Acute exercise enhances the response to paired associative stimulation-induced plasticity in the primary motor cortex

Investigating the acute effect of low and moderate intensity aerobic exercise on whole-body task learning and cognition in young adults

Recent studies have shown that a single bout of exercise has acute improvements on various forms of memory, including procedural motor learning, through mechanisms such as the plasticity-promoting effect. This study aimed to examine (1) the acute effects of timing and intensity of aerobic exercise on the acquisition and retention of motor learning in healthy adults, (2) the effect of sleep quality of the night before and after acquisition on motor learning, and (3) the acute effects of low and moderate-intensity aerobic exercise on cognitive functions. Seventy-five healthy adults were divided into five groups: Two groups performed low or moderate intensity aerobic exercise before motor practice; two groups performed low or moderate intensity aerobic exercise after motor practice; the control group only did motor practice. Low- and moderate-intensity exercises consisted of 30 min of running at 57%-63% and 64%-76% of the maximum heart rate, respectively. Motor learning was assessed using a golf putting task. The sleep quality of the night before and after the acquisition was evaluated using the Richard Campbell Sleep Questionnaire. Cognitive function was assessed before and after aerobic exercise using the Paced Auditory Serial Acquisition Task test. Results indicated that all groups demonstrated acquisition, 1-day and 7-day retention at a similar level (p > 0.05). Regression analysis revealed no significant relationship between sleep quality on the night before the experimental day and total acquisition (p > 0.05). However, a positive correlation was found between the sleep quality on the night of the experimental day and both 1-day and 7-day retention (p < 0.05). A single bout of low or moderate acute exercise did not modify motor skill acquisition and retention. Other results showed the importance of night sleep quality on the retention and proved that a single bout of moderate intensity exercise was associated with improved cognitive function.

Acute effects of aerobic exercise on corticomotor plasticity in individuals with and without depression

BACKGROUND

Although complex in nature, the pathophysiology of depression involves reduced or impaired neuroplastic capabilities. Restoring or enhancing neuroplasticity may serve as a treatment target for developing therapies for depression. Aerobic exercise (AEx) has antidepressant benefits and may enhance neuroplasticity in depression although the latter has yet to be substantiated. Therefore, we sought to examine the acute effect of AEx on neuroplasticity in depression.

METHODS

Sixteen individuals with (DEP; 13 female; age = 28.5 ± 7.3; Montgomery-Äsberg Depression Rating Scale [MADRS] = 21.3 ± 5.2) and without depression (HC; 13 female; age 27.2 ± 7.5; MADRS = 0.8 ± 1.2) completed three experimental visits consisting of 15 min of low intensity AEx (LO) at 35% heart rate reserve (HRR), high intensity AEx (HI) at 70% HRR, or sitting (CON). Following AEx, excitatory paired associative stimulation (PAS25ms) was employed to probe neuroplasticity. Motor evoked potentials (MEP) were assessed via transcranial magnetic stimulation before and after PAS25ms to indicate acute changes in neuroplasticity.

RESULTS

PAS25ms primed with HI AEx led to significant increases in MEP amplitude compared to LO and CON. HI AEx elicited enhanced PAS25ms-induced neuroplasticity for up to 1-h post-PAS. There were no significant between-group differences.

CONCLUSION

HI AEx enhances PAS measured neuroplasticity in individuals with and without depression. HI AEx may have a potent influence on the brain and serve as an effective primer, or adjunct, to therapies that seek to harness neuroplasticity.

Effects of acute aerobic exercise on resting state functional connectivity of motor cortex in college students

This study intends to inspect the effects of acute aerobic exercise (AE) on resting state functional connectivity (RSFC) in motor cortex of college students and the moderating effect of fitness level.

METHODS

20 high fitness level college students and 20 ordinary college students were recruited in public. Subjects completed 25 min of moderate- and high-intensity acute aerobic exercise respectively by a bicycle ergometer, and the motor cortex's blood oxygen signals in resting state were monitored by functional Near Infrared Spectroscopy (fNIRS, the Shimadzu portable Light NIRS, Japan) in pre- and post-test.

RESULTS

At the moderate intensity level, the total mean value of RSFC pre- and post-test was significantly different in the high fitness level group (pre-test 0.62 ± 0.18, post-test 0.51 ± 0.17, t(19) = 2.61, p = 0.02, d = 0.58), but no significant change was found in the low fitness level group. At the high-intensity level, there was no significant difference in the difference of total RSFC between pre- and post-test in the high and low fitness group. According to and change trend of 190 "edges": at the moderate-intensity level, the number of difference edges in the high fitness group (d = 0.58, 23) were significantly higher than those in the low fitness group (d = 0.32, 15), while at high-intensity level, there was a reverse trend between the high fitness group (d = 0.25, 18) and the low fitness group (d = 0.39, 23).

CONCLUSIONS

moderate-intensity AE can cause significant changes of RSFC in the motor cortex of college students with high fitness, while high fitness has a moderating effect on the relationship between exercise intensity and RSFC. RSFC of people with high fitness is more likely to be affected by AE and show a wider range of changes.

Transcranial Direct Current Stimulation to Ameliorate Post-Stroke Cognitive Impairment

Post-stroke cognitive impairment is a common and disabling condition with few effective therapeutic options. After stroke, neural reorganization and other neuroplastic processes occur in response to ischemic injury, which can result in clinical improvement through spontaneous recovery. Neuromodulation through transcranial direct current stimulation (tDCS) is a promising intervention to augment underlying neuroplasticity in order to improve cognitive function. This form of neuromodulation leverages mechanisms of neuroplasticity post-stroke to optimize neural reorganization and improve function. In this review, we summarize the current state of cognitive neurorehabilitation post-stroke, the practical features of tDCS, its uses in stroke-related cognitive impairment across cognitive domains, and special considerations for the use of tDCS in the post-stroke patient population.

Exercise-induced cortical disinhibition mediates the relationship between fitness and memory in older adults

Regular exercise benefits learning and memory in older adults, but the neural mechanisms mediating these effects remain unclear. Evidence in young adults indicates that acute exercise creates a favourable environment for synaptic plasticity by enhancing cortical disinhibition. As such, we investigated whether plasticity-related disinhibition mediated the relationship between cardiorespiratory fitness and memory function in healthy older adults (n = 16, mean age = 66.06). Participants completed a graded maximal exercise test and assessments of visual and verbal memory, followed by two counterbalanced sessions involving 20 min of either high-intensity interval training exercise or rest. Disinhibition was measured following intermittent theta burst stimulation via paired-pulse transcranial magnetic stimulation. In line with our hypotheses, we observed a positive correlation between cardiorespiratory fitness and verbal memory, which was mediated by plasticity-related cortical disinhibition. Our novel finding implicates cortical disinhibition as a mechanism through which the effects of acute bouts of exercise may translate to improved memory in older adults. This finding extends current understanding of the physiological mechanisms underlying the positive influence of cardiorespiratory fitness for memory function in older adults, and further highlights the importance of promoting exercise engagement to maintain cognitive health in later life. KEY POINTS: There are well established benefits of regular exercise for memory function in older adults, but the mechanisms are unclear. Cortical disinhibition is important for laying down new memories, and is enhanced following acute exercise in young adults, suggesting it is a potential mechanism underlying these benefits in ageing. Older adults completed a fitness test and assessments of memory, followed by two sessions involving either 20 min of exercise or rest. Disinhibition was measured following intermittent theta burst stimulation via paired-pulse transcranial magnetic stimulation. Cardiorespiratory fitness was positively associated with memory performance. Higher fitness was associated with enhanced cortical disinhibition following acute exercise. Cortical disinhibition completely mediated the relationship between fitness and memory. This novel finding provides a mechanistic account for the positive influence of cardiorespiratory fitness on memory in later life, and emphasises the importance of regular exercise for cognitive health in older populations.

