Multiple Complement Pathway-related Proteins Might Regulate Immunopathogenesis of Major Depressive Disorder.

Objective: Exacerbated inflammatory pathway has emerged as a predominant etiological construct of major depressive disorder (MDD). Innate immune molecules like complement proteins induce inflammatory responses and also regulate key neurobiological processes. However, there is a dearth of literature on the impact of critical complement proteins in MDD. Herein, plasma profiling of seven complement proteins was carried out to obtain a better insight into the role of the complement pathway in MDD. Methods: Plasma levels of C1q, C3, C3b/iC3b, C4, Factor B, Factor H, and properdin were assayed in 22 patients with MDD and 27 healthy controls by multiplex suspension assay. The patients with MDD were diagnosed as per DSM IV-TR. Hamilton Depression Rating Scale (HAM-D), Montgomery Depression Rating Scale and Clinical Global Improvement were used for clinical assessments of the patients. The plasma levels of these complement proteins were also correlated with various clinical scores and phenotypes of MDD. Results: The patients with MDD and healthy controls did not differ in terms of age and gender (p > 0.1). The patients with MDD had a mean duration of illness of around 3 years, with average number of depressive episodes being 6 and the mean HAM-D score was 19. Of the seven complement components, the plasma levels of C1q, Factor B, and Factor H (p ≤ 0.05) were significantly elevated in MDD patients compared to healthy controls. However, the plasma levels of these complement proteins were not found to correlate with the clinical profile of MDD patients. Conclusion: Both Factor B and Factor H are crucial in the induction and regulation of the alternative pathway of complement activation. The alternative pathway also plays a critical role in inflammation. These findings suggest an important role of the alternative complement pathway in immuno-inflammation in MDD.

Adjunct yoga therapy: Influence on heart rate variability in major depressive disorder - A randomized controlled trial.

HRV is inversely proportional to severity of depression. Effect of 12-weeks adjunct yoga therapy on HRV in patients with MDD was assessed through a randomized controlled trial. Sixty-eight subjects (40 females) with mean age 31.58 ± 8.79 years, scoring ≥ 18 on HDRS were randomized to either (YG; n = 35) or (WG; n = 33). Linear mixed model analysis showed no significant difference between groups. On comparing change in mean percentage, substantial more decrease could be elicited only for LF/HF ratio in YG compared to WG, while being comparable for other variables across the groups. Findings suggest Yoga therapy may help in bringing parasympathetic dominance in patients with MDD.

Feasibility and Pilot Efficacy Testing of Integrated Yoga and Shirodhara (Ayurvedic Oil-Dripping) Intervention on Clinical Symptoms, Cognitive Functions and Sleep Quality of Adults with Anxiety Disorder.

BACKGROUND: Beneficial effects of yoga therapy in anxiety disorders (ADs) are known. Traditional texts describe usefulness of Ayurvedic oil-dripping, Shirodhara technique, in relieving anxiety. Thus, present study was planned to assess the feasibility and synergistic value of Shirodhara as an add-on to yoga therapy in adults with AD. MATERIALS AND METHODS: Thirty adults (males = 14, females = 16) admitted in a residential holistic health care center with an age range of 29.66 ± 6.63 years and diagnosis of one of the ADs (generalized AD, n = 18; social phobia, n = 8; and panic AD, n = 4) as per mini-international neuropsychiatric interview (M. I. N. I. English version 5.0) by a psychiatrist were randomly divided into two groups: (1) integrated yoga-based lifestyle program (YT; n = 15) and (2) YT + Ayurveda (YA; n = 15). Both groups continued to receive conventional treatment and were on stable medications throughout the study period except in cases of emergency. Assessments were done by an independent assessor at baseline and after 2 weeks of intervention for clinical symptoms (HAM-A, State and Trait Anxiety Inventory, and Brief Psychiatric Rating Scale), sleep quality (sleep rating questionnaire), and cognition (Stroop test and digit letter substitution test) using standard validated tools. Parametric tests were applied using SPSS 10.0 to analyze the data. RESULTS: Twelve subjects in yoga group and thirteen subjects in YA group completed the trial. No side effects were reported in any of the groups. Within-group comparisons showed a significant improvement in clinical symptoms, cognition and sleep quality in both the groups. Between-group comparisons showed significantly better scores in Stroop word task for YA group as compared to YT group. Furthermore, there was a trend toward better improvement in sleep quality for YA group. CONCLUSION: Adding of Shirodhara technique to YT was feasible and may be useful in improving executive memory and sleep quality in adults with ADs.