7/15). Most results supported the benefits of adjunctive exercise interventions on illness outcomes.

LIMITATIONS

The studies had methodological limitations, including small sample sizes and an underrepresentation of somatic diseases.

CONCLUSIONS

The functional consequences of exercise-based interventions targeting depressive symptoms are often understudied. Incorporating exercise routinely as an add-on treatment for transdiagnostic depressive symptoms could improve overall functioning, quality of life, and symptom severity. There is a need to expand the focus of exercise-based interventions to incorporate functional outcomes. Future research should address the methodological limitations and include a wider range of participants, including those with somatic diseases.

Examining the validity and reliability of the Arabic translated version of the depression and somatic symptoms scale (A-DSSS) among the Lebanese adults

The prevalence of depression is high worldwide, and somatic symptoms are known to be one of the most debilitating aspects of depression. However, clinicians often face challenges in accurately assessing this comorbidity. To address this issue, the Depression and Somatic Symptoms Scale (DSSS) was developed as a self-administered scale that can diagnose both depression and somatic symptoms. The objective of this study is to evaluate the validity and reliability of the Arabic-translated version of the DSSS (A-DSSS) in a sample of Lebanese adults, as well as to explore its associated factors. A cross-sectional study was conducted over a period of one month, from February to March 2023, and involved a sample of 422 participants who were aged 18 years or older. Participants completed a questionnaire that included various measures, including demographic characteristics, alcohol and smoking habits, physical activity history, as well as two scales: the Patient Health Questionnaire-9 (PHQ9) scale and the A-DSSS scale. The A-DSSS showed high internal consistency (Cronbach's alpha = 0.936), strong test-retest reliability (ICC of 0.988 with CI 0.976-0.994; p < 0.001), and a three-factor structure consistent with previous research. Convergent validity was supported by a significant correlation with the PHQ-9. Stepwise linear regression revealed that engaging in physical activity and increasing calorie consumption (as measured by MET-min/week score) were associated with a significant decrease in the A-DSSS total score and subscales. However, a significant increase in the A-DSSS total score was seen in the female gender in comparison for male gender. The A-DSSS revealed good psychometric properties and may be a useful tool for assessing depression and somatic symptoms in this population. The study also identified potential factors associated with depression and somatic symptoms, such as physical activity, calorie consumption, and gender, which may have implications in addressing depression and somatic symptoms for future interventions and clinical practice.

Possible role of exercise therapy on depression: Effector neurotransmitters as key players

About 280 million people suffer from depression as the most common neurological disorder and the most common cause of death worldwide. Exercise with serotonin released in the brain by the 5-HT3-IGF-1 mechanism can lead to antidepressant effects. Swimming exercise has antidepressant effects by increasing the sensitivity of serotonin 5-HT2 receptors and postsynaptic 5-HT1A receptors, increasing 5-HT and 5HIAA levels, increasing TPH and serotonin, and decreasing inflammatory levels of IFN-γ and TNF-α. Anaerobic and aerobic exercises increase beta-endorphin, enkephalin, and dynorphin and have antidepressant effects. Exercise by increasing dopamine, D1R, and D2R leads to the expression of BDNF and activation of TrkB and has antidepressant behavior. Exercise leads to a significant increase in GABAAR (γ2 and α2 subunits) and reduces neurodegenerative disorders caused by GABA imbalance through anti-inflammatory pathways. By increasing glutamate and PGC1α and reducing glutamatergic neurotoxicity, exercise enhances neurogenesis and synaptogenesis and prevents neurodegeneration and the onset of depression. Irisin release during exercise shows an important role in depression by increasing dopamine, BDNF, NGF, and IGF-1 and decreasing inflammatory mediators such as IL-6 and IL-1β. In addition, exercise-induced orexin and NPY can increase hippocampal neurogenesis and relieve depression. After exercise, the tryptophan to large neutral amino acids (TRP/LNAA) ratio and the tryptophan to branched-chain amino acids (BCAA) ratio increase, which may have antidepressant effects. The expression of M5 receptor and nAChR α7 increases after exercise and significantly increases dopamine and acetylcholine and ameliorates depression. It appears that during exercise, muscarinic receptors can reduce depression through dopamine in the absence of acetylcholine. Therefore, exercise can be used to reduce depression by affecting neurotransmitters, neuromodulators, cytokines, and/or neurotrophins.