Acute exercise as a modifier of neocortical plasticity and aperiodic activity in the visual cortex

Long-term potentiation (LTP) is a form of neuroplasticity commonly implicated in mechanistic models of learning and memory. Acute exercise can boost LTP in the motor cortex, and is associated with a shift in excitation/inhibition (E:I) balance, but whether this extends to other regions such as the visual cortex is unknown. We investigated the effect of a preceding bout of exercise on LTP induction and the E:I balance in the visual cortex using electroencephalography (EEG). Young adults (N = 20, mean age = 24.20) engaged in 20 min of high-intensity interval training (HIIT) exercise and rest across two counterbalanced sessions. LTP was induced using a high frequency presentation of a visual stimulus; a "visual tetanus". Established EEG markers of visual LTP, the N1b and P2 component of the visual evoked potential, and an EEG-derived measure of the E:I balance, the aperiodic exponent, were measured before and after the visual tetanus. As expected, there was a potentiation of the N1b following the visual tetanus, with specificity to the tetanised stimulus, and a non-specific potentiation of the P2. These effects were not sensitive to a preceding bout of exercise. However, the E:I balance showed a late shift towards inhibition following the visual tetanus. A preceding bout of exercise resulted in specificity of this E:I balance shift to the tetanised stimulus, that was not seen following rest. This novel finding suggests a possible exercise-induced tuning of the visual cortex to stimulus details following LTP induction.

Cortico-cortical paired associative stimulation (ccPAS) over premotor-motor areas affects local circuitries in the human motor cortex via Hebbian plasticity

Transcranial magnetic stimulation (TMS) studies have shown that cortico-cortical paired associative stimulation (ccPAS) can strengthen connectivity between the ventral premotor cortex (PMv) and the primary motor cortex (M1) by modulating convergent input over M1 via Hebbian spike-timing-dependent plasticity (STDP). However, whether ccPAS locally affects M1 activity remains unclear. We tested 60 right-handed young healthy humans in two studies, using a combination of dual coil TMS and ccPAS over the left PMv and M1 to probe and manipulate PMv-to-M1 connectivity, and single- and paired-pulse TMS to assess neural activity within M1. We provide convergent evidence that ccPAS, relying on repeated activations of excitatory PMv-to-M1 connections, acts locally over M1. During ccPAS, motor-evoked potentials (MEPs) induced by paired PMv-M1 stimulation gradually increased. Following ccPAS, the threshold for inducing MEPs of different amplitudes decreased, and the input-output curve (IO) slope increased, highlighting increased M1 corticospinal excitability. Moreover, ccPAS reduced the magnitude of short-interval intracortical inhibition (SICI), reflecting suppression of GABA-ergic interneuronal mechanisms within M1, without affecting intracortical facilitation (ICF). These changes were specific to ccPAS Hebbian strengthening of PMv-to-M1 connectivity, as no modulations were observed when reversing the order of the PMv-M1 stimulation during a control ccPAS protocol. These findings expand prior ccPAS research that focused on the malleability of cortico-cortical connectivity at the network-level, and highlight local changes in the area of convergent activation (i.e., M1) during plasticity induction. These findings provide new mechanistic insights into the physiological basis of ccPAS that are relevant for protocol optimization.

Exerkines and long-term synaptic potentiation: Mechanisms of exercise-induced neuroplasticity

Physical exercise may improve cognitive function by modulating molecular and cellular mechanisms within the brain. We propose that the facilitation of long-term synaptic potentiation (LTP)-related pathways, by products induced by physical exercise (i.e., exerkines), is a crucial aspect of the exercise-effect on the brain. This review summarizes synaptic pathways that are activated by exerkines and may potentiate LTP. For a total of 16 exerkines, we indicated how blood and brain exerkine levels are altered depending on the type of physical exercise (i.e., cardiovascular or resistance exercise) and how they respond to a single bout (i.e., acute exercise) or multiple bouts of physical exercise (i.e., chronic exercise). This information may be used for designing individualized physical exercise programs. Finally, this review may serve to direct future research towards fundamental gaps in our current knowledge regarding the biophysical interactions between muscle activity and the brain at both cellular and system levels.

Intensity matters: protocol for a randomized controlled trial exercise intervention for individuals with chronic stroke

Rationale

Cardiovascular exercise is an effective method to improve cardiovascular health outcomes, but also promote neuroplasticity during stroke recovery. Moderate-intensity continuous cardiovascular training (MICT) is an integral part of stroke rehabilitation, yet it may remain a challenge to exercise at sufficiently high intensities to produce beneficial adaptations to neuroplasticity. High-intensity interval training (HIIT) could provide a viable alternative to achieve higher intensities of exercise by using shorter bouts of intense exercise interspersed with periods of recovery.

Methods and design

This is a two-arm, parallel-group multi-site RCT conducted at the Jewish Rehabilitation Hospital (Laval, Québec, Canada) and McMaster University (Hamilton, Ontario, Canada). Eighty participants with chronic stroke will be recruited at both sites and will be randomly allocated into a HIIT or MICT individualized exercise program on a recumbent stepper, 3 days per week for 12 weeks. Outcomes will be assessed at baseline, at 12 weeks post-intervention, and at an 8-week follow-up.

Outcomes

The primary outcome is corticospinal excitability, a neuroplasticity marker in brain motor networks, assessed with transcranial magnetic stimulation (TMS). We will also examine additional markers of neuroplasticity, measures of cardiovascular health, motor function, and psychosocial responses to training.

Discussion

This trial will contribute novel insights into the effectiveness of HIIT to promote neuroplasticity in individuals with chronic stroke.

Trial registration

ClinicalTrials.govNCT03614585. Registered on 3 August 2018

Supplementary Information

The online version contains supplementary material available at 10.1186/s13063-022-06359-w.

Walking and Balance Outcomes Are Improved Following Brief Intensive Locomotor Skill Training but Are Not Augmented by Transcranial Direct Current Stimulation in Persons With Chronic Spinal Cord Injury

Motor training to improve walking and balance function is a common aspect of rehabilitation following motor-incomplete spinal cord injury (MISCI). Evidence suggests that moderate- to high-intensity exercise facilitates neuroplastic mechanisms that support motor skill acquisition and learning. Furthermore, enhancing corticospinal drive via transcranial direct current stimulation (tDCS) may augment the effects of motor training. In this pilot study, we investigated whether a brief moderate-intensity locomotor-related motor skill training (MST) circuit, with and without tDCS, improved walking and balance outcomes in persons with MISCI. In addition, we examined potential differences between within-day (online) and between-day (offline) effects of MST. Twenty-six adults with chronic MISCI, who had some walking ability, were enrolled in a 5-day double-blind, randomized study with a 3-day intervention period. Participants were assigned to an intensive locomotor MST circuit and concurrent application of either sham tDCS (MST+tDCS_sham) or active tDCS (MST+tDCS). The primary outcome was overground walking speed measured during the 10-meter walk test. Secondary outcomes included spatiotemporal gait characteristics (cadence and stride length), peak trailing limb angle (TLA), intralimb coordination (ACC), the Berg Balance Scale (BBS), and the Falls Efficacy Scale-International (FES-I) questionnaire. Analyses revealed a significant effect of the MST circuit, with improvements in walking speed, cadence, bilateral stride length, stronger limb TLA, weaker limb ACC, BBS, and FES-I observed in both the MST+tDCS_sham and MST+tDCS groups. No differences in outcomes were observed between groups. Between-day change accounted for a greater percentage of the overall change in walking outcomes. In persons with MISCI, brief intensive MST involving a circuit of ballistic, cyclic locomotor-related skill activities improved walking outcomes, and selected strength and balance outcomes; however, concurrent application of tDCS did not further enhance the effects of MST.

