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抗抑郁药联合瑜伽治疗的抑郁症患者神经认知功能及血清脑源性神经营养因子水平的改善

Improvement in neurocognitive functions and serum brain-derived neurotrophic factor levels in patients with depression treated with antidepressants and yoga.

作者信息

Halappa Naveen Gowrapura, Thirthalli Jagadisha, Varambally Shivarama, Rao Mukund, Christopher Rita, Nanjundaiah Gangadhar B

机构信息

Department of Health and Yoga, Faculty of Allied Health Sciences, Chettinad Hospital and Research Institute, Chennai, Tamil Nadu, India.

Department of Psychiatry, NIMHANS Integrated Centre for Yoga, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India.

出版信息

Indian J Psychiatry. 2018 Jan-Mar;60(1):32-37. doi: 10.4103/psychiatry.IndianJPsychiatry_154_17.

Abstract

CONTEXT AND AIMS

Impairment in cognition is well-known in patients with major depressive disorder. This study examined the effect of yoga therapy with or without antidepressants and antidepressants alone on certain neuropsychological functions in patients with depression. Correlation between changes in neuropsychological test performance and serum brain-derived neurotrophic factor (BDNF) levels was also explored.

MATERIALS AND METHODS

Antidepressant-naïve/antidepressant-free outpatients with depression received antidepressant medication alone ( = 23) or yoga therapy with ( = 26) or without ( = 16) antidepressants. Depression was assessed using the Hamilton Depression Rating Scale. Neuropsychological tests included digit-span forward and backward, Rey Auditory Verbal Learning Test, and Trail Making Tests (TMT-A and B). These tests were administered before and 3 months after the treatment in patients, and once in healthy comparison subjects ( = 19).

STATISTICAL ANALYSIS

Baseline differences were analyzed using independent sample -test, Chi-square, and one-way ANOVA. Paired -test was used to analyze the change from baseline to follow-up. Pearson's correlation was used to explore the association of change between 2 variables.

RESULTS

Patients had impaired performance on most neuropsychological tests. After 3 months, there was significant improvement - patients' performance was comparable to that of healthy controls on majority of the tests. Significant inverse correlation was observed between increase in BDNF levels and improvement in TMT "A" duration in Yoga-alone group ( = -0.647; = 0.009).

CONCLUSIONS

To conclude that, Yoga therapy, alone or in combination with medications, is associated with improved neuropsychological functions and neuroplastic effects in patients with depression.

摘要

背景与目的

重度抑郁症患者存在认知功能损害,这是众所周知的。本研究探讨了单独使用抗抑郁药、联合或不联合抗抑郁药的瑜伽疗法对抑郁症患者某些神经心理功能的影响。同时还探讨了神经心理测试表现的变化与血清脑源性神经营养因子(BDNF)水平之间的相关性。

材料与方法

未服用过抗抑郁药/未服用抗抑郁药的抑郁症门诊患者单独接受抗抑郁药物治疗(n = 23),或联合(n = 26)或不联合(n = 16)抗抑郁药接受瑜伽疗法。使用汉密尔顿抑郁量表评估抑郁情况。神经心理测试包括数字广度顺背和倒背、雷伊听觉词语学习测验以及连线测验(TMT-A和TMT-B)。这些测试在患者治疗前和治疗3个月后进行,在健康对照受试者中进行一次(n = 19)。

统计分析

使用独立样本t检验、卡方检验和单因素方差分析分析基线差异。使用配对t检验分析从基线到随访的变化。使用Pearson相关性分析探索两个变量之间变化的关联。

结果

患者在大多数神经心理测试中的表现受损。3个月后,有显著改善——在大多数测试中,患者的表现与健康对照组相当。在仅接受瑜伽治疗的组中,观察到BDNF水平的升高与TMT“A”持续时间的改善之间存在显著负相关(r = -0.647;p = 0.009)。

结论

总之,瑜伽疗法单独或与药物联合使用,与抑郁症患者神经心理功能的改善和神经可塑性效应相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0f42/5914260/ec1fa4a18eee/IJPsy-60-32-g004.jpg

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