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Balbim GM, Boa Sorte Silva NC, Ten Brinke L, Falck RS, Hortobágyi T, Granacher U, Erickson KI, Hernández-Gamboa R, Liu-Ambrose T. Aerobic exercise training effects on hippocampal volume in healthy older individuals: a meta-analysis of randomized controlled trials. GeroScience 2024; 46:2755-2764. [PMID: 37943486 PMCID: PMC10828456 DOI: 10.1007/s11357-023-00971-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Accepted: 10/04/2023] [Indexed: 11/10/2023] Open
Abstract
We conducted a meta-analysis of randomized controlled trials investigating the effects of aerobic exercise training (AET) lasting ≥ 4 weeks on hippocampal volume and cardiorespiratory fitness (CRF) in cognitively unimpaired, healthy older individuals. Random-effects robust variance estimation models were used to test differences between AET and controls, while meta-regressions tested associations between CRF and hippocampal volume changes. We included eight studies (N = 554) delivering fully supervised AET for 3 to 12 months (M = 7.8, SD = 4.5) with an average AET volume of 129.85 min/week (SD = 45.5) at moderate-to-vigorous intensity. There were no significant effects of AET on hippocampal volume (SMD = 0.10, 95% CI - 0.01 to 0.21, p = 0.073), but AET moderately improved CRF (SMD = 0.30, 95% CI 0.12 to 0.48, p = 0.005). Improvement in CRF was not associated with changes in hippocampal volume (bSE = 0.05, SE = 0.51, p = 0.923). From the limited number of studies, AET does not seem to impact hippocampal volume in cognitively unimpaired, healthy older individuals. Notable methodological limitations across investigations might mask the lack of effects.
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Affiliation(s)
- Guilherme Moraes Balbim
- Djavad Mowafaghian Centre for Brain Health, Faculty of Medicine, University of British Columbia, Vancouver, Canada
- Department of Physical Therapy, Faculty of Medicine, University of British Columbia, Vancouver, Canada
- Centre for Aging SMART at Vancouver Coastal Health, Vancouver Coastal Health Research Institute, Vancouver, Canada
| | - Nárlon Cássio Boa Sorte Silva
- Djavad Mowafaghian Centre for Brain Health, Faculty of Medicine, University of British Columbia, Vancouver, Canada
- Department of Physical Therapy, Faculty of Medicine, University of British Columbia, Vancouver, Canada
- Centre for Aging SMART at Vancouver Coastal Health, Vancouver Coastal Health Research Institute, Vancouver, Canada
| | - Lisanne Ten Brinke
- Djavad Mowafaghian Centre for Brain Health, Faculty of Medicine, University of British Columbia, Vancouver, Canada
- Department of Physical Therapy, Faculty of Medicine, University of British Columbia, Vancouver, Canada
- Centre for Aging SMART at Vancouver Coastal Health, Vancouver Coastal Health Research Institute, Vancouver, Canada
| | - Ryan S Falck
- Djavad Mowafaghian Centre for Brain Health, Faculty of Medicine, University of British Columbia, Vancouver, Canada
- Department of Physical Therapy, Faculty of Medicine, University of British Columbia, Vancouver, Canada
- Centre for Aging SMART at Vancouver Coastal Health, Vancouver Coastal Health Research Institute, Vancouver, Canada
- School of Biomedical Engineering, University of British Columbia, Vancouver, Canada
| | - Tibor Hortobágyi
- Center for Human Movement Sciences, University of Groningen Medical Center, Groningen, the Netherlands
- Department of Kinesiology, Hungarian University of Sports Science, Budapest, Hungary
- Department of Sport Biology, Institute of Sport Sciences and Physical Education, University of Pécs, Pécs, Hungary
- Department of Neurology, Somogy County Kaposi Mór Teaching Hospital, Kaposvár, Hungary
| | - Urs Granacher
- Department of Sport and Sport Science, Exercise and Human Movement Science, University of Freiburg, Freiburg, Germany
| | - Kirk I Erickson
- AdventHealth Research Institute, Neuroscience, Orlando, USA
- Department of Psychology, University of Pittsburgh, Pittsburgh, USA
| | - Rebeca Hernández-Gamboa
- Djavad Mowafaghian Centre for Brain Health, Faculty of Medicine, University of British Columbia, Vancouver, Canada
- Department of Physical Therapy, Faculty of Medicine, University of British Columbia, Vancouver, Canada
- Centre for Aging SMART at Vancouver Coastal Health, Vancouver Coastal Health Research Institute, Vancouver, Canada
| | - Teresa Liu-Ambrose
- Djavad Mowafaghian Centre for Brain Health, Faculty of Medicine, University of British Columbia, Vancouver, Canada.
