Abrantes Ana M, Garnaat Sarah L, Stein Michael D, Uebelacker Lisa A, Williams David M, Carpenter Linda L, Greenberg Benjamin D, Desaulniers Julie, Audet Daniel
Butler Hospital, Providence, RI, USA.
Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, USA.
Contemp Clin Trials Commun. 2022 Aug 20;29:100972. doi: 10.1016/j.conctc.2022.100972. eCollection 2022 Oct.
Regular exercise protects against overweight/obesity as well as numerous chronic diseases. Yet, less than half of Americans exercise sufficiently. Elevated levels of depressive symptoms have been identified as an important correlate of physical inactivity as well as poor adherence to exercise programs. Individuals with depression are less sensitive to rewards and demonstrate an attentional bias toward negative stimuli. These, and other features of depression, may place them at increased risk for effectively managing the affective experience of exercise. Lower baseline levels of activation of the left (vs right) frontal cortex, an area implicated in affect regulation, have also been found in depression, potentially pointing to this region as a potential target for intervening on affect regulation during exercise. Transcranial direct current stimulation (tDCS) has shown promise in impacting a variety of cognitive and affective processes in a large number of individuals, including people with depression. Some findings have suggested that tDCS targeting the left dorsolateral prefrontal cortex (DLPFC), specifically, may improve emotion regulation. Transcranial direct current stimulation could theoretically be a novel and potentially promising approach to improving the affective experience of exercise, thereby increasing exercise adherence among individuals with depressive symptoms. Here we present the rationale, design, and baseline characteristics of a pilot randomized controlled trial of tDCS versus sham delivered 3x/week for 8 weeks in the context of supervised aerobic exercise (AE) program among 51 low-active individuals with elevated depressive symptoms (86.3% female; mean age = 49.5). Follow-up assessments were conducted at end of treatment, and three and six months after enrollment to examine changes in levels of objectively-measured moderate-to-vigorous physical activity (MVPA). If effective, this approach could have high public health impact on preventing obesity and chronic diseases among these at-risk individuals.
经常锻炼可预防超重/肥胖以及多种慢性疾病。然而，不到一半的美国人进行了足够的锻炼。抑郁症状水平升高已被确定为身体缺乏活动以及对锻炼计划依从性差的一个重要相关因素。患有抑郁症的个体对奖励不太敏感，并且对负面刺激表现出注意力偏差。抑郁症的这些以及其他特征，可能使他们在有效管理锻炼的情感体验方面面临更高的风险。在抑郁症患者中还发现，与情感调节有关的左（相对于右）额叶皮质的基线激活水平较低，这可能表明该区域是在锻炼期间干预情感调节的一个潜在靶点。经颅直流电刺激（tDCS）已显示出有望影响大量个体（包括抑郁症患者）的各种认知和情感过程。一些研究结果表明，特别是针对左背外侧前额叶皮质（DLPFC）的tDCS可能会改善情绪调节。从理论上讲，经颅直流电刺激可能是一种新颖且有潜在前景的方法，可改善锻炼的情感体验，从而提高有抑郁症状个体的锻炼依从性。在此，我们介绍一项初步随机对照试验的基本原理、设计和基线特征，该试验在51名抑郁症状水平较高的低活动个体（86.3%为女性；平均年龄 = 49.5岁）的监督有氧运动（AE）计划中，每周3次给予tDCS或假刺激，持续8周。在治疗结束时以及入组后3个月和6个月进行随访评估，以检查客观测量的中度至剧烈身体活动（MVPA）水平的变化。如果有效，这种方法可能对预防这些高危个体的肥胖和慢性疾病产生重大的公共卫生影响。
