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Open Access 01-12-2022 | Mood Disorders | Research

Cervical muscle stiffness and parasympathetic nervous system improvements for treatment-resistant depression

Authors: Takayoshi Matsui, Kazuhiro Hara, Makoto Iwata, Shuntaro Hojo, Nobuyuki Shitara, Yuzo Endo, Hideoki Fukuoka, Masaki Matsui, Hiroshi Kawaguchi

Published in: BMC Musculoskeletal Disorders | Issue 1/2022

Abstract

Background

Although treatment-resistant depression (TRD) is a major public health problem that increases mortality due to suicides, a considerable percentage of patients do not respond adequately to variable treatments. Patients with TRD sometimes have comorbid cervical stiffness. This observational study aims to examine the association of local modulation of cervical muscles with TRD and to learn the involvement of the parasympathetic nervous system in the underlying mechanism.

Methods

A total of 1103 hospitalized patients with TRD who were resistant to outpatient care were enrolled between May 2006 and October 2021. All patients underwent local modulation of the cervical muscles by physical therapy during hospitalization. The presence or absence of TRD and whole-body disorders, such as headache, dazzling, cervical stiffness, and cardiovascular and gastrointestinal disorders, was determined by the patient’s subjectivity using the self-rated medical interview sheet at admission and discharge. Pupil light reflex parameters were also measured at admission and discharge using a binocular infrared pupilometer.

Results

The improvement rate of TRD during hospitalization was 72.1%, and did not differ significantly by sex, age, and hospitalization period. The improvement of TRD showed a strong association with those of cervical stiffness and dazzling, a pupil light reflex disorder (p < 0.001: odds ratios = 12.76 and 6.39, respectively), but not with those of headache or cardiovascular and gastrointestinal disorders (p > 0.05). In the TRD-improved patients, the pupil light reflex parameters representative of the parasympathetic nervous system function ameliorated: pupil diameter decreased, while constriction rate and velocity increased during hospitalization. In contrast, little amelioration of the parameters was seen in the TRD-unimproved patients.

Conclusions

Cervical muscle stiffness may be associated with TRD, possibly through dysfunction of the parasympathetic nervous system.

Trial registration

ID: UMIN000040590. First registration date: 30/05/2020.

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Title: Cervical muscle stiffness and parasympathetic nervous system improvements for treatment-resistant depression
Authors: Takayoshi Matsui
Kazuhiro Hara
Makoto Iwata
Shuntaro Hojo
Nobuyuki Shitara
Yuzo Endo
Hideoki Fukuoka
Masaki Matsui
Hiroshi Kawaguchi
Publication date: 01-12-2022
Publisher: BioMed Central
Keywords: Mood Disorders
Affective Disorder
Physical Therapy
Headache
Published in: BMC Musculoskeletal Disorders / Issue 1/2022
Electronic ISSN: 1471-2474
DOI: https://doi.org/10.1186/s12891-022-05860-2

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Cervical muscle stiffness and parasympathetic nervous system improvements for treatment-resistant depression

Abstract

Background

Methods

Results

Conclusions

Trial registration

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

Trial registration

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