Department of Child and Adolescent Psychiatry Psychosomatic and Psychotherapy, University Hospital of Cologne, 50937 Cologne, Germany.
Institute of Medical Statistics and Computational Biology (IMSB), University of Cologne, 50937 Cologne, Germany.
Int J Environ Res Public Health. 2021 Jun 17;18(12):6527. doi: 10.3390/ijerph18126527.
Pro-inflammatory cytokines (PICs) have gained attention in the pathophysiology and treatment of depressive disorders. At the same time, the therapeutic effect of physical activity seems to work via immunomodulatory pathways. The interventional study "Mood Vibes" analyzed the influence of exercise on depression severity (primary endpoint) in depressive adolescents; the influence of PICs on the clinical outcome was analyzed as a secondary endpoint.
Clinically diagnosed depressed adolescents (N = 64; 28.1% male; mean age = 15.9; mean BMI = 24.6) were included and participated either in Whole Body Vibration (WBV) (n = 21) or bicycle ergometer training (n = 20) in addition to treatment-as-usual (TAU). Patients in the control treatment group received TAU only (n = 23). The PICs (interleukin-6-IL-6 and tumor necrosis factor-α-TNF-α) were analyzed before intervention, after 6 weeks of training (t1), and 8 weeks post-intervention (t2). The effects of the treatment on depression severity were rated by self-rating "Depression Inventory for Children and Adolescents" (DIKJ).
Basal IL-6 decreased in all groups from t0 to t1, but it increased again in WBV and controls at t2. TNF-α diminished in ergometer and controls from baseline to t1. PIC levels showed no correlation with depression severity at baseline. The influence on DIKJ scores over time was significant for IL-6 in the WBV group ( = 0.008). Sex had an impact on TNF-α ( < 0.001), with higher concentrations in male patients. Higher body mass index was associated with higher IL-6 concentrations over all measurement points ( < 0.001).
The positive effects of an intensive add-on exercise therapy on adolescent depression seem to be partly influenced by immunomodulation. A small sample size and non-randomized controls are limitations of this study.
促炎细胞因子（PICs）在抑郁障碍的病理生理学和治疗中受到关注。与此同时，身体活动的治疗效果似乎通过免疫调节途径发挥作用。干预研究“Mood Vibes”分析了运动对抑郁青少年严重程度（主要终点）的影响；PICs 对临床结果的影响作为次要终点进行了分析。
纳入了临床诊断为抑郁的青少年（N=64；28.1%为男性；平均年龄=15.9；平均 BMI=24.6），他们除了接受常规治疗（TAU）外，还分别参加全身振动（WBV）（n=21）或自行车测力计训练（n=20）。对照组（n=23）仅接受 TAU。在干预前（t0）、6 周训练后（t1）和干预后 8 周（t2）分析了 PICs（白细胞介素-6-IL-6 和肿瘤坏死因子-α-TNF-α）。用自我评定“儿童和青少年抑郁量表”（DIKJ）评定治疗对抑郁严重程度的影响。
所有组的基础 IL-6 均从 t0 降至 t1，但在 WBV 和对照组中又在 t2 时升高。从基线到 t1，测力计和对照组中的 TNF-α 减少。PIC 水平与基线时的抑郁严重程度无相关性。WBV 组中 IL-6 随时间的影响在 DIKJ 评分上有统计学意义（=0.008）。性别对 TNF-α有影响（<0.001），男性患者浓度较高。较高的 BMI 与所有测量点的 IL-6 浓度较高相关（<0.001）。
强化附加运动疗法对青少年抑郁的积极影响似乎部分受到免疫调节的影响。本研究的局限性是样本量小且非随机对照。
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