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Cortical inhibition in major depression: Investigating the acute effect of single-session yoga versus walking

Published:August 02, 2019DOI:https://doi.org/10.1016/j.brs.2019.07.029
      While the etiology of depressive disorders is multifactorial, spanning diverse polygenic origins and environmental exposures, its impact on an aberrant cortical inhibition-excitation balance is one of the final common pathophysiological processes [
      • Howard D.
      • Adams M.
      • Shirali M.
      • Clarke T.-K.
      • Marioni R.
      • Davies G.
      • et al.
      Summary statistics for three depression phenotypes in UK Biobank.
      ,
      • Lener M.S.
      • Niciu M.J.
      • Ballard E.D.
      • Park M.
      • Park L.T.
      • Nugent A.C.
      • et al.
      Glutamate and Gamma-aminobutyric acid systems in the pathophysiology of major depression and antidepressant response to ketamine.
      ,
      • Selten M.
      • van Bokhoven H.
      • Nadif Kasri N.
      Inhibitory control of the excitatory/inhibitory balance in psychiatric disorders.
      ]. Gamma-aminobutyric acid (GABA) – an abundant inhibitory neurotransmitter in the nervous system, along with glutamate – an excitatory neurotransmitter, is vital in maintaining an optimal balance required for healthy brain functions. One of the contributing factors to the cortical excitation-inhibition imbalance in depression is GABAergic dysfunction [
      • Brambilla P.
      • Perez J.
      • Barale F.
      • Schettini G.
      • Soares J.C.
      GABAergic dysfunction in mood disorders.
      ]. This is evident from observations of significantly lower cerebrospinal fluid GABA levels [
      • Gerner R.H.
      • Hare T.A.
      CSF GABA in normal subjects and patients with depression, schizophrenia, mania, and anorexia nervosa.
      ], reduced magnetic resonance spectroscopy-measured GABA concentrations in the anterior cingulate [
      • Rao N.P.
      • Venkatasubramanian G.
      • Gangadhar B.N.
      Proton magnetic resonance spectroscopy in depression.
      ], and reduced Transcranial Magnetic Stimulation (TMS)-measured short interval intracortical inhibition – a measure of GABAA neurotransmission and cortical silent period – a measure of GABAB neurotransmission – in the motor cortex of patients with depressive disorders [
      • Radhu N.
      • de Jesus D.R.
      • Ravindran L.N.
      • Zanjani A.
      • Fitzgerald P.B.
      • Daskalakis Z.J.
      A meta-analysis of cortical inhibition and excitability using transcranial magnetic stimulation in psychiatric disorders.
      ].
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