Acute effects of physical activity patterns on plasma cortisol and brain-derived neurotrophic factor in relation to corticospinal excitability

Brain-derived neurotrophic factor (BDNF) and cortisol are both capable of modulating synaptic plasticity, but it is unknown how physical activity-induced changes in their plasma levels relate to corticospinal plasticity in humans. Sixteen inactive middle-aged men and women participated in three separate interventions consisting of 3hours prolonged sitting (SIT); 3hours sitting interrupted every 30minutes with frequent short physical activity breaks (FPA); and 2.5hours prolonged sitting followed by 25minutes of moderate intensity exercise (EXE). These 3hour sessions were each followed by a 30min period of paired associative stimulation over the primary motor cortex (PAS). Blood samples were taken and corticospinal excitability measured at baseline, pre PAS, 5min and 30min post PAS. Here we report levels of plasma BDNF and cortisol over three activity conditions and relate these levels to previously published changes in corticospinal excitability of a non-activated thumb muscle. There was no interaction between time and condition in BDNF, but cortisol levels were significantly higher after EXE compared to after SIT and FPA. Higher cortisol levels at pre PAS predicted larger increases in corticospinal excitability from baseline to all subsequent time points in the FPA condition only, while levels of BDNF at pre PAS did not predict such changes in any of the conditions. Neither BDNF nor cortisol modified changes from pre PAS to the subsequent time points, suggesting that the increased corticospinal excitability was not mediated though an augmented effect of the PAS protocol. The relationship between cortisol and plasticity has been suggested to be U-shaped. This is possibly why the moderately high levels of cortisol seen in the FPA condition were positively associated with changes AURC, while the higher cortisol levels seen after EXE were not. A better understanding of the mechanisms for how feasible physical activity breaks affect neuroplasticity can inform the theoretical framework for how work environments and schedules should be designed. DATA AVAILABILITY: Data are available from the corresponding author upon reasonable request.

Motor cortex plasticity response to acute cardiorespiratory exercise and intermittent theta-burst stimulation is attenuated in premanifest and early Huntington’s disease

Huntington’s disease (HD) mouse models suggest that cardiovascular exercise may enhance neuroplasticity and delay disease signs, however, the effects of exercise on neuroplasticity in people with HD are unknown. Using a repeated-measures experimental design, we compared the effects of a single bout of high-intensity exercise, moderate-intensity exercise, or rest, on motor cortex synaptic plasticity in 14 HD CAG-expanded participants (9 premanifest and 5 early manifest) and 20 CAG-healthy control participants, using transcranial magnetic stimulation. Measures of cortico-motor excitability, short-interval intracortical inhibition and intracortical facilitation were obtained before and after a 20-min bout of either high-intensity interval exercise, moderate-intensity continuous exercise, or rest, and again after intermittent theta burst stimulation (iTBS). HD participants showed less inhibition at baseline compared to controls. Whereas the control group showed increased excitability and facilitation following high-intensity exercise and iTBS, the HD group showed no differences in neuroplasticity responses following either exercise intensity or rest, with follow-up Bayesian analyses providing consistent evidence that these effects were absent in the HD group. These findings indicate that exercise-induced synaptic plasticity mechanisms in response to acute exercise may be attenuated in HD, and demonstrate the need for future research to further investigate exercise and plasticity mechanisms in people with HD.

Acute High-Intensity Interval Exercise Modulates Corticospinal Excitability in Older Adults

INTRODUCTION

Acute exercise can modulate the excitability of the non-exercised upper-limb representation in the primary motor cortex (M1). Measures of M1 excitability using transcranial magnetic stimulation (TMS) are modulated following various forms of acute exercise in young adults, including high intensity interval training (HIIT). However, the impact of HIIT on M1 excitability in older adults is currently unknown. Therefore, the purpose of the current study was to investigate the effects of lower-limb cycling HIIT on bilateral upper-limb M1 excitability in older adults.

METHODS

We assessed the impact of acute lower-limb HIIT or rest on bilateral corticospinal excitability, intracortical inhibition and facilitation, and interhemispheric inhibition of the non-exercised upper-limb muscle in healthy older adults (aged 66 ± 8). We used single and paired-pulse TMS to assess motor evoked potentials (MEPs), short-interval intracortical inhibition (SICI), intracortical facilitation (ICF) and the ipsilateral silent period (iSP). Two groups of healthy older adults completed either HIIT exercise or seated rest for 23 min, with TMS measures performed pre (T0), immediately post (T1) and 30 min post (T2) HIIT/rest.

RESULTS

MEPs were significantly increased after HIIT exercise at T2 compared to T0 in the dominant upper-limb. Contrary to our hypothesis we did not find any significant change in SICI, ICF or iSP following HIIT.

CONCLUSIONS

Our findings demonstrate that corticospinal excitability of the non-exercised upper-limb is increased following HIIT in healthy older adults. Our results indicate that acute HIIT exercise impacts corticospinal excitability in older adults, without affecting intracortical or interhemispheric circuitry. These findings have implications for the development of exercise strategies to potentiate neuroplasticity in healthy older and clinical populations.

Exercise priming with transcranial direct current stimulation: a study protocol for a randomized, parallel-design, sham-controlled trial in mild cognitive impairment and Alzheimer's disease

Background

Transcranial direct current stimulation (tDCS) is a non-invasive type of brain stimulation that uses electrical currents to modulate neuronal activity. A small number of studies have investigated the effects of tDCS on cognition in patients with Mild Cognitive Impairment (MCI) and Alzheimer’s disease (AD), and have demonstrated variable effects. Emerging evidence suggests that tDCS is most effective when applied to active brain circuits. Aerobic exercise is known to increase cortical excitability and improve brain network connectivity. Exercise may therefore be an effective, yet previously unexplored primer for tDCS to improve cognition in MCI and mild AD.

Methods

Participants with MCI or AD will be randomized to receive 10 sessions over 2 weeks of either exercise primed tDCS, exercise primed sham tDCS, or tDCS alone in a blinded, parallel-design trial. Those randomized to an exercise intervention will receive individualized 30-min aerobic exercise prescriptions to achieve a moderate-intensity dosage, equivalent to the ventilatory anaerobic threshold determined by cardiopulmonary assessment, to sufficiently increase cortical excitability. The tDCS protocol consists of 20 min sessions at 2 mA, 5 times per week for 2 weeks applied through 35 cm² bitemporal electrodes. Our primary aim is to assess the efficacy of exercise primed tDCS for improving global cognition using the Montreal Cognitive Assessment (MoCA). Our secondary aims are to evaluate the efficacy of exercise primed tDCS for improving specific cognitive domains using various cognitive tests (n-back, Word Recall and Word Recognition Tasks from the Alzheimer’s Disease Assessment Scale-Cognitive subscale) and neuropsychiatric symptoms (Neuropsychiatric Inventory). We will also explore whether exercise primed tDCS is associated with an increase in markers of neurogenesis, oxidative stress and angiogenesis, and if changes in these markers are correlated with cognitive improvement.

Discussion

We describe a novel clinical trial to investigate the effects of exercise priming before tDCS in patients with MCI or mild AD. This proof-of-concept study may identify a previously unexplored, non-invasive, non-pharmacological combination intervention that improves cognitive symptoms in patients. Findings from this study may also identify potential mechanistic actions of tDCS in MCI and mild AD.

Trial registration

Clinicaltrials.gov, NCT03670615. Registered on September 13, 2018.

Acute Exercise Modulates the Excitability of Specific Interneurons in Human Motor Cortex

Acute exercise can modulate the excitability of the non-exercised upper-limb representation in the primary motor cortex (M1). Accumulating evidence demonstrates acute exercise affects measures of M1 intracortical excitability, with some studies also showing altered corticospinal excitability. However, the influence of distinct M1 interneuron populations on the modulation of intracortical and corticospinal excitability following acute exercise is currently unknown. We assessed the impact of an acute bout of leg cycling exercise on unique M1 interneuron excitability of a non-exercised intrinsic hand muscle using transcranial magnetic stimulation (TMS) in young adults. Specifically, posterior-to-anterior (PA) and anterior-to-posterior (AP) TMS current directions were used to measure the excitability of distinct populations of interneurons before and after an acute bout of exercise or rest. Motor evoked potentials (MEPs) and short-interval intracortical inhibition (SICI) were measured in the PA and AP current directions in M1 at two time points separated by 25 min of rest, as well as immediately and 30 min after a 25-minute bout of moderate-intensity cycling exercise. Thirty minutes after exercise, MEP amplitudes were significantly larger than other timepoints when measured with AP current, whereas MEP amplitudes derived from PA current did not show this effect. Similarly, SICI was significantly decreased immediately following acute exercise measured with AP but not PA current. Our findings suggest that the excitability of unique M1 interneurons are differentially modulated by acute exercise. These results indicate that M1 interneurons preferentially activated by AP current may play an important role in the exercise-induced modulation of intracortical and corticospinal excitability.