MTK, Orlowski SK. Effects of Environmental Enrichments on Welfare and Hepatic Metabolic Regulation of Broiler Chickens

The aims of this study were to find suitable environmental enrichment (EE) and evaluate the combined effect of two EEs, variable light intensity (VL) lighting program and EH, on mental health and hepatic metabolic regulation in commercial broilers. To find the advantageous EEs for broilers, three different EEs (board, hut, and ramp) were tested in trial 1. EEs were placed and the engagement of birds to EEs, dustbathing behavior, and daily physical activity were observed. Birds treated with huts showed higher engagement than the board- or ramp-treated birds (p < 0.05). The results of dustbathing behavior and daily physical activity indicated that the environmental hut (EH) is the most favorable enrichment for broilers. In the second trial, to test the effect of EHs on mental health and hepatic metabolic conditions, the brain and liver were sampled from the four treatment birds (20 lx_Con, 20 lx_Hut, VL_Con and VL_Hut) on day 42. The lower expression of TPH2 (tryptophan hydroxylase 2) of VL_Hut birds than those of VL_Con and 20 lx_Hut treated birds suggests the combining effect of EHs with the VL lighting program on the central serotonergic homeostasis of broilers. Reduced expressions of TH (tyrosine hydroxylase), GR (glucocorticoid receptor), BDNF (brain-derived neurotrophic factor) of VL_Hut treated birds compared to those of VL_Con and 20 lx_Hut birds suggest lower stress, stress susceptibility, and chronic social stress in VL_Hut treated birds. The expression of CPT1A (carnitine palmitoyl transferase 1) increased over three-fold in the liver of VL_Con birds compared to 20 lx_Con birds (p < 0.05). EHs treatment in VL birds (VL_Hut) significantly decreased CPT1A but not in 20 lx birds (20 lx_Hut). The expression of ACCα (acetyl-CoA carboxylase alpha) was significantly decreased in VL_Con birds compared to 20 lx_Con birds. There was no significant difference in the hepatic FBPase (fructose-1,6-bisphosphatase), GR, and 11β-HSD1 (11 β-hydroxysteroid dehydrogenease-1) expression between 20 lx_Con and VL_Con birds, but EHs significantly stimulated GR in 20 lx_Hut birds, and stimulated FBPase and 11β-HSD1 expression in the VL_Hut birds compared to 20 lx_Con birds, suggesting that the VL lighting program reduced fatty acid synthesis and increased fatty acid β-oxidation in the broilers' liver and VL_Hut improved the hepatic de novo glucose production. Taken together, the results suggest that the stimulated voluntary activity by EHs in the light-enriched broiler house improved mental health and hepatic metabolic function of broilers and may indicate that the improved hepatic metabolic function contributes to efficient nutritional support for broilers.

Extracellular Vesicles from Neural Stem Cells Carry microRNA-16-5p to Reduce Corticosterone-induced Neuronal Injury in Depression Rats

OBJECTIVE

Depression is a common mental illness. Neural stem cell-derived extracellular vesicles (NSC-EVs) are involved in repairing neuronal injury. We estimated the mechanism of miR-16-5p in depression rats.

METHODS

EVs were extracted from NSCs. The depression rat model was established by corticosterone (CORT) induction and treated with NSC-EVs. The depression behavioral/pathological changes in rats were assessed using forced swimming test, open field test, sucrose consumption test and western blotting. The neuronal apoptosis in hippocampal tissue were detected. CORT-induced PC12 cell model was established. EV uptake by PC12 cells was measured and PC12 cell apoptosis was detected. The downstream targets of miR-16-5p were predicted and verified. The expressions of miR-16-5p and MYB in rats, PC12 cells, and EVs were measured. Functional rescue experiments were conducted to verify the role of miR-16-5p and MYB in PC12 cell apoptosis.

RESULTS

CORT induction increased neuronal apoptosis in hippocampal tissue and induced depression-like behaviors in rats, while NSC-EV treatment improved depression-like behaviors and apoptosis in rats. In PC12 cells, NSC-EVs decreased CORT-induced PC12 cell apoptosis. NSC-EVs carried miR-16-5p into PC12 cells. miR-16-5p knockdown in EVs partially reversed the inhibitory effects of NSC-EVs on CORT-induced PC12 cell apoptosis. miR-16-5p targeted to inhibit MYB to repress CORT-induced PC12 cell apoptosis. In vivo experiments further verified that NSC-EVs reduced neuronal injury in CORT-induced depression rats via the miR-16-5p/MYB axis.

CONCLUSION

NSC-EVs-mediated alleviation on neuronal injury by carrying miR-16-5p to target MYB was highly likely one of the mechanisms by which NSC-EVs mediated miR-16-5p in neuroprotection of depression rats.

