Gerber Markus, Imboden Christian, Beck Johannes, Brand Serge, Colledge Flora, Eckert Anne, Holsboer-Trachsler Edith, Pühse Uwe, Hatzinger Martin
Sport Science Section, Department of Sport, Exercise and Health, University of Basel, CH-4052 Basel, Switzerland.
Psychiatric Services Solothurn, 4503 Solothurn, Switzerland.
J Clin Med. 2020 May 11;9(5):1419. doi: 10.3390/jcm9051419.
Physical activity is associated with a favourable (blunted) cortisol stress reactivity in healthy people. However, evidence from experimental study and with psychiatric patients is missing. This study examines whether exercise training impacts on cortisol stress reactivity in inpatients with major depressive disorder (MDD). These new insights are important because the stress reactivity of healthy people and patients with severe symptoms of depression might differ. Methods: The study was designed as a randomized controlled trial (trial registration number: NCT02679053). In total, 25 patients (13 women, 12 men, mean age: 38.1 12.0 years) completed a laboratory stressor task before and after a six-week intervention period. Nine samples of salivary free cortisol were taken before and after the Trier social stress test (TSST). Fourteen participants took part in six weeks of aerobic exercise training, while 11 patients were allocated to the control condition. While the primary outcome of the study was depressive symptom severity, the focus of this paper is on one of the secondary outcomes (cortisol reactivity during the TSST). The impact of aerobic exercise training was examined with a repeated-measures analysis of variance. We also examined the association between change in depression and cortisol response via correlational analysis. Cortisol reactivity did not change from baseline to post-intervention, either in the intervention or the control group. Participation in six weeks of aerobic exercise training was not associated with participants' cortisol reactivity. Moreover, depressive symptom change was not associated with change in cortisol response. Aerobic exercise training was not associated with patients' stress reactivity in this study. Because many patients initially showed a relatively flat/blunted cortisol response curve, efforts might be needed to find out which treatments are most efficient to promote a normalization of HPA axis reactivity.
体育活动与健康人群中良好的（钝化的）皮质醇应激反应性相关。然而，缺乏来自实验研究以及针对精神疾病患者的证据。本研究旨在探讨运动训练对重度抑郁症（MDD）住院患者皮质醇应激反应性的影响。这些新见解很重要，因为健康人和有严重抑郁症状患者的应激反应可能不同。方法：本研究设计为随机对照试验（试验注册号：NCT02679053）。共有25名患者（13名女性，12名男性，平均年龄：38.1±12.0岁）在为期六周的干预期前后完成了一项实验室应激源任务。在特里尔社会应激测试（TSST）前后采集了9份唾液游离皮质醇样本。14名参与者参加了为期六周的有氧运动训练，而11名患者被分配到对照组。虽然该研究的主要结果是抑郁症状严重程度，但本文的重点是次要结果之一（TSST期间的皮质醇反应性）。通过重复测量方差分析来检验有氧运动训练的影响。我们还通过相关分析研究了抑郁变化与皮质醇反应之间的关联。无论是干预组还是对照组，从基线到干预后皮质醇反应性均未改变。参加六周的有氧运动训练与参与者的皮质醇反应性无关。此外，抑郁症状变化与皮质醇反应变化无关。在本研究中，有氧运动训练与患者的应激反应性无关。由于许多患者最初表现出相对平坦/钝化的皮质醇反应曲线，可能需要努力找出哪些治疗方法最有效地促进下丘脑-垂体-肾上腺（HPA）轴反应性的正常化。
