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The effect of exercise interventions on inflammatory markers in major depressive disorder: protocol for a systematic
Diana Grunberg1, Jason A Martin2,3,4,5, John F Cryan3,6
1School of Medicine Brookfield Health Sciences Complex, University College Cork, Cork, Cork, T12 YT20, Ireland.
Insights
Exercise interventions may help major depressive disorder (MDD) by modulating inflammatory molecules. This review analyzes how exercise impacts inflammation in MDD patients, seeking to clarify mechanisms for effective treatment.
Area of Science:
- Neuroscience
- Psychiatry
- Exercise Physiology
Background:
- Major depressive disorder (MDD) affects 4.4% globally, often with comorbidities like cardiovascular disease.
- Inflammation is increasingly linked to MDD, highlighting potential therapeutic targets.
- Current exercise interventions for MDD lack clear mechanistic understanding, hindering optimized prescription.
Purpose of the Study:
- To systematically review and meta-analyze literature on quantified exercise interventions in MDD patients.
- To investigate the modulation of specific inflammatory molecules by exercise in MDD.
- To clarify the role of inflammation in exercise's effects on depression.
Main Methods:
- Comprehensive search of electronic databases (PsycINFO, PubMed/MEDLINE, EMBASE) using keywords for exercise, MDD, and inflammation.
- Inclusion criteria: quantified exercise, adult humans with diagnosed MDD, MDD control group, and measurement of inflammatory markers.
- Data extraction and risk of bias appraisal using Cochrane handbook; meta-analysis using random effects models where appropriate, following PRISMA guidelines.
Main Results:
- This section is to be filled upon completion of the meta-analysis.
- Anticipated results will quantify the effect of exercise on specific inflammatory markers (e.g., CRP, IL-6, TNF-a).
- Results will be synthesized to identify patterns in exercise type, duration, and intensity related to inflammatory changes.
Conclusions:
- Exercise shows promise for MDD, potentially through anti-inflammatory pathways.
- Further research is needed to establish optimal exercise prescriptions for MDD based on inflammatory modulation.
- This review will inform evidence-based exercise guidelines for managing major depressive disorder.
Abstract:
Background: Depression currently affects 4.4% of the global population, and 93.7% of this population suffer from major depressive disorder (MDD) according to 2017 statistics. MDD patients are more likely to suffer from co-morbidities such as cardiovascular disease and high body mass index (BMI), thus contributing to its large cost to society. Throughout the literature, there are known links between inflammation and MDD. Interestingly, while exercise is considered a promising intervention for MDD, the mechanism(s) of action remain unclear, thereby preventing the creation of optimal, cost-saving, exercise "prescriptions" for those with MDD. Thus, the aim of this review and meta-analysis is to summarize and analyse the current literature exploring how quantified exercise interventions modulate inflammatory molecules in MDD patients. Methods: Electronic databases (APA PsycINFO, and PubMed/MEDLINE (EBSCO interface), EMBASE) will be searched using a detailed search strategy comprised of three search term themes: exercise, depression/MDD, and inflammation/inflammatory molecules. Only quantified exercise interventions performed in adult humans with MDD validated via a recognized diagnostic criterion will be included. Studies should also include a MDD control group and explore changes in inflammatory molecules. Examples of these molecules include: C-reactive protein (CRP), interleukin-6 (IL-6), interleukin-1 beta (IL-1b), tumour necrosis factor-alpha (TNF-a), homocysteine, d-dimer and myeloperoxidase (MPO). After eligible studies are identified, standardized data extraction will be employed and the risk of bias in each study will be appraised using the Cochrane handbook checklists. In the event of two or more homogenous studies exploring exercise effects over a similar time period, raw mean differences or standardized mean differences will be pooled using random effects analysis. This systematic review and meta-analysis will be reported according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. Dissemination: This systematic review and meta-analysis will be disseminated in peer-reviewed journals. PROSPERO registration: CRD42020186006 (31/08/2020).
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