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太极拳作为辅助治疗对老年抑郁症脑连接的影响。

Impact of Tai Chi as an adjunct treatment on brain connectivity in geriatric depression.

机构信息

Department of Psychiatry, Jane and Terry Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA, USA; G. Oppenheimer Center for Neurobiology of Stress and Resilience, University of California, Los Angeles, CA, USA.

Department of Psychiatry, Jane and Terry Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA, USA.

出版信息

J Affect Disord. 2022 Oct 15;315:1-6. doi: 10.1016/j.jad.2022.07.049. Epub 2022 Jul 26.

Abstract

BACKGROUND

As an adjunct to antidepressant treatment, Tai Chi Chih (TCC) is superior to health education and wellness (HEW) training in improving the general health of patients with geriatric depression (GD). This study investigated the brain connectivity changes associated with TCC and HEW in combination with antidepressant treatment in patients with GD.

METHODS

Forty patients with GD under stable antidepressant treatment underwent TCC training (n = 21) or HEW training (n = 19) for 12 weeks, and completed baseline and 3-month follow-up resting state magnetic resonance imaging scans. Within-group and between-group differences in parcel-to-parcel connectivity changes with intervention were evaluated by general linear modeling. Relationships between significant connectivity changes and symptom/resilience improvement were evaluated by partial least squares correlation analysis.

RESULTS

Significantly greater increases in connectivity with TCC than with HEW (FDR-corrected p < .05) were observed for 167 pairwise connections, most frequently involving the default mode network (DMN). In both groups, increased connectivity involving largely DMN regions was significantly and positively correlated with improvement in symptoms/resilience.

LIMITATIONS

The sample size was relatively small, mainly due to neuroimaging contraindications (e.g., implants). Additionally, the standard antidepressant treatment varied greatly among patients, adding heterogeneity.

CONCLUSIONS

Non-pharmacological adjuncts, such as TCC, may enhance DMN connectivity changes associated with improved depressive symptoms and psychological resilience in the treatment of GD.

摘要

背景

作为抗抑郁治疗的辅助手段,太极气功(TCC)在改善老年抑郁症(GD)患者的整体健康方面优于健康教育和健康促进(HEW)训练。本研究调查了 TCC 和 HEW 联合抗抑郁治疗与 GD 患者大脑连通性变化的关系。

方法

40 名接受稳定抗抑郁治疗的 GD 患者接受 TCC 训练(n=21)或 HEW 训练(n=19),为期 12 周,并在基线和 3 个月时完成静息态磁共振成像扫描。采用一般线性模型评估干预后各亚区之间的连通性变化的组内和组间差异。采用偏最小二乘相关分析评估与症状/韧性改善相关的显著连通性变化的关系。

结果

与 HEW 相比,TCC 引起的连通性显著增加(经 FDR 校正,p<0.05),涉及 167 对连接,最常见于默认模式网络(DMN)。在两组中,涉及 DMN 区域的连通性增加与症状/韧性改善呈显著正相关。

局限性

样本量相对较小,主要是由于神经影像学禁忌症(如植入物)。此外,患者之间的标准抗抑郁治疗差异很大,增加了异质性。

结论

非药物辅助手段,如 TCC,可能增强与改善抑郁症状和心理韧性相关的 DMN 连通性变化,从而治疗 GD。

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