Biologische Mechanismen antidepressiver Wirksamkeit von körperlicher Aktivität

Zusammenfassung

Untersuchungen an depressiven Patienten legen antidepressive Effekte aerober kontinuierlicher körperlicher Aktivität nahe (z.B. Jogging, Walken). Auf der anderen Seite ist bisher ungeklärt, über welche neurobiologischen Mechanismen eine solche Wirkung erzielt wird; humanmedizinische Untersuchungen zu dieser Fragestellung liegen nicht vor. Ergebnisse tierexperimenteller Studien weisen darauf hin, dass körperliche Aktivität u. a. mit einem signifikanten Anstieg zerebraler Monoamine und neurotropher Faktoren (Brain Derived Neurotrophic Factor BDNF) korreliert. Letzteres wiederum bewirkt verstärkte Neurogenese speziell im Hippocampus. In der Grundlagenforschung haben Neurogenese und Neuroplastizität in jüngster Zeit herausragende Bedeutung erlangt. Vielleicht eröffnet die Methode des Dauerleistungstrainings neue therapeutische Optionen nicht nur für depressive Störungen.

Summary

Investigations in depressive patients suggested antidepressive effects of continuous aerobic physical exercise (e.g. jogging, walking). On the other hand, it is yet unclear which mode(s) of neurobiological action are responsible for this since there are no human studies addressing this question. Results of animal studies showed an increase of cerebral monoamines and the Brain Derived Neurotrophic Factor BDNF, which is associated with neuroneogenesis especially in the hippocampus. In today's basic research it has been repeatedly stated that neuroneogenesis and neuroplasticity are of outstanding relevance so that maybe continuous neuromuscular activity opens new therapeutic options not only for depressive disorders.

