Incongruent Expression of Brain-Derived Neurotrophic Factor and Cortisol in Schizophrenia: Results from a Randomized Controlled Trial of Laughter Intervention
0
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Objective Schizophrenia has been associated with dysfunction of the hypothalamic-pituitary-adrenal axis. Furthermore, alterations in neurotrophic factors might contribute to the pathogenesis of schizophrenia. We aimed to evaluate the effects of a simulated laughter intervention on the levels of cortisol and BDNF and to determine whether the effects associated with simulated laughter could be sustained after discontinuation of the intervention. Methods In this randomized controlled study, patients with schizophrenia according to DSM-IV clinical criteria were randomly assigned to receive either 8-week-long simulated laughter intervention (n=32) or treatment-as-usual group (control group, n=27). The serum levels of BDNF and cortisol were measured at baseline, week 8, and four weeks after discontinuation (week 12) of the intervention program.Results After an 8-week simulated laughter intervention, the laughter group had significantly higher levels of BDNF; however, four weeks after discontinuation of the intervention, the levels of BDNF significantly dropped. Interestingly, the levels of cortisol did not change significantly at week 8, but they were significantly elevated at week 12. The levels of BDNF and cortisol in the control group did not change significantly between week 0 and week 8.Conclusion These findings suggest that the simulated laughter intervention has an early effect on neurogenesis with a significant delayed effect on stress regulation in subjects with schizophrenia.
Abstract
Objective Schizophrenia has been associated with dysfunction of the hypothalamic-pituitary-adrenal axis. Furthermore, alterations in neurotrophic factors might contribute to the pathogenesis of schizophrenia. We aimed to evaluate the effects of a simulated laughter intervention on the levels of cortisol and BDNF and to determine whether the effects associated with simulated laughter could be sustained after discontinuation of the intervention. Methods In this randomized controlled study, patients with schizophrenia according to DSM-IV clinical criteria were randomly assigned to receive either 8-week-long simulated laughter intervention (n=32) or treatment-as-usual group (control group, n=27). The serum levels of BDNF and cortisol were measured at baseline, week 8, and four weeks after discontinuation (week 12) of the intervention program.Results After an 8-week simulated laughter intervention, the laughter group had significantly higher levels of BDNF; however, four weeks after discontinuation of the intervention, the levels of BDNF significantly dropped. Interestingly, the levels of cortisol did not change significantly at week 8, but they were significantly elevated at week 12. The levels of BDNF and cortisol in the control group did not change significantly between week 0 and week 8.Conclusion These findings suggest that the simulated laughter intervention has an early effect on neurogenesis with a significant delayed effect on stress regulation in subjects with schizophrenia.
참고문헌 (39)
- Bryant GA, "The animal nature of spontaneous human laughter", Evol Hum Behav, 35, pp.327~335 (2014)
- Mora-Ripoll R, "Potential health benefits of simulated laughter : a narrative review of the literature and recommendations for future research", Complement Ther Med, 19, pp.170~177 (2011)
- Mora-Ripoll R, "The therapeutic value of laughter in medicine", Altern Ther Health Med, 16 (2010)
- Kim SH, "Laughter and stress relief in cancer patients : a pilot study", Evid Based Complement Alternat Med, 2015, pp.864739~ (2015)
- Manninen S, "Social laughter triggers endogenous opioid release in humans", J Neurosci, 37, pp.6125~6131 (2017)
- Kahn RS, "Schizophrenia", Nat Rev Dis Primers, 1, pp.15067~ (2015)
- Murri MB, "Hypothalamic-pituitary-adrenal axis and clinical symptoms in first-episode psychosis", Psychoneuroendocrinology, 37, pp.629~644 (2012)
- Aas M, "Abnormal cortisol awakening response predicts worse cognitive function in patients with first-episode psychosis", Psychol Med, 41, pp.463~476 (2011)
- Mondelli V, "Abnormal cortisol levels during the day and cortisol awakening response in first-episode psychosis : the role of stress and of antipsychotic treatment", Schizophr Res, 116, pp.234~242 (2010)