Potential Beneficial Effects of Naringin and Naringenin on Long COVID-A Review of the Literature

Coronavirus disease 2019 (COVID-19) caused a severe epidemic due to severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). Recent studies have found that patients do not completely recover from acute infections, but instead, suffer from a variety of post-acute sequelae of SARS-CoV-2 infection, known as long COVID. The effects of long COVID can be far-reaching, with a duration of up to six months and a range of symptoms such as cognitive dysfunction, immune dysregulation, microbiota dysbiosis, myalgic encephalomyelitis/chronic fatigue syndrome, myocarditis, pulmonary fibrosis, cough, diabetes, pain, reproductive dysfunction, and thrombus formation. However, recent studies have shown that naringenin and naringin have palliative effects on various COVID-19 sequelae. Flavonoids such as naringin and naringenin, commonly found in fruits and vegetables, have various positive effects, including reducing inflammation, preventing viral infections, and providing antioxidants. This article discusses the molecular mechanisms and clinical effects of naringin and naringenin on treating the above diseases. It proposes them as potential drugs for the treatment of long COVID, and it can be inferred that naringin and naringenin exhibit potential as extended long COVID medications, in the future likely serving as nutraceuticals or clinical supplements for the comprehensive alleviation of the various manifestations of COVID-19 complications.

Metabolic bioactivation of antidepressants: advance and underlying hepatotoxicity

Many drugs that serve as first-line medications for the treatment of depression are associated with severe side effects, including liver injury. Of the 34 antidepressants discussed in this review, four have been withdrawn from the market due to severe hepatotoxicity, and others carry boxed warnings for idiosyncratic liver toxicity. The clinical and economic implications of antidepressant-induced liver injury are substantial, but the underlying mechanisms remain elusive. Drug-induced liver injury may involve the host immune system, the parent drug, or its metabolites, and reactive drug metabolites are one of the most commonly referenced risk factors. Although the precise mechanism by which toxicity is induced may be difficult to determine, identifying reactive metabolites that cause toxicity can offer valuable insights for decreasing the bioactivation potential of candidates during the drug discovery process. A comprehensive understanding of drug metabolic pathways can mitigate adverse drug-drug interactions that may be caused by elevated formation of reactive metabolites. This review provides a comprehensive overview of the current state of knowledge on antidepressant bioactivation, the metabolizing enzymes responsible for the formation of reactive metabolites, and their potential implication in hepatotoxicity. This information can be a valuable resource for medicinal chemists, toxicologists, and clinicians engaged in the fields of antidepressant development, toxicity, and depression treatment.

Common and divergent molecular mechanisms of fasting and ketogenic diets

Intermittent short-term fasting (ISTF) and ketogenic diets (KDs) exert overlapping but not identical effects on cell metabolism, function, and resilience. Whereas health benefits of KD are largely mediated by the ketone bodies (KBs), ISTF engages additional adaptive physiological responses. KDs act mainly through inhibition of histone deacetylases (HDACs), reduction of oxidative stress, improvement of mitochondria efficiency, and control of inflammation. Mechanisms of action of ISTF include stimulation of autophagy, increased insulin and leptin sensitivity, activation of AMP-activated protein kinase (AMPK), inhibition of the mechanistic target of rapamycin (mTOR) pathway, bolstering mitochondrial resilience, and suppression of oxidative stress and inflammation. Frequent switching between ketogenic and nonketogenic states may optimize health by increasing stress resistance, while also enhancing cell plasticity and functionality.

Early depressive manifestations in patients with dementia caused by Alzheimer's disease

Previous studies on the complex interplay between depression and dementia in patients with Alzheimer's disease revealed that early-life depression is a risk factor for dementia. Both depression and dementia appear to share common etiopathological mechanisms. In the present study, a comprehensive retrospective analysis was performed on a study group of patients with dementia suffering from previously diagnosed depression. The aim was to assess potentially relevant clinical and imaging parameters that can be used to characterize depression as a risk factor for dementia in later life. Statistically significant data correlating cognitive scores with the moment of depression onset and the length of time period to the diagnosis of dementia were identified. Furthermore, at the moment of depression diagnosis, structural cerebral alterations tended to appear more frequently in women compared with men. However, this sex-associated difference is not maintained after the moment of dementia diagnosis. Results from the present study contributed additional data to the evidence supporting a relationship between a history of depression and the occurrence of Alzheimer's disease, discussing relevant clinical and imaging parameters featured in patients with dementia and their inter-relations.