- Department of Physical Therapy, Faculty of Medicine, University of British Columbia, Vancouver, Canada.
- Centre for Aging SMART at Vancouver Coastal Health, Vancouver Coastal Health Research Institute, Vancouver, Canada.
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Roig-Coll F, Castells-Sánchez A, Monté-Rubio G, Dacosta-Aguayo R, Lamonja-Vicente N, Torán-Monserrat P, Pere G, García-Molina A, Tormos JM, Alzamora MT, Stavros D, Sánchez-Ceron M, Via M, Erickson KI, Mataró M. Changes in cardiovascular health and white matter integrity with aerobic exercise, cognitive and combined training in physically inactive healthy late-middle-aged adults: the "Projecte Moviment" randomized controlled trial. Eur J Appl Physiol 2024; 124:909-924. [PMID: 37768344 PMCID: PMC10879245 DOI: 10.1007/s00421-023-05319-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Accepted: 08/31/2023] [Indexed: 09/29/2023]
Abstract
INTRODUCTION This is a 12-weeks randomized controlled trial examining the effects of aerobic exercise (AE), computerized cognitive training (CCT) and their combination (COMB). We aim to investigate their impact on cardiovascular health and white matter (WM) integrity and how they contribute to the cognitive benefits. METHODS 109 participants were recruited and 82 (62% female; age = 58.38 ± 5.47) finished the intervention with > 80% adherence. We report changes in cardiovascular risk factors and WM integrity (fractional anisotropy (FA); mean diffusivity (MD)), how they might be related to changes in physical activity, age and sex, and their potential role as mediators in cognitive improvements. RESULTS A decrease in BMI (SMD = - 0.32, p = 0.039), waist circumference (SMD = - 0.42, p = 0.003) and diastolic blood pressure (DBP) (SMD = - 0.42, p = 0.006) in the AE group and a decrease in BMI (SMD = - 0.34, p = 0.031) and DBP (SMD = - 0.32, p = 0.034) in the COMB group compared to the waitlist control group was observed. We also found decreased global MD in the CCT group (SMD = - 0.34; p = 0.032) and significant intervention-related changes in FA and MD in the frontal and temporal lobes in the COMB group. CONCLUSIONS We found changes in anthropometric measures that suggest initial benefits on cardiovascular health after only 12 weeks of AE and changes in WM microstructure in the CCT and COMB groups. These results add evidence of the clinical relevance of lifestyle interventions and the potential benefits when combining them. CLINICAL TRIAL REGISTRATION ClinicalTrials.gov NCT031123900.
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Affiliation(s)
- Francesca Roig-Coll
- Department of Clinical Psychology and Psychobiology, University of Barcelona, Passeig Vall d'Hebron 171, 08035, Barcelona, Spain
- Institut de Neurociències, University of Barcelona, Barcelona, Spain
| | - Alba Castells-Sánchez
- Department of Clinical Psychology and Psychobiology, University of Barcelona, Passeig Vall d'Hebron 171, 08035, Barcelona, Spain
- Institut de Neurociències, University of Barcelona, Barcelona, Spain
| | - Gemma Monté-Rubio
- Institut de Neurociències, University of Barcelona, Barcelona, Spain
- Medical Psychology Unit, Department of Medicine, University of Barcelona, Barcelona, Catalonia, Spain
- Centre de Medicina Comparativa i Bioimatge (CMCiB), Institut d'Investigació en Ciències de la Salut Germans Trias I Pujol (IGTP), Badalona, Spain
| | - Rosalía Dacosta-Aguayo
- Department of Clinical Psychology and Psychobiology, University of Barcelona, Passeig Vall d'Hebron 171, 08035, Barcelona, Spain
- Unitat de Suport a la Recerca Metropolitana Nord, Fundació Institut Universitari per a la Recerca a l'Atenció Primària de Salut Jordi Gol i Gurina, Mataró, Spain
- Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol (IGTP), Badalona, Spain
| | - Noemí Lamonja-Vicente
- Department of Clinical Psychology and Psychobiology, University of Barcelona, Passeig Vall d'Hebron 171, 08035, Barcelona, Spain
- Institut de Neurociències, University of Barcelona, Barcelona, Spain
- Unitat de Suport a la Recerca Metropolitana Nord, Fundació Institut Universitari per a la Recerca a l'Atenció Primària de Salut Jordi Gol i Gurina, Mataró, Spain
- Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain
| | - Pere Torán-Monserrat
- Unitat de Suport a la Recerca Metropolitana Nord, Fundació Institut Universitari per a la Recerca a l'Atenció Primària de Salut Jordi Gol i Gurina, Mataró, Spain
- Department of Medicine, Universitat de Girona, Girona, Spain
| | - Guillem Pere