- Fujibayashi M, "Autonomic nervous system activity and psychiatric severity in schizophrenia", Psychiatry Clin Neurosci, 63, pp.538~545 (2009)
- Iwamoto Y, "Dose-dependent effect of antipsychotic drugs on autonomic nervous system activity in schizophrenia", BMC Psychiatry, 12, pp.199~ (2012)
- Kim JH, "Heart rate dynamics and their relationship to psychotic symptom severity in clozapine-treated schizophrenic subjects", Prog Neuropsychopharmacol Biol Psychiatry, 28, pp.371~378 (2004)
- Bär KJ, "The phrenic component of acute schizophrenia--a name and its physiological reality", PLoS One, 7, pp.e33459~ (2012)
- Jáuregui OI, "Autonomic nervous system activation during social cognition tasks in patients with schizophrenia and their unaffected relatives", Cogn Behav Neurol, 24, pp.194~203 (2011)
- Green M, "Brain-derived neurotrophic factor levels in schizophrenia : a systematic review with meta-analysis", Mol Psychiatry, 16, pp.960~972 (2011)
- Fernandes B, "Peripheral brain-derived neurotrophic factor in schizophrenia and the role of antipsychotics : meta-analysis and implications", Mol Psychiatry, 20, pp.1108~1119 (2015)
- Huang EJ, "Neurotrophins : roles in neuronal development and function", Annu Rev Neurosci, 24, pp.677~736 (2001)
- van Haren NE, "Schizophrenia as a progressive brain disease", Eur Psychiatry, 23, pp.245~254 (2008)
- Niitsu T, "Associations of serum brain-derived neurotrophic factor with cognitive impairments and negative symptoms in schizophrenia", Prog Neuropsychopharmacol Biol Psychiatry, 35, pp.1836~1840 (2011)
- Favalli G, "The role of BDNF in the pathophysiology and treatment of schizophrenia", J Psychiatr Res, 46, pp.1~11 (2012)
- Cai C, "Effectiveness of humor intervention for patients with schizophrenia : a randomized controlled trial", J Psychiatr Res, 59, pp.174~178 (2014)
- Knapp M, "The global costs of schizophrenia", Schizophr Bull, 30, pp.279~293 (2004)
- Chang C, "Psychological, immunological and physiological effects of a Laughing Qigong Program(LQP)on adolescents", Complement Ther Med, 21, pp.660~668 (2013)
- Hsieh CJ, "Empirical study of the influence of a Laughing Qigong Program on long-term care residents", Geriatr Gerontol Int, 15, pp.165~173 (2015)
- Kuo TB, "Effect of aging on gender differences in neural control of heart rate", Am J Physiol, 277, pp.H2233~2239 (1999)
- Hsu CC, "Incongruent changes in heart rate variability and body weight after discontinuing aerobic exercise in patients with schizophrenia", Int J Psychophysiol, 109, pp.132~137 (2016)
- Rosenberg M, "Society and the Adolescent Self-Image" (1989), Wesleyan University Press
- Beck AT, "An inventory for measuring depression", Arch Gen Psychiatry, 4, pp.561~571 (1961)
- Kim HJ, "Increase of circulating BDNF levels and its relation to improvement of physical fitness following 12 weeks of combined exercise in chronic patients with schizophrenia : a pilot study", Psychiatry Res, 220, pp.792~796 (2014)
- Szuhany KL, "A meta-analytic review of the effects of exercise on brain-derived neurotrophic factor", J Psychiatr Res, 60, pp.56~64 (2015)
- Montaquila JM, "Heart rate variability and vagal tone in schizophrenia : a review", J Psychiatr Res, 69, pp.57~66 (2015)
- 차미연, "웃음치료가 중년기 여성의 세로토닌, 우울 및 삶의 질에 미치는 영향과 경로분석", Journal of Korean Academy of Nursing, 45(2), pp.221~230 (2015), 한국간호과학회
- Yim J, "Therapeutic benefits of laughter in mental health : a theoretical review", Tohoku J Exp Med, 239, pp.243~249 (2016)
- Hackney AC, "Stress and the neuroendocrine system : the role of exercise as a stressor and modifier of stress", Expert Rev Endocrinol Metab, 1, pp.783~792 (2006)
- Davies C, "Effects of exercise on adrenocortical function", J Appl Physiol, 35, pp.887~891 (1973)
- Hill E, "Exercise and circulating cortisol levels : the intensity threshold effect", J Endocrinol Invest, 31, pp.587~591 (2008)
- Albus M, "Situational reactivity of autonomic functions in schizophrenic patients", Psychiatry Res, 6, pp.361~370 (1982)
- Jansen LM, "Selective impairments in the stress response in schizophrenic patients", Psychopharmacology, 149, pp.319~325 (2000)
- Cohrs S, "The atypical antipsychotics olanzapine and quetiapine, but not haloperidol, reduce ACTH and cortisol secretion in healthy subjects", Psychopharmacology, 185, pp.11~18 (2006)