ObjectiveThe aim of this study is to investigate the effects of exercise as an add-on therapy with antidepressant medication and cognitive behavioral group therapy (CBGT) on treatment outcomes in low-active major depressive disorder (MDD) patients. We also explored whether exercise reduces the residual symptoms of depression, notably cognitive impairment and poor sleep quality, and aimed to identify putative biochemical markers related to treatment response.MethodsSixteen low-active MDD patients were recruited from a mental health day treatment program at a local hospital. Eight medicated patients performed an 8-week exercise intervention in addition to CBGT, and eight medicated patients attended the CBGT only. Twenty-two low-active, healthy participants with no history of mental health illness were also recruited to provide normal healthy values for comparison.ResultsResults showed that exercise resulted in greater reduction in depression symptoms (p = 0.007, d = 2.06), with 75% of the patients showing either a therapeutic response or a complete remission of symptoms vs. 25% of those who did not exercise. In addition, exercise was associated with greater improvements in sleep quality (p = 0.046, d = 1.28) and cognitive function (p = 0.046, d = 1.08). The exercise group also had a significant increase in plasma brain-derived neurotrophic factor (BDNF), p = 0.003, d = 6.46, that was associated with improvements in depression scores (p = 0.002, R2 = 0.50) and sleep quality (p = 0.011, R2 = 0.38).ConclusionWe provide evidence that exercise as an add-on to conventional antidepressant therapies improved the efficacy of standard treatment interventions. Our results suggest that plasma BDNF levels and sleep quality appear to be good indicators of treatment response and potential biomarkers associated with the clinical recovery of MDD.

ObjectiveThe benefits of exercise on brain health is well known in aging and psychiatric populations. However, the relationship between habitual exercise in young and healthy adults remains unclear. This study explored the effects an eight-week exercise prescription on cognitive function, brain-derived neurotrophic factor (BDNF) and cathepsin B (CTHB) in young and healthy adults.MethodsA total of 22 low-active, young and healthy adults were recruited from a local university. A total of 12 participants performed an eight-week exercise prescription and 12 participants served as controls. Cognitive assessments, cardiorespiratory fitness and plasma BDNF and CTHB concentrations were measured at baseline and eight weeks.ResultsResults showed exercise improved cardiorespiratory fitness (p = 0.044, d = 1.48) with no improvements in cognitive function or no changes in plasma BDNF and CTHB concentrations.ConclusionWe provide evidence that a short-term course of moderate exercise does not improve cognitive function or change plasma biochemical markers concentrations in young and healthy adults, despite mild improvements in cardiorespiratory fitness. These results suggest that cognitive health may peak during early adulthood leaving little room for improvement throughout this period of the lifespan.

Memory impairments are a frequently reported cognitive symptom in people suffering from major depressive disorder (MDD) and often persist despite antidepressant therapy. Neuroimaging studies have identified abnormal hippocampal activity during memory processes in MDD. Exercise as an ad-on treatment for MDD is a promising therapeutic strategy shown to improve mood, cognitive function, and neural structure and function. To advance our understanding of how exercise impacts neural function in MDD, we must also understand how exercise impacts healthy individuals without MDD. This pilot study used a subsequent memory paradigm to investigate the effects of an eight-week exercise intervention on hippocampal function in low-active healthy (n = 8) and low-active MDD (n = 8) individuals. Results showed a marked improvement in depression scores for the MDD group (p < 0.0001) and no change in memory performance for either group (p > 0.05). Functional imaging results showed a marginally significant decrease in hippocampal activity in both groups following the exercise intervention. Our whole brain analysis collapsed across groups revealed a similar deactivation pattern across several memory-associated regions. These results suggest that exercise may enhance neural efficiency in low-fit individuals while still resulting in a substantially greater mood effect for those suffering from MDD. This trial is registered with clinical trials.gov NCT03191994.

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