University of Texas, Southwestern Medical Center, Dallas, TX, USA.
University of Texas, Southwestern Medical Center, Dallas, TX, USA.
Gen Hosp Psychiatry. 2017 Nov;49:19-25. doi: 10.1016/j.genhosppsych.2017.06.002. Epub 2017 Jul 6.
Cognitive impairment is increasingly recognized as a significant symptom in patients with major depressive disorder (MDD). While exercise is already recommended in many treatment guidelines for patients with MDD and has been shown to improve cognition in other disorders (e.g., Alzheimer's, Parkinson's, schizophrenia), limited research is available evaluating the effect of exercise on cognition in MDD.
We provide a narrative review of existing literature regarding the effect(s) of exercise on cognition across several neurodegenerative and psychiatric diseases, and particularly in MDD, with specific emphasis on study design and methodology that may impair adequate synthesis of the results. We also describe mechanisms by which exercise may improve cognition in depression and other brain disorders.
Of existing studies with MDD, data are equivocal, as some are supportive of improved cognition, whereas others demonstrate no benefit. Several limitations were noted, including insufficiently-powered designs, variability in interventions examined (e.g., aerobic, anaerobic, mind-body) or control groups, lack of attention to the status of baseline cognitive impairment, and/or heterogeneity across outcome measures and clinical characteristics.
While preliminary results suggest the potential for exercise as a beneficial treatment or augmentation strategy for impaired cognition in MDD, the aforementioned limitations necessitate further investigation.
认知障碍在重度抑郁症（MDD）患者中越来越被视为一个重要的症状。虽然运动已经在许多 MDD 患者的治疗指南中被推荐，并且已经被证明可以改善其他疾病（如阿尔茨海默病、帕金森病、精神分裂症）的认知功能，但关于运动对 MDD 认知功能影响的研究有限。
我们对现有文献进行了叙述性综述，探讨了运动对几种神经退行性和精神疾病（特别是 MDD）认知功能的影响，特别强调了可能影响结果综合的研究设计和方法。我们还描述了运动改善抑郁和其他脑部疾病认知功能的机制。
现有的 MDD 研究数据存在分歧，有些研究支持认知功能改善，而有些则没有益处。研究中存在几个局限性，包括设计力度不足、干预措施（如有氧运动、无氧运动、身心运动）或对照组的差异、对基线认知障碍状况的关注不足，以及/或在结果测量和临床特征方面的异质性。
虽然初步结果表明运动作为 MDD 认知障碍有益的治疗或增效策略的潜力，但上述局限性需要进一步研究。