Key words

physical exercise - depression - cerebral monoamines - neurogenesis

Literatur

• 1 Akil H. et al. . Multiple HPA profiles in endogenous depression: effect of age and sex on cortisol and beta-endorpin.  Biol Psychiatry. 1993;  33 73-85
• 2 Altshule LL. et al. . Does thyroid supplementation accelerate tricyclic antidepressant response? A review and meta-analysis of the literature.  Am J Psychiatry. 2001;  158 1617-1622
• 3 Angst J. Epidemiologie affektiver Störungen.  Journal of the ZNS. 1992;  1 2-8
• 4 Aspler R. et al. . Correlates of compliance with psychoactive prescriptions.  J Psychoactive Drugs. 1984;  16 193-199
• 5 Bauer M. et al. . Hochdosierte Thyroxinbehandlung bei therapie- und prophylaxeresistenten Patienten mit affektiven Psychosen.  Nervenarzt. 1998;  69 1019-22
• 6 Bauer M. et al. . Thyroid hormone, neural tissue and mood modulation.  World J Biol Psychiatry. 2001;  2 59-69
• 7 Bauer M. et al. . Supraphysiological doses of L-thyroxine in the maintenance treatment of prophylaxis-resistant affective disorders.  Neuropsychopharmacolpgy. 2002;  27 620-628
• 8 Beblo T. et al. . Neuropsychologische Defizite bei depressiven Störungen.  Fortschr Neurol Psychiat. 2000;  68 1-11
• 9 Bench CJ. et al. . Regional cerebral blood flow in depression measured by positron emission tomography: the relationship with clinical dimensions.  Psychol Med. 1993;  23 579-590
• 10 Berchtold NC. et al. . Estrogen and exercise interact to regulate brain-derives neurotrophic factor mRNA and protein expression in the hippocampus.  Eur J Neurosci. 2001;  14 1992-2002
• 11 Blomstrand E. et al. . Changes in plasma concentrations of aromatic and branched-chain amino acids during sustained exercise in man and their role in fatigue.  Acta Physiol Scand. 1988;  133 115-121
• 12 Blumenthal JA. et al. . Stress activity and exercise training in premenopausal and postmenopausal women.  Health Psychol. 1991;  10 384-391
• 13 Blumenthal JA. et al. . Comparison of aerobic exercise in older patients with major depression.  Arch Intern Med. 1999;  159 2349-2356
• 14 Brosse AL. et al. . Exercise and the treatment of clinical depression in adults.  Sports Med. 2002;  32 741-760
• 15 Carro E. et al. . Circulating insulin-like growth factor I mediates effects of exercise on the brain.  J Neurosci. 2000;  20 2926-33
• 16 Chaouloff F. Effects of acute physical exercise on central serotonergic systems.  Med Sci Sports Exerc. 1997;  29 58-62
• 17 Chaouloff F. Physical exercise and brain monoamines: a review.  Acta Physiol Scand. 1989;  137 1-13
• 18 Cotman CW. Exercise: A behavioral intervention to enhance brain health and plasticity.  Trends Neurosci. 2002;  25 295-301
• 19 Cotman CW. et al. . Exercise enhances and protects brain function.  Exerc Sport Sci Rev. 2002;  30 75-79
• 20 Craft LL. et al. . The effect of exercise on clinical depression and depression resulting from mental illness: a metaanalysis.  J Sport Exerc Psych. 1998;  20 339-357
• 21 Dishman RK. Brain monoamines, exercise and behavioral stress: animal models.  Med Sci Sports Exerc. 1997;  29 63-74
• 22 Dishman RK. et al. . Treadmill exercise training augments brain norepinephrine response to familiar and novel stress.  Brain Res Bull. 2000;  52 337-342
• 23 Drevets WC. et al. . A functional anatomical study of unipolar depression.  J Neurosci. 1992;  12 3628-3641
• 24 Drevetz WC. et al. . Neuroanatomical circuits in depression: implications for treatment mechanisms.  Psychopharmacol Bull. 1992;  28 261-274
• 25 Dunn AL. et al. . Brain norepinephrine and metabolites after treadmill training and wheel running in rats.  Med Sci Sports Exerc. 1996;  28 204-209
• 26 Ebert D. et al. . Role of the cingulate gyrus in depression: From functional anatomy to depression.  Biol Psychiatry. 1996;  39 1044-1050
• 27 Eriksson PS. et al. . Neurogenesis in the adult human hippocampus.  Nat Med. 1998;  4 1313-7
• 28 Fawcett J. Compliance: Definitions and key issues.  J Clin Psychiatry. 1995;  56 4-8
• 29 Gomez-Pinilla F. et al. . Physical exercise induces FGF-2 and its mRNA in the hippocampus.  Brain Res. 1997;  764 1-8
• 30 Greist JH. et al. . Running as a treatment for depression.  Compr Psychiatry. 1979;  20 41-54
• 31 Herrmann M. et al. . Poststroke depression: Is there a pathoanatomic correlate for depression in the postacute stage of stroke?.  Stroke. 1995;  26 850-856
• 32 Hollmann W. et al. . Körperliche Aktivität fördert Gehirngesundheit und -leistungsfähigkeit - Übersicht und eigene Befunde.  Nervenheilkunde. 2003;  9 467-474
• 33 Hollmann W. et al. . Zur Biochemie des Gehirns bei muskulärer Arbeit.  Nervenheilkunde. 1998;  17 30-35
• 34 Holsboer F. The rationale for corticotropinreleasing hormone receptor (CRH-R) antagonists to treat depression and anxiety.  J Psychiatr Res. 1999;  33 181-214
• 35 Ketter TA. et al. . Functional brain imaging, limbic function, and affective disorders.  The Neuroscientist. 1996;  2 55-65
• 36 Lawlor DA. et al. . The effectiveness of exercise as an intervention in the management of depression: Systematic review and meta-regression analysis of randomised trials.  BMJ. 2001;  322 1-8
• 37 Lechin F. et al. . Plasma neurotransmitters, blood pressure, and heart rate during supine resting, orthostasis, and moderate exercise in dysthymic depressed patients.  Biol Psychiatry. 1995;  37 884-891
• 38 Martinsen EW. et al. . Comparing aerobic with nonaerobic forms of exercise in the treatment of clinical depression: A randomized trial.  Compr Psychiatry. 1989;  30 324-331
• 39 Martinsen EW. Benefits of exercise for the treatment of depression.  Sports Med. 1990;  9 380-389
• 40 Mayberg HS. et al. . Cingulate function in depression: a potential predictor of treatment response.  Neuroreport. 1997;  8 1057-1061
• 41 Murray CJL. et al. . Global mortality, disability, and the contribution of risk factors: Global burden of disease study.  Lancet. 1997;  349 1436-1442
• 42 Neeper SA. et al. . Physical activity increases mRNA for brain-derived neurotrophic factor and nerve growth factor in rat brain.  Brain Res. 1996;  726 49-56
• 43 Nutt DJ. The neuropharmacology of serotonin and noradrenalin in depression.  Int Clin Psychopharmacol. 2002;  17 1-12
• 44 Russo-Neustadt AA. et al. . Physical activity and antidepressant treatment potentiate the expression of specific brain-derived neurotrophic factor transcripts in the rat hippocampus.  Neuroscience. 2000;  101 305-312
• 45 Salloway S. et al. . Subcortical disease and neuropsychiatric illness.  J Neuropsychiatry Clin Neurosci. 1994;  6 93-99
• 46 Stern R. et al. . Depressive symptoms following stroke.  Am J Psychiatry. 1991;  154 351-356
• 47 Ströhle A. Die Neuroendokrinologie von Stress und die Pathophysiologie und Therapie von Depression und Angst.  Nervenarzt. 2003;  74 279-292
• 48 Swaab DF. et al. . Interaction of prefrontal cortical and hypothalamic systems in pathogenesis of depression.  Prog Brain Res. 2000;  126 369-396
• 49 Tong L. et al. . Effects of exercise on gene-expression profile in the rat hippocampus.  Neurobiol Dis. 2001;  8 1046-56
• 50 Veale D. et al. . Aerobic exercise in the adjunctive treatment of depression: a randomised controlled trial.  J R Soc Med. 1992;  85 541-544
• 51 Weicker H. et al. . Influence of exercise on serotonergic neuromodulation in the brain.  Amino Acids. 2001;  20 35-47
• 52 Wittert GA. et al. . Adaption of the hypothalamopituitary adrenal axis to chronic exercise stress in humans.  Med Sci Sports Exerc. 1996;  28 1015-1019

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