- Unitat de Suport a la Recerca Metropolitana Nord, Fundació Institut Universitari per a la Recerca a l'Atenció Primària de Salut Jordi Gol i Gurina, Mataró, Spain
| | - Alberto García-Molina
- Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol (IGTP), Badalona, Spain
- Institut Guttmann, Institut Universitari de Neurorehabilitació, Universitat Autònoma de Barcelona, Badalona, Spain
| | - José Maria Tormos
- Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol (IGTP), Badalona, Spain
- Institut Guttmann, Institut Universitari de Neurorehabilitació, Universitat Autònoma de Barcelona, Badalona, Spain
| | - Maria Teresa Alzamora
- Unitat de Suport a la Recerca Metropolitana Nord, Fundació Institut Universitari per a la Recerca a l'Atenció Primària de Salut Jordi Gol i Gurina, Mataró, Spain
| | - Dimitriadis Stavros
- Department of Clinical Psychology and Psychobiology, University of Barcelona, Passeig Vall d'Hebron 171, 08035, Barcelona, Spain
- Institut de Neurociències, University of Barcelona, Barcelona, Spain
| | - Marta Sánchez-Ceron
- Institut de Diagnòstic per la Imatge, Hospital Germans Trias i Pujol, Badalona, Spain
| | - Marc Via
- Department of Clinical Psychology and Psychobiology, University of Barcelona, Passeig Vall d'Hebron 171, 08035, Barcelona, Spain
- Institut de Neurociències, University of Barcelona, Barcelona, Spain
- Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain
| | - Kirk I Erickson
- Department of Psychology, University of Pittsburgh, Pittsburgh, USA
- AdventHealth Research Institute, Orlando, FL, USA
- Department of Physical and Sports Education, Faculty of Sport Sciences, PROFITH "PROmoting FITness and Health Through Physical Activity" Research Group, Sport and Health University Research Institute (iMUDS), University of Granada, Granada, Spain
| | - Maria Mataró
- Department of Clinical Psychology and Psychobiology, University of Barcelona, Passeig Vall d'Hebron 171, 08035, Barcelona, Spain.
- Institut de Neurociències, University of Barcelona, Barcelona, Spain.
- Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain.
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Zhang M, Jia J, Yang Y, Zhang L, Wang X. Effects of exercise interventions on cognitive functions in healthy populations: A systematic review and meta-analysis. Ageing Res Rev 2023; 92:102116. [PMID: 37924980 DOI: 10.1016/j.arr.2023.102116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 10/17/2023] [Accepted: 10/31/2023] [Indexed: 11/06/2023]
Abstract
Chronic exercise intervention is a non-pharmacological therapy suggested to improve cognitive function in various populations. However, few meta-analyses have assessed the cognitive benefits associated with all FITT-VP variables (exercise frequency, intensity, bout duration time, type, volume or total intervention length, and progression) in healthy populations by age. Thus, this meta-analysis assessed the effects of each FITT-VP variable on cognitive function in healthy children, adults, and older adults. This study followed PRISMA guidelines. After searching PubMed and the Web of Science, we included 54 randomized controlled trials to examined the effects of FITT-VP variables on five cognitive domains: global cognition, executive function, memory, attention, and information processing. Moderation analyses assessed the effects by age and by each exercise variables. Exercise benefitted overall cognition and all subcognitive domains. Aerobic and resistance exercise showed the greatest benefits on global cognition and executive function respectively, whereas mind-body exercise benefitted memory. Among all populations, older adults showed the greatest benefits of exercise on global cognition, executive function, and memory compared with controls. Additional studies are needed to assess the effects of exercise on attention and information processing. This meta-analysis offers new insights on the relationships between cognition and FITT-VP exercise variables in healthy populations.
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Affiliation(s)
- Minggang Zhang
- School of Psychology, Shanghai University of Sport, Shanghai 200438, China
| | - Jiafeng Jia
- School of Psychology, Shanghai University of Sport, Shanghai 200438, China
| | - Yang Yang
- School of Psychology, Shanghai University of Sport, Shanghai 200438, China
| | - Lepu Zhang
- School of Psychology, Shanghai University of Sport, Shanghai 200438, China
| | - Xiaochun Wang
- School of Psychology, Shanghai University of Sport, Shanghai 200438, China.