Physical activity, motor performance and skill learning: a focus on primary motor cortex in healthy aging

Participation in physical activity benefits brain health and function. Cognitive function generally demonstrates a noticeable effect of physical activity, but much less is known about areas responsible for controlling movement, such as primary motor cortex (M1). While more physical activity may support M1 plasticity in older adults, the neural mechanisms underlying this beneficial effect remain poorly understood. Aging is inevitably accompanied by diminished motor performance, and the extent of plasticity may also be less in older adults compared with young. Motor complications with aging may, perhaps unsurprisingly, contribute to reduced physical activity in older adults. While the development of non-invasive brain stimulation techniques have identified that human M1 is a crucial site for learning motor skills and recovery of motor function after injury, a considerable lack of knowledge remains about how physical activity impacts M1 with healthy aging. Reducing impaired neural activity in older adults may have important implications after neurological insult, such as stroke, which is more common with advancing age. Therefore, a better understanding about the effects of physical activity on M1 processes and motor learning in older adults may promote healthy aging, but also allow us to facilitate recovery of motor function after neurological injury. This article will initially provide a brief overview of the neurophysiology of M1 in the context of learning motor skills, with a focus on healthy aging in humans. This information will then be proceeded by a more detailed assessment that focuses on whether physical activity benefits motor function and human M1 processes.

The effect of acute aerobic exercise on the consolidation of motor memories

Acute aerobic exercise performed prior to training may assist with motor skill acquisition through enhancement of motor cortical plasticity. In addition, high-intensity exercise performed after training improves retention, although the mechanisms of this are unclear. We hypothesized that acute continuous moderate-intensity exercise performed post-motor training would also assist with motor skill retention and that this behavioral change would be positively correlated with neural markers of training-related cortical adaptation. Participants [n = 33; assigned to an exercise (EXE) or control (CON) group] completed a single visuomotor training session using bilateral wrist movements while movement-related cortical potentials (MRCPs) were collected. After motor training, the EXE group exercised for 20 min [70% of heart rate reserve (HRR)] and the CON group read for the same amount of time. Both groups completed two post-training tests after exercise/rest: 10 min and ~ 30 min once heart rate returned to resting level in EXE. Retention and transfer tests were both completed 1 and 7 days later. MRCPs measured training-related neural adaptations during the first visit and motor performance was assessed as time and trajectory to the target. The EXE group had better performance than CON at retention (significant 7 days post-training). MRCP amplitudes increased from early to late motor training and this amplitude change was correlated with motor performance at retention. Results suggest that moderate-intensity exercise post-motor training helps motor skill retention and that there may be a relationship with motor training-related cortical adaptations that is enhanced with post-motor training exercise.

Current Methodological Pitfalls and Caveats in the Assessment of Exercise-Induced Changes in Peripheral Brain-Derived Neurotrophic Factor: How Result Reproducibility Can Be Improved

Neural mechanisms, such as enhanced neuroplasticity within the motor system, underpin exercise-induced motor improvements. Being a key mediator of motor plasticity, brain-derived neurotrophic factor (BDNF) is likely to play an important role in mediating exercise positive effects on motor function. Difficulties in assessing brain BDNF levels in humans have drawn attention to quantification of blood BDNF and raise the question of whether peripheral BDNF contributes to exercise-related motor improvements. Methodological and non-methodological factors influence measurements of blood BDNF introducing a substantial variability that complicates result interpretation and leads to inconsistencies among studies. Here, we discuss methodology-related issues and approaches emerging from current findings to reduce variability and increase result reproducibility.

A Single Bout of High-intensity Interval Exercise Increases Corticospinal Excitability, Brain-derived Neurotrophic Factor, and Uncarboxylated Osteolcalcin in Sedentary, Healthy Males

Exercise induces neuroplasticity in descending motor pathways facilitating motor learning, and as such it could be utilized as an intervention in neurorehabilitation, for example when re-learning motor skills after stroke. To date, however, the neurophysiological and molecular mechanisms underlying exercise-induced neuroplasticity remain largely unknown impeding the potential utilization of exercise protocols as 'motor learning boosters' in clinical and non-clinical settings. Here, we assessed corticospinal excitability, intracortical facilitation (ICF) and short-interval intracortical inhibition (SICI) using transcranial magnetic stimulation (TMS) and serum biochemical markers including brain-derived neurotrophic factor (BDNF), total and precursor cathepsin B (tCTSB, proCTSB), uncarboxylated and carboxylated osteocalcin (unOCN, cOCN) and irisin using ELISA. Measurements were carried out in sedentary, healthy males before and after a single session of high-intensity interval exercise (HIIE) or in individuals who rested and did not perform exercise (No Exercise). We found that HIIE increased corticospinal excitability, BDNF and unOCN, and decreased cOCN. We also determined that greater increases in BDNF were associated with increases in unOCN and irisin and decreases in cOCN only in participants who underwent HIIE, suggesting that unOCN and irisin may contribute to exercise-induced BDNF increases. Conversely, no changes other than a decrease in serum unOCN/tOCN were found in No Exercise participants. The present findings show that a single session of HIIE is sufficient to modulate corticospinal excitability and to increase BDNF and unOCN in sedentary, healthy males.

Investigating Parietal and Premotor Influence on Motor Cortical Excitability Associated with Visuomotor Associative Plasticity

The brain changes in response to sensory signals it is exposed to. It has been shown that long term potentiation-like neuroplasticity can be experimentally induced via visual paired-associative stimulation (V-PAS). V-PAS combines afferent visual stimuli with a transcranial magnetic stimulation pulse to induce plasticity. Preparation of a reaching movement to generate activity in superior parietal occipital cortex (SPOC) was used in this study as an additional afferent contributor to modulate the resultant plasticity. We hypothesized that V-PAS with a reaching movement would induce greater cortical excitability than V-PAS alone and would exhibit facilitated SPOC to M1 projections. All four experiments enrolled groups of 10 participants to complete variations of V-PAS in a repeated measures design. SPOC to M1 projections facilitated motor cortex excitability following V-PAS regardless of intervention received. We did not observe evidence indicating extra afferent information provided an additive effect to participants. Investigation of PMd to M1 projections confirmed disinhibition and suggested interneuronal populations within M1 may be mechanistically involved. Future research should look to rule out the existence of an upper limit for effective afference during V-PAS and investigate the average influence of V-PAS on cortical excitability in the larger population.

Intensity Matters: High-intensity Interval Exercise Enhances Motor Cortex Plasticity More Than Moderate Exercise

A single bout of cardiovascular exercise can enhance plasticity in human cortex; however, the intensity required for optimal enhancement is debated. We investigated the effect of exercise intensity on motor cortex synaptic plasticity, using transcranial magnetic stimulation. Twenty healthy adults (Mage = 35.10 ± 13.25 years) completed three sessions. Measures of cortico-motor excitability (CME) and inhibition were obtained before and after a 20-min bout of either high-intensity interval exercise, moderate-intensity continuous exercise, or rest, and again after intermittent theta burst stimulation (iTBS). Results showed that high-intensity interval exercise enhanced iTBS plasticity more than rest, evidenced by increased CME and intracortical facilitation, and reduced intracortical inhibition. In comparison, the effect of moderate-intensity exercise was intermediate between high-intensity exercise and rest. Importantly, analysis of each participant's plasticity response profile indicated that high-intensity exercise increased the likelihood of a facilitatory response to iTBS. We also established that the brain-derived neurotrophic factor Val66Met polymorphism attenuated plasticity responses following high-intensity exercise. These findings suggest that high-intensity interval exercise should be considered not only when planning exercise interventions designed to enhance neuroplasticity, but also to maximize the therapeutic potential of non-invasive brain stimulation. Additionally, genetic profiling may enhance efficacy of exercise interventions for brain health.

