Abstract
Background: 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. Methods: 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). Results: 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 (p = 0.008). Sex had an impact on TNF-α (p < 0.001), with higher concentrations in male patients. Higher body mass index was associated with higher IL-6 concentrations over all measurement points (p < 0.001). Conclusions: 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.
Highlights
Adolescent depression with prevalence rates of between 3 and 6% increases the risk of chronicity in adulthood and leads frequently to major impairments in psychosocial functioning and scholastic performances [1,2]
Our findings show a decrease of TNF-α only for ergometer and controls during the intervention time, whereas the Whole Body Vibration (WBV) group increased in this time
The study of Pallavi et al found higher IL-6 levels in females, whereas TNFα was not affected by sex. This was the contrary in our sample, where we found higher TNF-α in males compared to females, whereas IL-6 was not affected by sex but by BMI
Summary
Adolescent depression with prevalence rates of between 3 and 6% increases the risk of chronicity in adulthood and leads frequently to major impairments in psychosocial functioning and scholastic performances [1,2]. There is a growing interest in physical activity as an alternative treatment option for adults and for adolescents, [7,8,9]. One of the more recently explored influencing factors is the pro-inflammatory cytokines (PICs) in adult depression [11,12,13]. A more profound understanding of the role of cytokines in exercise treatment could open further options of tailored therapies in adolescent MDD [18]. Only a few studies analyze juvenile depression from an immune perspective, and to our knowledge, our study is the first to explore the effects of exercise treatment in MDD on cytokines and depression outcomes [13,19,20,21]. 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)
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