The Effects of Exercise on Depression Symptoms Using Levels of Neurotransmitters and EEG as Markers
Condition: Depression
MeSH terms: Depression; Depressive Disorder
Study type: Interventional

Summary: 
      The purpose of this study is to examine the effects of exercise on the symptoms of depression
      using serum levels of serotonin, catecholamine's, Alpha EEG asymmetry, and self-report of
      symptoms as markers.

      In an attempt to further understand the mechanisms of improved mood through exercise; this
      study will examine the known factors that contribute to depressed mood in a single study
      using serotonin and catecholamine levels via blood serum and EEG slow wave asymmetry. Such
      information can be useful in understanding the overall neurological components of depression
      and the effects of exercise on the brain in depressed individuals that would make the
      prescription of exercise a viable treatment option.
    

Detailed description: 
      There is an increasing demand for clinical effective, safe, and cost conscious forms of
      treatment for depression. Research shows depression to account for the largest decrease in
      overall health compared to asthma, angina, arthritis, and diabetes (Maussavi, 2007). The cost
      of lost productivity at work due to depression is a new focus of research as no current and
      accurate numbers exist. Stewart, Ricci, Hahn, & Morganstein (2013) were among the first to
      examine this issue and found that lost productivity due to depression cost an estimated $44
      billion dollars per year in spite of current medical treatments commonly prescribed. The lost
      productivity among those with depression and the low level of treatment suggest that there
      may be cost effective opportunities for improving depression outcomes within the general
      workforce and society at large.

      The question of value regarding the use of exercise as a treatment for depression has
      remained a source of investigation in recent years. In cooperation with Centra Health and
      Liberty University, this study seeks to understand the mechanisms that make exercise a viable
      treatment in depression by examining self-report of symptoms, serum levels of serotonin and
      catecholamines (epinephrine, norepinephrin, and dopamine) and frontal slow wave EEG activity
      as markers. Although these markers have been examined individually in previous studies, this
      is the only known study that examines each of these components in a single study. Such
      information can be useful in understanding the overall neurological components of depression
      and the effects of exercise on the brain in depressed individuals that would make the
      prescription of exercise a viable treatment in depression.

      Multiple trials, meta-analyses, and reviews have been conducted in the attempt to clarify the
      use of exercise in depressed patients. Research has shown that exercise as a treatment may
      result in fewer relapses than sertraline (Strohle, 2009). Similar results are indicated when
      exercise is prescribed as an adjunct treatment with psychotherapy (Balon, Sidhu, & Pankhuree,
      2009; Blumenthal, Smith, & Hoffman, 2012; Gill, Womack, & Safranek, 2010). Preliminary
      characteristics of the ideal dosage of exercise as a treatment have been researched, although
      a definitive dose-response curve has yet to be produced (Callaghan, Khalil, Morres, & Carter,
      2011; Perraton, Kumar, & Machotka, 2010).

      Electroencephalographic (EEG) scans have been shown to demonstrate a left frontal bias in
      alpha (8-12 Hz) and theta (4-7 Hz) wave activity (Allen, Urry, Hitt, & Coan, 2004; Demos,
      2005; Iosifescu et al., 2008; Nissen et al., 2006). The up-training or down-training of
      individual bandwidths in the treatment of depression, anxiety, ADHD, and traumatic brain
      injury have long been established (La Vaque, 2002). Although there are no established norms
      for neurotransmitter levels, we know through clinical medication trials that the inhibition
      of the reuptake of serotonin and or norepinephrine improve mood. Previous studies examining
      low levels of serotonin and decreased mood have found a correlation between exercise and
      increased serotonin availability without the use of pharmaceuticals (Chaouloff et al., 1985;
      Ernst, Olsen, Pinel, Lam, & Christie, 2006; Jacobs & Fornal, 1999). More routine type studies
      often use neurotransmitter levels as markers (Lande, Williams, Fileta, 2012; Lidberg, Tuck,
      Asberg, Scalia-Tomba, & Bertilsson, 1985; Mann & Stanley, 1984).
    

Intervention name(s): Exercise
Intervention type(s): Behavioral
Intervention description(s): The experimental group will engage in mild-moderate level of exercise. This program will be structured and clinically supervised. Exercise will take place 2-3 days per week for a duration of 30-45 mins. for 12 weeks.
Allocation: Randomized
Intervention model: Single Group Assignment
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: Depression; Exercise; Neurotransmitters; Catecholimines; EEG