The Associations between the Number of School Sports Teams That a Student Regularly Participates in and Factors Such as Perceived Stress, Loneliness, and Sleep Satisfaction among Korean Adolescents Who Have Attempted Suicide

Adolescents who have attempted suicide are more likely to experience a recurrence of suicidal behavior, thus necessitating systematic follow-ups and management. We aimed to investigate the association between the number of school sports teams that a student regularly participates in and psychological factors such as perceived stress, loneliness, and sleep satisfaction among 1393 Korean adolescents who have attempted suicide by using data from the 2022 Korea Youth Risk Behavior Survey. Frequency analyses were performed to evaluate participant characteristics. Chi-square analyses were used to examine the differences in participant characteristics according to the number of teams. Multivariate logistic regression analysis was used to examine the associations between the number of teams and perceived stress, loneliness, and sleep satisfaction. Our results indicated that participating in a greater number of sports teams at school was more strongly associated with reduced perceived stress, reduced loneliness, and increased sleep satisfaction. Specifically, the odds ratio (OR) for feeling very much stressed was 0.613 (range: 0.387-0.969; p = 0.036) among the participants who belonged to one team. Among those who belonged to two teams, the OR for feeling very much stressed was 0.482 (range: 0.281-0.286; p = 0.008). Among those who belonged to two teams, the OR for feeling a lot of stress was 0.514 (range: 0.304-0.870; p = 0.013), and that for not feeling much stress was 2.663 (range: 1.103-6.426; p = 0.029). The OR for not feeling much stress was 4.697 for those who belonged to three teams (range: 1.531-14.408; p = 0.007) and 6.671 for those who belonged to four or more teams (range: 1.858-23.953; p = 0.004). The OR for feeling no stress at all was 11.629 (range: 2.229-60.661; p = 0.004) for those who belonged to three teams and 93.531 (range: 19.260-454.207; p < 0.001) for those who belonged to four or more teams. In terms of loneliness, the OR for rarely feeling lonely was 2.651 (range: 1.148-6.123; p = 0.022) among those who belonged to one team. The OR for feeling lonely all the time was 0.370 (range: 0.155-0.884; p = 0.025) among those who belonged to two teams. In terms of sleep satisfaction, the OR for having very sufficient sleep was 4.371 (range: 1.627-11.742; p = 0.003) for those who belonged to four or more teams. These results suggest that school sports are an advantageous tool for suicide prevention, given their low costs, absence of side effects, and ease of participation.

Effect of mindfulness-based cognitive therapy vs. psychoeducational intervention on plasma brain-derived neurotrophic factor and cognitive function in bipolar patients: a randomized controlled trial

Introduction

Few controlled trials have assessed the benefits of Mindfulness Based Cognitive Therapy (MBCT) on cognitive functions and brain-derived neurotrophic factor (BDNF) in bipolar disorder (BD). This study aims to evaluate the impact of MBCT adjunctive treatment on these variables. Main hypothesis was that MBCT would improve cognitive functioning and BDNF more than Psychoeducation and TAU.

Methods

Randomized, multicenter, prospective and single-blinded trial. Included BD outpatients randomly assigned to three treatment arms: MBCT plus treatment as usual (TAU), Psychoeducation plus Tau and TAU. Cognitive functions were assessed with Continuous Performance Test-III, Stroop Test, Trail Making Test, Digit Span and Letter-Number Sequencing from Wechsler Adult Intelligence Scale III, Face Emotion Identification Task and Face Emotion Discrimination Task. BDNF serum level was measured with ELISA. Patients were assessed at baseline, 8 weeks and 6 months.

Results

Eighty-four patients were recruited (TAU = 10, Psychoeducation = 34, MBCT = 40). No significant differences between treatment groups were found. MBCT does not achieve better results than Psychoeducation or TAU.

Discussion

Being Psychoeducation and TAU efficient interventions, as well as the scarce duration of a more complex intervention, such as MBCT, are suggested as explanatory variables of these results.

Trial registration

ClinicalTrials.gov: NCT02133170. Registered 04/30/2014.

Correlation analysis between per-fluoroalkyl and poly-fluoroalkyl substances exposure and depressive symptoms in adults: NHANES 2005-2018

BACKGROUND

Excessive exposure to per and poly-fluoroalkyl compounds (PFAS) can lead to various negative health effects. However, there's a lack of research studying the link between PFAS exposure and depression in adults, and the existing findings are inconsistent.

OBJECTIVES

Utilizing data collected from the National Health and Nutrition Examination Survey (NHANES) database spanning 2005 to 2018, this study aimed to examine the potential connection between PFAS exposure and depressive symptoms in adults.

