title: Muscle sympathetic nervous activity in depressed patients before and after treatment with sertraline.
abstract: BACKGROUND
  Sympathetic hyperactivity is one of the mechanisms involved in the increased cardiovascular risk associated with depression, and there is evidence that antidepressants decrease sympathetic activity.
  
  
  OBJECTIVE
  We tested the following two hypotheses: patients with major depressive disorder with high scores of depressive symptoms (HMDD) have augmented muscle sympathetic nervous system activity (MSNA) at rest and during mental stress compared with patients with major depressive disorder with low scores of depressive symptoms (LMDD) and controls; sertraline decreases MSNA in depressed patients.
  
  
  METHODS
  Ten HMDD, nine LMDD and 11 body weight-matched controls were studied. MSNA was directly measured from the peroneal nerve using microneurography for 3 min at rest and 4 min during the Stroop color word test. For the LMDD and HMDD groups, the tests were repeated after treatment with sertraline (103.3 +/- 40 mg).
  
  
  RESULTS
  Resting MSNA was significantly higher in the HMDD [29.1 bursts/min (SE 2.9)] compared with LMDD [19.9 (1.6)] and controls [22.2 (2.0)] groups (P = 0.026 and 0.046, respectively). There was a significant positive correlation between resting MSNA and severity of depression. MSNA increased significantly and similarly during stress in all the studied groups. Sertraline significantly decreased resting MSNA in the LMDD group and MSNA during mental stress in LMDD and HMDD groups. Sertraline significantly decreased resting heart rate and heart rate response to mental stress in the HMDD group.
  
  
  CONCLUSIONS
  Moderate-to-severe depression is associated with increased MSNA. Sertraline treatment reduces MSNA at rest and during mental challenge in depressed patients, which may have prognostic implications in this group.
authors.affiliation: Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada. scalcoa@mcmaster.ca
authors.forename: Andréia Zavaloni
authors.initials: AZ
authors.lastname: Scalco
authors.forename: Maria Urbana Pinto Brandão
authors.initials: MU
authors.lastname: Rondon
authors.forename: Ivani Credidio
authors.initials: IC
authors.lastname: Trombetta
authors.forename: Mateus Camaroti
authors.initials: MC
authors.lastname: Laterza
authors.forename: João Batista Costa Carvalho
authors.initials: JB
authors.lastname: Azul
authors.forename: Eleanor Maria
authors.initials: EM
authors.lastname: Pullenayegum
authors.forename: Mônica Zavaloni
authors.initials: MZ
authors.lastname: Scalco
authors.forename: Fátima Helena Sert
authors.initials: FH
authors.lastname: Kuniyoshi
authors.forename: Maurício
authors.initials: M
authors.lastname: Wajngarten
authors.forename: Carlos Eduardo
authors.initials: CE
authors.lastname: Negrão
authors.forename: Francisco
authors.initials: F
authors.lastname: Lotufo-Neto
mesh_terms: D000293:Adolescent; D000328:Adult; D001794:Blood Pressure / Q000187:drug effects; D002316:Cardiotonic Agents / Q000627:therapeutic use; D003071:Cognition / Q000187:drug effects / Q000502:physiology; D003866:Depressive Disorder / Q000188:drug therapy* / Q000378:metabolism; D004594:Electrophysiology; D005260:Female; D006801:Humans; D008297:Male; D008839:Microelectrodes; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000294:innervation*; D010543:Peroneal Nerve / Q000378:metabolism; D011581:Psychological Tests; D012039:Regional Blood Flow / Q000187:drug effects; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use*; D020280:Sertraline / Q000627:therapeutic use*; D013315:Stress, Psychological; D013564:Sympathetic Nervous System / Q000378:metabolism*; D055815:Young Adult
chemical_list: D002316:Cardiotonic Agents; D017367:Selective Serotonin Reuptake Inhibitors; D020280:Sertraline