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J Psychiatr Res. 2014 Oct;57:117-24. doi: 10.1016/j.jpsychires.2014.06.018. Epub 2014 Jul 5.

Electroconvulsive therapy and aerobic exercise training increased BDNF and ameliorated depressive symptoms in patients suffering from treatment-resistant major depressive disorder.

Author information

1
Research Center for Behavioral Disorders and Substances Abuse, Hamadan University of Medical Sciences, Hamadan, Iran.
2
Psychiatry & Psychology Research Center (PPRC), Roozbeh Hospital, Tehran University of Medical Sciences, Tehran, Iran; ASEAN Institute for Health Development, Mahidol University, Salaya, Phutthamonthon, Nakhon Pathom 73170, Thailand.
3
Department of Sport, Exercise and Health, Division of Sport Science, University of Basel, Basel, Switzerland.
4
Institute of Neurobiology, Bulgarian Academy of Sciences, Sofia, Bulgaria.
5
Psychiatric Clinics of the University of Basel, Center for Affective, Stress and Sleep Disorders (ZASS), Basel, Switzerland.
6
Department of Sport, Exercise and Health, Division of Sport Science, University of Basel, Basel, Switzerland; Psychiatric Clinics of the University of Basel, Center for Affective, Stress and Sleep Disorders (ZASS), Basel, Switzerland. Electronic address: serge.brand@upkbs.ch.

Abstract

BACKGROUND:

To treat patients suffering from treatment-resistant major depressive disorder (TR-MDD), research has focused on electroconvulsive therapy (ECT) and aerobic exercise training (AET). Brain derived neurotrophic factor (BDNF) seems to be key in MDD. The aims of the present study were therefore two-fold, to investigate in a three-arm interventional study the differential effects of ECT, ECT plus AET, and AET alone in patients suffering from TR-MDD on 1. depressive symptoms and 2.

BDNF METHODS:

60 patients with TR-MDD (mean age: 31 years; 31.6% female patients) were randomly assigned either to the ECT, ECT + AET, or AET condition. The AET condition consisted of treadmill exercise for 30 min, three times a week. Both depression severity and BDNF levels were assessed at baseline and 4 weeks later. All patients were further treated with an SSRI standard medication.

RESULTS:

BDNF levels increased over time in all three study conditions. After completion of the intervention program, the ECT group showed significantly higher BDNF levels compared to the ECT + AET and the AET conditions. Depressive symptoms decreased in all three conditions over time. The combination of ECT + AET led to a significantly greater decrease than in either the ECT or AET alone conditions. BDNF levels were not associated with symptoms of depression.

CONCLUSIONS:

The pattern of results suggests that ECT, AET and particularly their combination are promising directions for treatment patients suffering from TR-MDD, and that it remains unclear to what extent BDNF is key and a reliable biomarker for TR-MDD.

KEYWORDS:

Aerobic exercise training; BDNF; Electroconvulsive therapy; Treatment-resistant major depressive disorder

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