Determining the Intracortical Responses After a Single Session of Aerobic Exercise in Young Healthy Individuals: A Systematic Review and Best Evidence Synthesis

ABSTRACT

Alibazi, RJ, Pearce, AJ, Rostami, M, Frazer, AK, Brownstein, C, and Kidgell, DJ. Determining the intracortical responses after a single session of aerobic exercise in young healthy individuals: a systematic review and best evidence synthesis. J Strength Cond Res 35(2): 562-575, 2021-A single bout of aerobic exercise (AE) may induce changes in the excitability of the intracortical circuits of the primary motor cortex (M1). Similar to noninvasive brain stimulation techniques, such as transcranial direct current stimulation, AE could be used as a priming technique to facilitate motor learning. This review examined the effect of AE on modulating intracortical excitability and inhibition in human subjects. A systematic review, according to PRISMA guidelines, identified studies by database searching, hand searching, and citation tracking between inception and the last week of February 2020. Methodological quality of included studies was determined using the Downs and Black quality index and Cochrane Collaboration of risk of bias tool. Data were synthesized and analyzed using best-evidence synthesis. There was strong evidence for AE not to change corticospinal excitability and conflicting evidence for increasing intracortical facilitation and reducing silent period and long-interval cortical inhibition. Aerobic exercise did reduce short-interval cortical inhibition, which suggests AE modulates the excitability of the short-latency inhibitory circuits within the M1; however, given the small number of included studies, it remains unclear how AE affects all circuits. In light of the above, AE may have important implications during periods of rehabilitation, whereby priming AE could be used to facilitate motor learning.

Locomotor activities as a way of inducing neuroplasticity: insights from conventional approaches and perspectives on eccentric exercises

Corticospinal excitability, and particularly the balance between cortical inhibitory and excitatory processes (assessed in a muscle using single and paired-pulse transcranial magnetic stimulation), are affected by neurodegenerative pathologies or following a stroke. This review describes how locomotor exercises may counterbalance these neuroplastic alterations, either when performed under its conventional form (e.g., walking or cycling) or when comprising eccentric (i.e., active lengthening) muscle contractions. Non-fatiguing conventional locomotor exercise decreases intracortical inhibition and/or increases intracortical facilitation. These modifications notably seem to be a consequence of neurotrophic factors (e.g., brain-derived neurotrophic factor) resulting from the hemodynamic solicitation. Furthermore, it can be inferred from non-invasive brain and peripheral stimulation studies that repeated activation of neural networks can endogenously shape neuroplasticity. Such mechanisms could also occur following eccentric exercises (lengthening of the muscle), during which motor-related cortical potential (electroencephalography) is of greater magnitude and lasts longer than during concentric exercises (i.e., muscle shortening). As single-joint eccentric exercise decreased short- and long-interval intracortical inhibition and increased intracortical facilitation, locomotor eccentric exercise (e.g., downhill walking or eccentric cycling) may be even more potent by adding hemodynamic-related neuroplastic processes to endogenous processes. Besides, eccentric exercise is especially useful to develop relatively high force levels at low cardiorespiratory and perceived intensities, which can be a training goal alongside the induction of neuroplastic changes. Even though indirect evidence let us think that locomotor eccentric exercise could shape neuroplasticity in ways relevant to neurorehabilitation, its efficacy remains speculative. We provide future research directions on the neuroplastic effects and underlying mechanisms of locomotor exercise.

Motor Point Stimulation in Spinal Paired Associative Stimulation can Facilitate Spinal Cord Excitability

Paired associative stimulation at the spinal cord (spinal PAS) has been shown to increase muscle force and dexterity by strengthening the corticomuscular connection, through spike timing dependent plasticity. Typically, transcranial magnetic stimulation (TMS) and transcutaneous peripheral nerve electrical stimulation (PNS) are often used in spinal PAS. PNS targets superficial nerve branches, by which the number of applicable muscles is limited. Alternatively, a muscle can be activated by positioning the stimulation electrode on the “motor point” (MPS), which is the most sensitive location of a muscle to electrical stimulation. Although this can increase the number of applicable muscles for spinal PAS, nobody has tested whether MPS can be used for the spinal PAS to date. Here we investigated the feasibility of using MPS instead of PNS for spinal PAS. Ten healthy male individuals (26.0 ± 3.5 yrs) received spinal PAS on two separate days with different stimulation timings expected to induce (1) facilitation of corticospinal excitability (REAL) or (2) no effect (CONTROL) on the soleus. The motor evoked potentials (MEP) response curve in the soleus was measured prior to the spinal PAS, immediately after (0 min) and at 10, 20, 30 min post-intervention as a measure of corticospinal excitability. The post-intervention MEP response curve areas were larger in the REAL condition than the CONTROL conditions. Further, the post-intervention MEP response curve areas were significantly larger than pre-intervention in the REAL condition but not in the CONTROL condition. We conclude that MPS can facilitate corticospinal excitability through spinal PAS.

HIIT the Road Jack: An Exploratory Study on the Effects of an Acute Bout of Cardiovascular High-Intensity Interval Training on Piano Learning

Pairing high-intensity interval training (HIIT) with motor skill acquisition may improve learning of some implicit motor sequences (albeit with some variability), but it is unclear if HIIT enhances explicit learning of motor sequences. We asked whether a single bout of HIIT after non-musicians learned to play a piano melody promoted better retention of the melody than low-intensity interval training (LIIT). Further, we investigated whether HIIT facilitated transfer of learning to a new melody. We generated individualized exercise protocols by having participants (n = 25) with little musical training undergo a graded maximal exercise test (GXT) to determine their cardiorespiratory fitness (VO_{2 peak}) and maximum power output (W_max). In a subsequent session, participants practiced a piano melody (skill acquisition) and were randomly assigned to a single bout of HIIT or LIIT. Retention of the piano melody was tested 1 hour, 1 day, and 1 week after skill acquisition. We also evaluated transfer to learning a new melody 1 week after acquisition. Pitch and rhythm accuracy were analyzed with linear mixed-effects modeling. HIIT did not enhance sequence-specific retention of pitch or rhythmic elements of the piano melody, but there was modest evidence that HIIT facilitated transfer to learning a new melody. We tentatively conclude that HIIT enhances explicit, task-general motor consolidation.

The effect of breaking up prolonged sitting on paired associative stimulation-induced plasticity

Paired associative stimulation (PAS) can induce plasticity in the motor cortex, as measured by changes in corticospinal excitability (CSE). This effect is attenuated in older and less active individuals. Although a single bout of exercise enhances PAS-induced plasticity in young, physically inactive adults, it is not yet known if physical activity interventions affect PAS-induced neuroplasticity in middle-aged inactive individuals. Sixteen inactive middle-aged office workers participated in a randomized cross-over design investigating how CSE and short-interval intracortical inhibition (SICI) were affected by PAS preceded by 3 h of sitting (SIT), 3 h of sitting interrupted every 30 min by 3 min of frequent short bouts of physical activity (FPA) and 2.5 h of sitting followed by 25 min of moderate-intensity exercise (EXE). Transcranial magnetic stimulation was applied over the primary motor cortex (M1) of the dominant abductor pollicis brevis to induce recruitment curves before and 5 min and 30 min post-PAS. Linear mixed models were used to compare changes in CSE using time and condition as fixed effects and subjects as random effects. There was a main effect of time on CSE and planned within-condition comparisons showed that CSE was significantly increased from baseline to 5 min and 30 min post-PAS, in the FPA condition, with no significant changes in the SIT or EXE conditions. SICI decreased from baseline to 5 min post-PAS, but this was not related to changes in CSE. Our findings suggest that in middle-aged inactive adults, FPAs may promote corticospinal neuroplasticity. Possible mechanisms are discussed.

