| Objective:Depression is a mental illness with a high incidence and easy recurrence.At present,the main methods for the treatment of depression are antidepressant medication,psychotherapy,physical therapy,etc.,but some patients with depression receive poor outcome of current treatment methods.Thus,we need to explore other treatment methods.It has been found in literature that exercise intervention has a good effect on depression,and is economical and easy to operate.However,there are few studies on the improvement of cognitive function and possible biochemical mechanisms in patients with depression by exercise intervention.Furthermore,domestic research in this area is even rarer.According to reports in domestic and foreign literatures,most of the patients with depression have decreased cognitive ability,such as executive function,learning,memory and mental exercise speed,and drug intervention can decrease depressive symptoms while the improvement of cognitive dysfunction is not satisfactory.It is well known that one of the main pathogenesis of depression is the decreased level of monoamine neurotransmitters(mainly DA,NE,5-HT),so increasing monoamine neurotransmitter levels in patients with depression could decrease depressive symptoms.In addition,the pathogenesis of depression is also related to non-monoamine neurotransmitters,such as y-aminobutyric acid(GABA)and glutamic acid.At present,many studies have shown that y-aminobutyric acid levels in patients with depression might be reduced.Exercise intervention could improve the anti-depressant effect by increasing GABA levels.Our study is trying to explore the effects of exercise intervention on the symptoms and cognitive function of depression,as well as the changes of the GABA levels in patients with depression,and the possible biochemical mechanisms of exercise intervention in improving depression.Methods:65 adult patients with depression from Anhui mental health center from November 2018 to April 2019 were selected and numbered.Then the numbers were randomly by the lottery method assigned into intervention group(n=35)and control group(n=30).Five patients in the intervention group were dropped out the study because they could not persist in exercise.The intervention group took aerobic exercise on a treadmill about 35 minutes per day in a frequency of 3 to 5 times a week for 6 weeks.The whole exercise included a warm-up exercise for about 10 minutes at first,jogging for about 20 minutes,and a slow-down exercise for about 5 minutes.The heart rate of the patient was measured by using a treadmill before and after exercise,and the patient's highest training heart rate was controlled at(220-age)× 70%.Besides,both of the intervention and the control group were treated with antidepressant sertraline(maximum dose of 150mg/d).Depression symptoms were assessed by the Hamilton Depression Rating Scale.Cognitive function was assessed by the Montreal Cognitive Rating Scale.The GABA levels in human plasma were measured by enzyme-linked immunosorbent assay.The t-test of independent samples was used to compare sample data before and after treatment for the same group,while the t-test of paire' samples were adopted for inter-group data.Different data were compared by the obtained means and variances.Results:Both of the HAMD scores of the control group and the intervention group significantly decreased after treatment,the reduction of HAMD scores before and after treatment was(24.23±8.95)in the control group,and(32.73±4.71)in the intervention group.Comparing the two groups,after exercise,combined with antidepressant drugs,the symptoms of depression were significantly decreased(t=4.43,p<0.05).The concentration of GABA in the control group and the intervention group increased after treatment.The difference of GABA concentration before and after treatment was(0.32±1.54)mg/L for the control group,and(1.87±0.73)mg/L for the intervention group.GABA concentration increased significantly after exercise combined with antidepressant drugs(t=9.21,p<0.05).The MoCA scores of the two groups were increased after treatment.The total difference of MoCA in the control group before and after treatment was(1.44±1.06)points.The total score of MoCA before and after treatment in the intervention group was(4.07±1.49)points,and the cognitive function was significantly improved after exercise combined with antidepressant treatment(t=8.26),p<0.05).Conclusion:1.Exercise intervention combined with drug treatment can decrease depression symptoms more efficiently.2.Exercise intervention improves cognitive function,naming,attention,language,ion,delayed recall and other cognitive functions in patients with depression.3.Exercise intervention can decrease depressive symptoms by increasing the amino acid neurotransmitter GABA in patients with depression.4.Exercise intervention is an economic and safe adjuvant method for drug therapy,and can be vigorously promoted. |
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