METHODS

The correlation between individual PFAS exposure and depressive symptoms was examined through the establishment of weighted logistic regression models (crude model, model 1, model 2) and restricted cubic spline models. To verify the stability of the model, receiver operating characteristic (ROC) curves of the logistic regression model were generated, and a ten-fold cross-validation model was employed. Additionally, the relationship between adult depressive symptoms and mixed PFAS exposure was tested through the utilization of quantile g-computation (qgcomp).

RESULTS

The findings revealed that heightened exposure levels to PFOA, PFHxS, and PFUnDA, were connected with a diminished risk of depressive symptoms in adults (ORPFOA: 0.67, 95 % confidence interval (CI): 0.47, 0.95; ORPFHxS: 0.66, 95 %CI: 0.49, 0.89; ORPFUnDA: 0.65, 95 %CI: 0.45, 0.96). PFOS, PFHxS, and PFDA demonstrated a dose-response relationship with the risk of depressive symptoms. The ROC curve indicated model stability, with recognition accuracy exceeding 90 % in the cross-validation model. The outcomes of qgcomp demonstrated that an increase in serum PFAS concentration was linked to a decreased risk of depressive symptoms in adults (OR: 0.85, 95 %CI: 0.75, 0.96).

DISCUSSION

Due to the cross-sectional design of this study, it's important to acknowledge the potential for reverse causality between PFAS exposure and depressive symptoms. As a result, the outcomes should not be oversimplified to interpret PFAS exposure as a protective factor against adult depressive symptoms.

A randomized controlled trial of mindfulness-based cognitive therapy for major depressive disorder in undergraduate students: Dose- response effect, inflammatory markers and BDNF

To examine the dose-response effect of mindfulness-based cognitive therapy (MBCT) for college students with major depressive disorder (MDD), a randomized control trial with MBCT and a wait-list (WL) group was performed. All participants were invited to self-administer a set of questionnaires at baseline, mid-intervention (4th week), and post-intervention (8th week) by the 9-item Patient Health Questionnaire (PHQ-9), the 7-item Generalized Anxiety Disorder scale (GAD-7), the Pittsburgh Sleep Quality Index (PSQI), the Five Facet Mindfulness Questionnaire (FFMQ), the Self-Compassion Scale (SCS). The serum levels of IL-1β, IL-6, IL-8, TNF-α, BDNF were detected at baseline and post-intervention. After intervention, the scores of PHQ-9, GAD-7, PSQI, and the levels of IL-1β, IL-6, IL-8 and TNF-α in the MBCT were significantly lower than those in WL group, and total scores of FFMQ, SCS, and the level of BDNF were significantly higher than those in WL group. In MBCT group, daily practice time and session numbers positively related to reduction rates of PHQ-9, GAD-7 and PSQI at post-intervention. The reduction rate of PHQ-9, GAD-7 and PSQI at post-intervention in the completers were higher significantly than those in the partial attendees. These findings suggested MBCT is effective for MDD, and the intervention has a dose-response effect. TRIAL REGISTRATION: Registration number is [ChiCTR2100044309].

High-frequency rTMS of the left dorsolateral prefrontal cortex for post-stroke depression: A systematic review and meta-analysis

OBJECTIVE

This meta-analysis investigated the therapeutic efficacy of high-frequency repetitive transcranial magnetic stimulation (rTMS) over the left dorsolateral prefrontal cortex (DLPFC) for treatment of post-stroke depression (PSD).

METHODS

Ten articles with 266 patients in rTMS group and 258 patients in control group were included. The primary outcome was performed to examine the efficacy of rTMS for PSD. Secondary outcomes of response rates and remission rates and subgroup analyses were further explored.

RESULTS

Our meta-analysis revealed a significant pooled effect size (the standard mean difference (SMD) was -1.45 points (95% CI, -2.04 to -0.86; p < 0.00001)). The odds ratio (OR) of the response rate and remission rate were 8.41 (95% CI, 2.52-28.12, p = 0.0005) and 6.04 (95% CI, 1.5-24.39, p = 0.01). Moreover, rTMS treatment for PSD patients in subacute phase and targeting the left DLPFC at 5-cm anterior to the left motor hotspot or the midpoint of the middle frontal gyrus showed significant antidepressant effect. In addition, the Hamilton Depression Rating Scale (HAMD) was sensitive to detect depressive changes in patients.

CONCLUSIONS

Our meta-analysis elucidated that the application of high-frequency rTMS over the left DLPFC was an effective treatment alternative for PSD.

SIGNIFICANCE

Our meta-analysis may help to develop more reasonable treatment strategies in clinical practice for PSD patients.