No changes in corticospinal excitability, biochemical markers, and working memory after six weeks of high-intensity interval training in sedentary males

A single bout of aerobic exercise modulates corticospinal excitability, intracortical circuits, and serum biochemical markers such as brain‐derived neurotrophic factor (BDNF) and insulin‐like growth factor 1 (IGF‐1). These effects have important implications for the use of exercise in neurorehabilitation. Here, we aimed to determine whether increases in cardiorespiratory fitness (CRF) induced by 18 sessions of high‐intensity interval training (HIIT) over 6 weeks were accompanied by changes in corticospinal excitability, intracortical excitatory and inhibitory circuits, serum biochemical markers and working memory (WM) capacity in sedentary, healthy, young males. We assessed motor evoked potential (MEP) recruitment curves for the first dorsal interosseous (FDI) both at rest and during tonic contraction, intracortical facilitation (ICF), and short‐interval intracortical inhibition (SICI) using transcranial magnetic stimulation (TMS). We also examined serum levels of BDNF, IGF‐1, total and precursor (pro) cathepsin B (CTSB), as well as WM capacity. Compared to pretraining, CRF was increased and ICF reduced after the HIIT intervention, but there were no changes in corticospinal excitability, SICI, BDNF, IGF‐1, total and pro‐CTSB, and WM capacity. Further, greater CRF gains were associated with larger decreases in total and pro‐CTSB and, only in Val/Val carriers, with larger increases in SICI. Our findings confirm that HIIT is efficacious in promoting CRF and show that corticospinal excitability, biochemical markers, and WM are unchanged after 18 HIIT bouts in sedentary males. Understanding how aerobic exercise modulates M1 excitability is important in order to be able to use exercise protocols as an intervention, especially in rehabilitation following brain injuries.

Effects of twelve weeks' aerobic training on motor cortex excitability

BACKGROUND

Regular physical activity or aerobic exercise is well known to increase brain plasticity. Recent studies have reported that aerobic exercise enhances neuroplasticity and motor learning. The aim of this study was to investigate if 12 weeks' aerobic training can modify cortical excitability and motor evoked potential (MEP) responses.

METHODS

Fifteen untrained males were recruited. Cortical excitability was investigated using TMS. VO2<inf>max</inf> was estimated using Cooper's test. Aerobic intervention lasted 12 weeks. The subjects performed a 6-week supervised aerobic workout, 3 times a week, at 60-75% of their maximum heart rate (HR<inf>max</inf>). Over the following 6 weeks, they performed a supervised aerobic workout 3 times a week at 70-75% of FC<inf>max</inf>.

RESULTS

After 8 weeks of aerobic training there was a significant increase of distance covered during Cooper's test (P<0.001) and a significant increase of VO2<inf>max</inf> (P<0.001); there was also an improvement in resting motor threshold (rMT decreased from 60.5±6.6% [T0] to 55.8±5.9% [T2]; P<0.001), motor evoked potential latency decreased (from 25.3±0.8 ms [T0] to 24.1±0.8 ms [T2]; P<0.001), and motor evoked potential amplitude increased (from 0.58±0.09 mV [T0] to 0.65±0.08 mV [T2]; P<0.001). Furthermore, after 12 weeks' aerobic training there were improvements in all parameters.

CONCLUSIONS

This study shows that aerobic activity seems to induce changes in cortical excitability if performed for a period longer than 4 weeks, in addition to typical cardiorespiratory benefits in previously untrained males.

Effects of Exercise on Long-Term Potentiation in Neuropsychiatric Disorders

Various neuropsychiatric conditions, such as depression, Alzheimer's disease, and Parkinson's disease, demonstrate evidence of impaired long-term potentiation, a cellular correlate of episodic memory function. This chapter discusses the mechanistic effects of these neuropsychiatric conditions on long-term potentiation and how exercise may help to attenuate these detrimental effects.

Global Corticospinal Excitability as Assessed in A Non-Exercised Upper Limb Muscle Compared Between Concentric and Eccentric Modes of Leg Cycling

This study investigated the effects of eccentric (ECC) and concentric (CON) semi-recumbent leg cycling on global corticospinal excitability (CSE), assessed through the activity of a non-exercised hand muscle. Thirteen healthy male adults completed two 30-min bouts of moderate intensity ECC and CON recumbent cycling on separate days. Power output (POutput), heart rate (HR) and cadence were monitored during cycling. Global CSE was assessed using transcranial magnetic stimulation to elicit motor-evoked potentials (MEP) in the right first dorsal interosseous muscle before (‘Pre’), interleaved (at 10 and 20 mins, t10 and t20, respectively), immediately after (post, P0), and 30-min post exercise (P30). Participants briefly stopped pedalling (no more than 60 s) while stimulation was applied at the t10 and t20 time-points of cycling. Mean POutput, and rate of perceived exertion (RPE) did not differ between ECC and CON cycling and HR was significantly lower during ECC cycling (P = 0.01). Group mean MEP amplitudes were not significantly different between ECC and CON cycling at P0, t10, t20, and P30 and CON (at P > 0.05). Individual participant ratios of POutput and MEP amplitude showed large variability across the two modes of cycling, as did changes in slope of stimulus-response curves. These results suggest that compared to ‘Pre’ values, group mean CSE is not significantly affected by low-moderate intensity leg cycling in both modes. However, POutput and CSE show wide inter-participant variability which has implications for individual neural responses to CON and ECC cycling and rates of adaptation to a novel (ECC) mode. The study of CSE should therefore be analysed for each participant individually in relation to relevant physiological variables and account for familiarisation to semi-recumbent ECC leg cycling.

Combined Patterns Of Physical Activity And Screen-Related Sedentary Behavior Among Chinese Adolescents And Their Correlations With Depression, Anxiety And Self-Injurious Behaviors

Background and purpose

There are increasing concern about independent associations between physical activity, screen-based sedentary behavior (SSB), and psychological problems, but only a few studies have attempted to explore combined patterns of physical activity and SSB in adolescents and their correlations with psychological problems. This study was aimed at identifying combined patterns of moderate-to-vigorous physical activity (MVPA) and SSB and examining the prevalence of different combined patterns and their correlations with depression, anxiety, and self-injurious behavior among Chinese adolescents.

Methods

Junior and senior high school students (N = 13,659; mean age 15.18±1.89) were recruited. Latent class analysis was conducted to identify combined patterns of MVPA and SSB. Associations between subgroups of MVPA and SSB and socio-demographic characteristics were assessed by logistic regression. Their correlation with depression, anxiety, and self-injurious behaviors was assessed by analysis of variance with analysis stratified by gender.

Results

Four latent classes were identified: high MVPA/low SSB group (64.7%), low MVPA/low SSB (26.7%), low MVPA/high SSB (4.8%), and low MVPA/moderate SSB (3.9%). Generally, the high MVPA/low SSB class was a relatively healthy group. The low MVPA/high SSB class was at risk of enduring depression, anxiety, and self-injurious behavior, with boys being more at risk than girls.

Conclusion

Four latent subgroups of MVPA and SSB were identified in Chinese adolescents. The findings highlight the potential role of concurrent MVPA and SSB, with gender-specific characteristics in the primary prevention of adolescent depression, anxiety, and self-injurious behaviors.

Acute Low-Intensity Aerobic Exercise Modulates Intracortical Inhibitory and Excitatory Circuits in an Exercised and a Non-exercised Muscle in the Primary Motor Cortex

Recent studies have reported that acute aerobic exercise modulates intracortical excitability in the primary motor cortex (M1). However, whether acute low-intensity aerobic exercise can also modulate M1 intracortical excitability, particularly intracortical excitatory circuits, remains unclear. In addition, no previous studies have investigated the effect of acute aerobic exercise on short-latency afferent inhibition (SAI). The aim of this study was to investigate whether acute low-intensity aerobic exercise modulates intracortical circuits in the M1 hand and leg areas. Intracortical excitability of M1 (Experiments 1, 2) and spinal excitability (Experiment 3) were measured before and after acute low-intensity aerobic exercise. In Experiment 3, skin temperature was also measured throughout the experiment. Transcranial magnetic stimulation was applied over the M1 non-exercised hand and exercised leg areas in Experiments 1, 2, respectively. Participants performed 30 min of low-intensity pedaling exercise or rested while sitting on the ergometer. Short- and long-interval intracortical inhibition (SICI and LICI), and SAI were measured to assess M1 inhibitory circuits. Intracortical facilitation (ICF) and short-interval intracortical facilitation (SICF) were measured to assess M1 excitatory circuits. We found that acute low-intensity aerobic exercise decreased SICI and SAI in the M1 hand and leg areas. After exercise, ICF in the M1 hand area was lower than in the control experiment, but was not significantly different to baseline. The single motor-evoked potential, resting motor threshold, LICI, SICF, and spinal excitability did not change following exercise. In conclusion, acute low-intensity pedaling modulates M1 intracortical circuits of both exercised and non-exercised areas, without affecting corticospinal and spinal excitability.

