The Treatment of Depression with Yoga and Walking

瑜伽和步行治疗抑郁症

• 批准号: 8532830
• 负责人: Chris Conway Streeter
• 金额: $ 74.58万
• 依托单位: BOSTON UNIVERSITY MEDICAL CAMPUS
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-09-01 至 2017-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8532830
• 关键词: Acids; Acute; Affect; Amygdaloid structure; Anatomic structures; Anxiety; Autonomic nervous system; Behavior Therapy; Brain; Brain Stem; Cell Nucleus; Complex; Control Groups; Depressed mood; Dose; Effectiveness; Emotions; Epilepsy; Exercise; Feasibility Studies; Foundations; Functional disorder; Grant; Hippocampus (Brain); Hour; Individual; Insula of Reil; Interneurons; Intervention; Length; Magnetic Resonance Spectroscopy; Major Depressive Disorder; Measurement; Measures; Mental Depression; Metabolic; Moods; Nerve; Nervous System Physiology; Parasympathetic Nervous System; Physical activity; Population; Posture; Randomized; Recovery; Reporting; Scanning; Sinus Arrhythmia; Staging; Symptoms; System; Thalamic structure; Time; Training; Walking; Yoga; active control; depressive symptoms; emotion regulation; experience; gamma-Aminobutyric Acid; improved; instrument; interest; neurochemistry; novel strategies; psychologic; receptor; respiratory

DESCRIPTION (provided by applicant): Major Depressive Disorder (MDD) affects up to 17% of the population and is not treated effectively in up to 40% of individuals. There is evidence tha negative emotions are related to decreased activity in the parasympathetic nervous system (PNS) as measured by vagal tone. Both yoga practices and vagal nerve stimulation (VNS) can increase PNS activity by increasing vagal tone. Both yoga treatments and VNS have been shown to improve symptoms in depression and epilepsy. Using magnetic resonance spectroscopy (MRS), brain gamma-aminobutryic acid (GABA) levels have been shown to be low in subjects with MDD and epilepsy, and when the same subjects are treated with pharmacologic agents, GABA levels increase and symptoms decrease. Using MRS, our group has shown that thalamic GABA levels rise after a 60-minute yoga session and that increases in GABA levels are associated with improved mood. Our hypothesis is that low activity in the PNS and GABA systems is associated with depressive symptoms, and that a yoga intervention will stimulate the PNS afferents to brain stem nuclei, such that associated increases in GABA levels and decreased depressive symptoms will be observed. Aims: 1: To measure and compare baseline GABA levels in MDD and non-depressed healthy subjects (ND) in three anatomic structures, the thalamus, insula and hippocampal/amygdala complex. 2: To obtain four MRS scans in MDD subjects: Baseline (Scan 1); After 12- week yoga or walking interventions (Scan 2); Immediately after Scan 2, subjects will complete a 60-minute intervention (yoga or walking); Followed by Scan 3, and again two days after Scans 2 & 3 (Scan 4). 3: To measure changes in mood using psychological instruments and PNS activity using respiratory sinus arrhythmia (RSA) over the course of the study. Hypotheses: I: Baseline GABA levels will be lower in the MDD group compared to the ND group in all ROIs (i.e., thalamus, insula and hippocampal/amygdala complex). IIa & IIb: There will be a within-group change in tonic GABA levels (Scan 2-Scan 1) in the MDD subjects assigned to the yoga group. There will be a between-group difference in tonic GABA levels when comparing the MDD yoga group with the MDD walking group. IIIa & IIIb: There will be a within-group change in acute GABA levels (Scan 3-Scan 2) in the MDD yoga group. There will be a between-group difference in acute GABA levels when comparing the MDD yoga group with the MDD walking group. IV: There will be no change in recovery GABA levels (Scan 4 - Scan 2). V & VI: GABA levels, mood scales and RSA obtained at the time of scanning will be correlated, such that increasing GABA levels are associated with improved mood, decreased depression and decreased anxiety. VII: There will be a greater improvement in mood over the course of the interventions in the yoga group compared to the walking group. PUBLIC HEALTH RELEVANCE: This study will explore the use of yoga and walking to treat mild to moderate depression. Changes in neurochemistry, autonomic nervous system function and mood states associated with the interventions will be measured in both interventions over a 12-week treatment.

描述（由申请人提供）：重度抑郁症（MDD）最多影响人口的17％，并且在多达40％的个体中没有有效治疗。有证据表明，负面情绪与通过迷走神经的副交感神经系统（PNS）的活性减少有关。瑜伽练习和迷走神经刺激（VNS）都可以通过增加迷走神经来增加PNS活性。瑜伽治疗和VN均已证明可以改善抑郁症和癫痫的症状。使用磁共振光谱（MRS），已证明脑γ-氨基丁酸（GABA）水平在MDD和癫痫患者中较低，并且当用药理药物治疗相同的受试者时，GABA水平会增加，症状降低。使用MRS，我们的小组表明，丘脑GABA水平在60分钟的瑜伽疗程后上升，而GABA水平的增加与情绪的改善有关。我们的假设是，PNS和GABA系统中的低活性与抑郁症状有关，瑜伽干预会刺激PNS对脑干核的传播物，从而观察到GABA水平的相关增加和抑郁症状的降低。目的：1：测量和比较三种解剖结构中的MDD和不抑郁的健康受试者（ND）的基线GABA水平，即丘脑，岛岛和海马/杏仁核综合体。 2：在MDD受试者中获得四个MRS扫描：基线（扫描1）；在12周瑜伽或步行干预措施后（扫描2）；扫描2后，受试者立即完成60分钟的干预（瑜伽或步行）；其次是扫描3，扫描2和3后两天（扫描4）。 3：在研究过程中，使用心理仪器和PNS活性来衡量情绪变化。假设：I：与所有ROI中的ND组相比，MDD组的基线GABA水平将较低（即Thalamus，Insula和Hippocampal/Amygdala综合体）。 IIA＆IIB：在分配给瑜伽组的MDD受试者中，将会发生补品GABA水平（扫描2-SCAN 1）的组内变化。将MDD瑜伽组与MDD步行组进行比较时，补品GABA水平会有组间差异。 IIIA和IIIB：MDD瑜伽组的急性GABA水平（扫描3-扫描2）会发生组内变化。将MDD瑜伽组与MDD步行组进行比较时，急性GABA水平的组间差异将存在。 IV：恢复GABA级别不会改变（扫描4-扫描2）。 V＆VI：在扫描时获得的GABA水平，情绪尺度和RSA将是相关的，因此，增加的GABA水平与情绪的改善相关，抑郁症和焦虑症减少有关。 VII：与步行组相比，瑜伽组的干预措施在整个干预过程中的情绪将有所改善。 公共卫生相关性：这项研究将探索瑜伽的使用和步行以治疗轻度至中度抑郁症。神经化学，自主神经系统功能和与干预措施相关的情绪状态的变化将在两种干预措施中进行为期12周的治疗。