Tolahunase Madhuri R, Sagar Rajesh, Faiq Muneeb, Dada Rima
Department of Anatomy, Lab for Molecular Reproduction and Genetics, All India Institute of Medical Sciences (AIIMS), New Delhi, India.
Department of Psychiatry, All India Institute of Medical Sciences (AIIMS), New Delhi, India.
Restor Neurol Neurosci. 2018;36(3):423-442. doi: 10.3233/RNN-170810.
Current interventions for major depressive disorder (MDD) are suboptimal, and only one third respond to them on initial treatment. Neuroplasticity theories are the basis for several emerging treatments. Evidence on the impact of yoga, a well-known mind-body intervention, on neuroplasticity in MDD is limited.
To determine the effects of 12-week yoga- and meditation-based lifestyle intervention (YMLI) on depression severity and systemic biomarkers of neuroplasticity in adult MDD patients on routine drug treatment.
A total of 58 MDD patients were randomized into yoga or control group. The severity of depression was assessed with Beck Depression Inventory-II scale (BDI-II). Blood samples were collected before and after intervention for the measurement of the biomarkers that characterize neuroplasticity, including mind-body communicative and cellular health biomarkers.
There was a significant decrease [difference between means, (95% CI)] in BDI-II score [-5.83 (-7.27, -4.39), p < 0.001] and significant increase in BDNF (ng/ml) [5.48 (3.50, 7.46), p < 0.001] after YMLI compared to control group. YMLI significantly increased DHEAS, sirtuin 1, and telomerase activity levels, and decreased cortisol, and IL-6 levels, in addition to decreasing DNA damage and balancing oxidative stress. Multiple regression analyses were used to associate neuroplasticity biomarkers with depression severity. A 'post-intervention change in BDNF' x 'group' interaction indicated that yoga group had more BDNF in association with less BDI-II scores relative to controls. Increased sirtuin 1 and telomerase activity and decreased cortisol significantly predicted this association (all p < 0.05).
These results suggest that decrease in depression severity after YMLI in MDD is associated with improved systemic biomarkers of neuroplasticity. Thus YMLI can be considered as a therapeutic intervention in MDD management.
目前针对重度抑郁症（MDD）的干预措施并不理想，只有三分之一的患者在初始治疗时对这些干预措施有反应。神经可塑性理论是几种新兴治疗方法的基础。瑜伽作为一种著名的身心干预方式，其对MDD患者神经可塑性影响的证据有限。
确定基于瑜伽和冥想的12周生活方式干预（YMLI）对接受常规药物治疗的成年MDD患者抑郁严重程度和神经可塑性系统生物标志物的影响。
总共58例MDD患者被随机分为瑜伽组或对照组。使用贝克抑郁量表第二版（BDI-II）评估抑郁严重程度。在干预前后采集血样，以测量表征神经可塑性的生物标志物，包括身心交流和细胞健康生物标志物。
与对照组相比，YMLI后BDI-II评分显著降低[均值差异，（95%CI），-5.83（-7.27，-4.39），p<0.001]，脑源性神经营养因子（BDNF，ng/ml）显著升高[5.48（3.50，7.46），p<0.001]。YMLI除了减少DNA损伤和平衡氧化应激外，还显著提高了硫酸脱氢表雄酮、沉默调节蛋白1和端粒酶活性水平，并降低了皮质醇和白细胞介素-6水平。使用多元回归分析将神经可塑性生物标志物与抑郁严重程度相关联。“干预后BDNF的变化”ד组间”交互作用表明，相对于对照组，瑜伽组的BDNF更多，且BDI-II评分更低。沉默调节蛋白1和端粒酶活性增加以及皮质醇降低显著预测了这种关联（所有p<0.05）。
这些结果表明，MDD患者YMLI后抑郁严重程度的降低与神经可塑性系统生物标志物的改善有关。因此，YMLI可被视为MDD管理中的一种治疗干预措施。