Modulation of inhibitory function in the primary somatosensory cortex and temporal discrimination threshold induced by acute aerobic exercise

Acute aerobic exercise beneficially affects brain function. The effect of acute aerobic exercise on the inhibitory mechanism of the primary somatosensory cortex (S1) and somatosensory function remains unclear. We investigated whether acute aerobic exercise modulates S1 inhibitory function and somatosensory function. In Experiment 1, we measured somatosensory evoked potentials (SEP) and paired-pulse inhibition (PPI) in 15 healthy right-handed participants. The right median nerve underwent electrical stimulation (ES). Interstimulus intervals were 5 ms, 30 ms, and 100 ms. In Experiment 2, we assessed the somatosensory function by using a somatosensory temporal discrimination task. Single or paired ES was applied to the distal phalanx of the right index finger. Both the experiments involved three sessions: 20 min of moderate-intensity exercise, 30 min of low-intensity exercise, and 30 min of seated rest. Before and after each session, PPI and somatosensory temporal discrimination task performance were measured. The N20 latency was significantly shortened immediately after moderate exercise. The SEP amplitude was not modulated in any session. The PPI at 30 ms (PPI_30ms) significantly decreased 20 min after moderate exercise, whereas the PPI at 5 ms (PPI_5ms) and PPI at 100 ms (PPI_100ms) did not change. The 50% and 75% thresholds and reaction time did not improve in any session. We found negative relationships between the change in PPI_5ms and the change in the 75% threshold under low-intensity exercise condition. Thus, acute aerobic exercise modulated S1 inhibitory function depending on exercise intensity. The exercise-induced change in PPI was associated with the change in temporal discrimination.

Corticospinal excitability changes following downhill and uphill walking

Locomotor exercise may induce corticospinal excitability and/or cortical inhibition change in the knee extensors. This study investigated whether the mode of muscle contraction involved during a locomotor exercise modulates corticospinal and intracortical responsiveness. Eleven subjects performed two 45-min treadmill walking exercises in an uphill (+ 15%) or a downhill (- 15%) condition matched for speed. Maximal voluntary isometric torque (MVIC), voluntary activation level (VAL), doublet (Dt) twitch torque, and M-wave area of the knee extensors were assessed before and after exercise. At the same time-points, motor-evoked potential (MEP), cortical silent period (CSP), and short-interval cortical inhibition (SICI) were recorded in the vastus lateralis (VL) and rectus femoris (RF) muscles. After exercise, uphill and downhill conditions induced a similar loss in MVIC torque (- 9%; p < 0.001), reduction in VAL (- 7%; p < 0.001), and in M-wave area in the VL muscle (- 8%; p < 0.001). Dt twitch torque decreased only after the downhill exercise (- 11%; p < 0.001). MEP area of the VL muscle increased after the downhill condition (p = 0.007), with no change after the uphill condition. MEP area of the RF muscle remained stable after exercises. CSP and SICI did not change in the two conditions for both muscles. Downhill walking induces an increase in MEP area of the VL muscle, with no change of the CSP duration or SICI ratio. The eccentric mode of muscle contraction during a locomotor exercise can modulate specifically corticospinal excitability in the knee extensors.

A short bout of high-intensity exercise alters ipsilesional motor cortical excitability post-stroke

Background: Acute exercise can increase motor cortical excitability and enhance motor learning in healthy individuals, an effect known as exercise priming. Whether it has the same effects in people with stroke is unclear. Objectives: The objective of this study was to investigate whether a short, clinically-feasible high-intensity exercise protocol can increase motor cortical excitability in non-exercised muscles of chronic stroke survivors. Methods: Thirteen participants with chronic, unilateral stroke participated in two sessions, at least one week apart, in a crossover design. In each session, they underwent either high-intensity lower extremity exercise or quiet rest. Motor cortical excitability of the extensor carpi radialis muscles was measured bilaterally with transcranial magnetic stimulation before and immediately after either exercise or rest. Motor cortical excitability changes (post-exercise or rest measures normalized to pre-test measures) were compared between exercise vs. rest conditions. Results: All participants were able to reach the target high-intensity exercise level. Blood lactate levels increased significantly after exercise (p < .001, d = 2.85). Resting motor evoked potentials from the lesioned hemisphere increased after exercise (mean 1.66; 95% CI: 1.19, 2.13) compared to the rest condition (mean 1.23; 95% CI: 0.64, 1.82), p = .046, d = 2.76, but this was not the case for the non-lesioned hemisphere (p = .406, d = 0.25). Conclusions: High-intensity exercise can increase lesioned hemisphere motor cortical excitability in a non-exercised muscle post-stroke. Our short and clinically-advantageous exercise protocol shows promise as a potential priming method in stroke rehabilitation.

Redundancy Among Parameters Describing the Input-Output Relation of Motor Evoked Potentials in Healthy Subjects and Stroke Patients

Background: Transcranial magnetic stimulation (TMS) is widely used to probe corticospinal excitability through Motor Evoked Potential (MEP) amplitude measurements. The input-output (I/O) curve is a sigmoid-shaped relation between the MEP amplitude at incremented TMS intensities. The aim of this study was to examine the relationships between seven parameters derived from the sigmoid function.

Methods: Principal Component Analysis and Spearman's rank correlation matrices were used to determine if the seven I/O curve parameters capture similar or, conversely, different aspects of the corticospinal excitability in 24 healthy subjects and 40 stroke survivors with a hand motor impairment.

Results: Maximum amplitude (MEP_max), peak slope, area under the I/O curve (AUC), and MEP amplitude recorded at 140% of the resting motor threshold showed strong linear relationships with each other (ρ > 0.72, p < 0.001). Results were found to be similar in healthy subjects and in both hemispheres of stroke patients. Our results did not support an added benefit of sampling entire I/O curves in both healthy subjects and stroke patients, with the exception of S₅₀, the stimulus intensity needed to obtain half of MEP_max amplitude.

Conclusions: This demonstrates that MEP elicited at a single stimulus intensity allows to capture the same characteristics of the corticospinal excitability as measured by the AUC, MEP_max and the peak slope, which may be of interest in both clinical and research settings. However, it is still necessary to plot I/O curves if an effect or a difference is expected at S₅₀.

Building your best day for healthy brain aging-The neuroprotective effects of optimal time use

As the number of older people increases, so too does the prevalence of neurodegenerative disease. Worldwide, health organisations have identified the need for practical, affordable interventions to slow or delay the onset of neurodegenerative diseases such as dementia, for which there are multiple modifiable risk factors. The effects of various interventions on brain health has been investigated, including achieving sufficient physical activity, getting appropriate amounts and quality of sleep, and limiting sedentary behaviours. Few of these studies, though, have taken into account more than one lifestyle behaviour within a single study. Epidemiologists have recently initiated a paradigm shift to move away from studying the independent effects of each physical activity, sleep and sedentary behaviour, and towards an integrated 24-h time-use paradigm. Time is finite, and thus to increase time in one activity (for example physical activity), equal time must be taken away from other activities (sleep and sedentary behaviour). This 24-h time-use paradigm has begun to be used when studying obesity, adiposity and quality of life; however, to the authors' knowledge, it has not yet been adopted by cognitive neuroscientists for the study of cognition or brain function. This narrative review synthesises the evidence for the neurophysiological effects of physical activity, sleep and sedentary behaviour independently, with a particular focus on brain structure, function and neurodegenerative disease risk. Then, we conclude with a call to action, addressing the need for studies to move towards an integrated 24-h time-use paradigm.

Improving office workers' mental health and cognition: a 3-arm cluster randomized controlled trial targeting physical activity and sedentary behavior in multi-component interventions

BACKGROUND

Physically inactive and sedentary lifestyles are negatively related to both mental health and cognition. For office-workers, who spend two-thirds of their workday sitting, it is important to improve these lifestyles. The aim of this study is to assess the effectiveness of multi-component interventions, incorporating individual, environmental and organizational changes, to increase physical activity or reduce sedentary behavior among office-workers in order to improve mental health and cognition.

