Impact of Proinflammatory Cytokines and Early Life Stress on Cognitive Functions in Athletes: Exploring Links to Performance and Mental Health

Abstract

Background: The multifactorial etiology of depression involves biological, psychological, and social factors, often accompanied by impaired executive function. Among athletes, this interaction may influence mental health and performance, particularly when considering the roles of proinflammatory cytokines and adverse childhood experiences (ACEs). This study investigates the potential interactions between these elements in athletes with depressive symptoms. Method: We measured serum levels of interleukin-1β (IL-1β), interleukin-6 (IL-6), interleukin-10 (IL-10), and tumor necrosis factor-alpha (TNF-α) in 145 athletes aged 18-65 diagnosed with depression, alongside 145 healthy athlete controls, at the First Affiliated Hospital of Chongqing Medical University, China, from July 2021 to August 2022. Participants underwent the Wisconsin Card Sorting Test (WCST) to assess executive functions, with metrics including the number of completed categories (CC), false responses (RE), persistent errors (RPE), and non-persistent errors (NRPE) analyzed. Results: Levels of IL-6 and TNF-α were significantly elevated in depressed athletes with ACEs compared to those without (P<0.05), and against healthy athletes without ACEs (P<0.05). In terms of executive function, depressed athletes with ACEs exhibited higher rates of RE, RPE, and NRPE compared to those without ACEs (P<0.05). Among depressed athletes with ACEs, IL-1β and IL-6 showed positive correlations with RPE (r=0.228, P<0.05; r=0.170, P<0.05, respectively), while TNF-α negatively correlated with CC (r=-0.096, P<0.01). Conclusions: Elevated proinflammatory cytokines may serve as biomarkers for both the pathogenesis of depression and the accompanying executive dysfunction in athletes, particularly those with ACEs. These findings underscore the importance of monitoring inflammatory markers and executive function in athletes, offering insights for tailored interventions that address both psychological and physical aspects of athlete health. Further research is necessary to unravel the underlying mechanisms and to evaluate intervention strategies.