METHODS

a 3-arm, clustered randomized controlled trial (RCT) with waiting list control group amongst adult office-workers of two large Swedish companies. Cluster teams will be randomized into 6-month interventions or to a passive waiting list control group which will receive the allocated intervention with a 6-month delay. Two multicomponent interventions will be studied of which one focuses on improving physical activity and the other on reducing sedentary behavior. Both interventions include 5 sessions of motivational counselling. In the physical activity intervention persons also get access to a gym and team leaders will organize lunch walks and encourage to exercise. In the sedentary behavior intervention standing- and walking meetings will be implemented and team leaders will encourage to reduce sitting. The recruitment target is 110 office-workers per arm (330 in total). Measurements will be repeated every 6 months for a total intended duration of 24 months. Proximal main outcomes are physical activity measured with accelerometers and sedentary behavior with inclinometers. Distal outcomes are self-reported mental health and a cognition test battery. Additional outcomes will include cardiovascular fitness, body composition, sleep, self-reported physical activity and sedentary behavior, other health habits, physical health, and working mechanisms from blood samples and questionnaires.

DISCUSSION

This cluster RCT will contribute to the currently available evidence by comparing the effectiveness of multi-component interventions targeting physical activity or sedentary behavior with the end goal of improving mental health and cognition. This study is strong in its cluster randomized design, numerous objective outcome measures and long-term follow-up. The exact content of the interventions has been defined by combining theory with results from a larger research project as well as having a continuous dialogue with the involved companies.

TRIAL REGISTRATION

ISRCTN92968402 .

Intensity of acute aerobic exercise but not aerobic fitness impacts on corticospinal excitability

Aerobic exercise (AE) modulates cortical excitability. It can alter both corticospinal excitability and intra-cortical networks, which has implications for its use as a tool to facilitate processes such as motor learning, where increased levels of excitability are conducive to the induction of neural plasticity. Little is known about how different intensities of AE modulate cortical excitability or how individual-level characteristics impact on it. Therefore, we investigated whether AE intensities, lower than those previously employed, would be effective in increasing cortical excitability. We also examined whether the aerobic fitness of individual participants was related to the magnitude of change in AE-induced cortical excitability. In both experiments we employed transcranial magnetic stimulation to probe corticospinal excitability before and after AE. We show that 20 min of continuous moderate- (40% and 50% of heart rate reserve, HRR), but not low- (30% HRR) intensity AE was effective at increasing corticospinal excitability. We also found that while we observed increased corticospinal excitability following 20 min of continuous moderate-intensity (50% HRR) AE, aerobic fitness was not related to the magnitude of change. Our results suggest that there is a lower bound intensity of AE that is effective at driving changes in cortical excitability, and that while individual-level characteristics are important predictors of response to AE, aerobic fitness is not. Overall these findings have implication for the way that AE is used to facilitate processes such as motor learning, where increased levels of cortical excitability and plasticity are favourable.

Acute Exercise as an Intervention to Trigger Motor Performance and EEG Beta Activity in Older Adults

Acute bouts of exercise have been shown to improve fine motor control performance and to facilitate motor memory consolidation processes in young adults. Exercise effects might be reflected in EEG task-related power (TRPow) decreases in the beta band (13-30 Hz) as an indicator of active motor processing. This study aimed to investigate those effects in healthy older adults. Thirty-eight participants (65-74 years of age) were assigned to an experimental (EG, acute exercise) or a control group (CG, rest). Fine motor control was assessed using a precision grip force modulation (FM) task. FM performance and EEG were measured at (1) baseline (immediately before acute exercise/rest), (2) during practice sessions immediately after, (3) 30 minutes, and (4) 24 hours (FM only) after exercise/rest. A marginal significant effect indicated that EG revealed more improvement in fine motor performance immediately after exercise than CG after resting. EG showed enhanced consolidation of short-term and long-term motor memory, whereas CG revealed only a tendency for short-term motor memory consolidation. Stronger TRPow decreases were revealed immediately after exercise in the contralateral frontal brain area as compared to the control condition. This finding indicates that acute exercise might enhance cortical activation and thus, improves fine motor control by enabling healthy older adults to better utilize existing frontal brain capacities during fine motor control tasks after exercise. Furthermore, acute exercise can act as a possible intervention to enhance motor memory consolidation in older adults.

Exercise intensity affects acute neurotrophic and neurophysiological responses poststroke

Aerobic exercise may acutely prime the brain to be more responsive to rehabilitation, thus facilitating neurologic recovery from conditions like stroke. This aerobic priming effect could occur through multiple mechanisms, including upregulation of circulating brain-derived neurotrophic factor (BDNF), increased corticospinal excitability, and decreased intracortical inhibition. However, optimal exercise parameters for targeting these mechanisms are poorly understood. This study tested the effects of exercise intensity on acute BDNF and neurophysiological responses. Sixteen ambulatory persons >6 mo poststroke performed three different 20-min exercise protocols in random order, approximately 1 wk apart, including the following: 1) treadmill high-intensity interval training (HIT-treadmill); 2) seated-stepper HIT (HIT-stepper); and 3) treadmill moderate-intensity continuous exercise (MCT-treadmill). Serum BDNF and transcranial magnetic stimulation measures of paretic lower limb excitability and inhibition were assessed at multiple time points during each session. Compared with MCT-treadmill, HIT-treadmill elicited significantly greater acute increases in circulating BDNF and corticospinal excitability. HIT-stepper initially showed BDNF responses similar to HIT-treadmill but was no longer significantly different from MCT-treadmill after decreasing the intensity in reaction to two hypotensive events. Additional regression analyses showed that an intensity sufficient to accumulate blood lactate appeared to be important for eliciting BDNF responses, that the interval training approach may have facilitated the corticospinal excitability increases, and that the circulating BDNF response was (negatively) related to intracortical inhibition. These findings further elucidate neurologic mechanisms of aerobic exercise and inform selection of optimal exercise-dosing parameters for enhancing acute neurologic effects. NEW & NOTEWORTHY Acute exercise-related increases in circulating BDNF and corticospinal excitability are thought to prime the brain for learning. Our data suggest that these responses can be obtained among persons with stroke using short-interval treadmill high-intensity interval training, that a vigorous aerobic intensity sufficient to generate lactate accumulation is needed to increase BDNF, that interval training facilitates increases in paretic quadriceps corticospinal excitability, and that greater BDNF response is associated with lesser intracortical inhibition response.

The effect of energy-matched exercise intensity on brain-derived neurotrophic factor and motor learning

BACKGROUND

Pairing a bout of high-intensity exercise with motor task practice can enhance motor learning beyond task practice alone, which is thought, in part, to be facilitated by an exercise-related increase in brain-derived neurotrophic factor (BDNF). The purpose of the current study was to examine the effect of different exercise intensities on BDNF levels and motor learning while controlling for exercise-related energy expenditure.

METHODS

Forty-eight young, healthy participants were assigned to one of three groups: high-intensity exercise [High], low-intensity exercise [Low], or quiet rest [Rest]. The duration of the exercise bouts were individually adjusted so that each participant expended 200 kcals regardless of exercise intensity. BDNF was measured before and after exercise or rest. After exercise or rest, all participants practiced a 3-dimensional motor learning task, which involved reach movements made to sequentially presented targets. Retention was tested after 24-h. BDNF genotype was determined for each participant to explore its effects on BDNF and motor learning.

RESULTS

All participants equally improved performance, indicated by a reduction in time to complete the task. However, the kinematic profile used to control the reach movement differed by group. The Rest group travelled the shortest distance between the targets, the High group had higher reach speed (peak velocity), and the Low group had earlier peak velocities. The rise in BDNF post-exercise was not significant, regardless of exercise intensity, and the change in BDNF was not associated with motor learning. The BDNF response to exercise did not differ by genotype. However, performance differed between those with the polymorphism (Met carriers) and those without (Val/Val). Compared to the Val/Val genotype, Met carriers had faster response times throughout task practice, which was supported by higher reach speeds and earlier peak velocities.

CONCLUSION

Results indicated that both low and high-intensity exercise can alter the kinematic approach used to complete a reach task, and these changes appear unrelated to a change in BDNF. In addition, the BDNF genotype did not influence BDNF concentration, but it did have an effect on motor performance of a sequential target reach task.