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Lang L, Wang Y. Markov model combined with MR diffusion tensor imaging for predicting the onset of Alzheimer's disease. Open Life Sci 2023; 18:20220714. [PMID: 37954101 PMCID: PMC10638840 DOI: 10.1515/biol-2022-0714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 07/26/2023] [Accepted: 08/08/2023] [Indexed: 11/14/2023] Open
Abstract
Alzheimer's disease (AD) affects cognition, behavior, and memory of brain. It causes 60-80% of dementia cases. Cross-sectional imaging investigations of AD show that magnetic resonance (MR) with diffusion tensor image (DTI)-detected lesion locations in AD patients are heterogeneous and distributed across the imaging area. This study suggested that Markov model (MM) combined with MR-DTI (MM + MR-DTI) was offered as a method for predicting the onset of AD. In 120 subjects (normal controls [NCs], amnestic mild cognitive impairment [aMCI] patients, and AD patients) from a discovery dataset and 122 subjects (NCs, aMCI, and AD) from a replicated dataset, we used them to evaluate the white matter (WM) integrity and abnormalities. We did this by using automated fiber quantification, which allowed us to identify 20 central WM tracts. Point-wise alterations in WM tracts were shown using discovery and replication datasets. The statistical analysis revealed a substantial correlation between microstructural WM alterations and output in the patient groups and cognitive performance, suggesting that this may be a potential biomarker for AD. The MR-based classifier demonstrated the following performance levels for the basis classifiers, with DTI achieving the lowest performance. The following outcomes were seen in MM + MR-DTI using multimodal techniques when combining two modalities. Finally, a combination of every imaging method produced results with an accuracy of 98%, a specificity of 97%, and a sensitivity of 99%. In summary, DTI performs better when paired with structural MR, despite its relatively weak performance when used alone. These findings support the idea that WM modifications play a significant role in AD.
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Affiliation(s)
- Lili Lang
- Basic Medical College, Changzhi Medical College, Changzhi, Shanxi, 046000, China
| | - Ying Wang
- Endoscopic Chamber, Muling Town Forest District Hospital, Mudanjiang, Heilongjiang, 157513, China
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Oh J, Crockett RA, Hsu CL, Dao E, Tam R, Liu-Ambrose T. Resistance Training Maintains White Matter and Physical Function in Older Women with Cerebral Small Vessel Disease: An Exploratory Analysis of a Randomized Controlled Trial. J Alzheimers Dis Rep 2023; 7:627-639. [PMID: 37483319 PMCID: PMC10357123 DOI: 10.3233/adr-220113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Accepted: 05/17/2023] [Indexed: 07/25/2023] Open
Abstract
Background As the aging population grows, there is an increasing need to develop accessible interventions against risk factors for cognitive impairment and dementia, such as cerebral small vessel disease (CSVD). The progression of white matter hyperintensities (WMHs), a key hallmark of CSVD, can be slowed by resistance training (RT). We hypothesize RT preserves white matter integrity and that this preservation is associated with improved cognitive and physical function. Objective To determine if RT preserves regional white matter integrity and if any changes are associated with cognitive and physical outcomes. Methods Using magnetic resonance imaging data from a 12-month randomized controlled trial, we compared the effects of a twice-weekly 60-minute RT intervention versus active control on T1-weighted over T2-weighted ratio (T1w/T2w; a non-invasive proxy measure of white matter integrity) in a subset of study participants (N = 21 females, mean age = 69.7 years). We also examined the association between changes in T1w/T2w with two key outcomes of the parent study: (1) selective attention and conflict resolution, and (2) peak muscle power. Results Compared with an active control group, RT increased T1w/T2w in the external capsule (p = 0.024) and posterior thalamic radiations (p = 0.013) to a greater degree. Increased T1w/T2w in the external capsule was associated with an increase in peak muscle power (p = 0.043) in the RT group. Conclusion By maintaining white matter integrity, RT may be a promising intervention to counteract the pathological changes that accompany CSVD, while improving functional outcomes such as muscle power.
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Affiliation(s)
- Jean Oh
- Aging, Mobility, and Cognitive Health Laboratory, University of British Columbia, Vancouver, Canada
| | - Rachel A. Crockett
- Aging, Mobility, and Cognitive Health Laboratory, University of British Columbia, Vancouver, Canada
- Department of Neurology and Neurological Sciences, Stanford University School of Medicine, Stanford, CA, USA
- Djavad Mowafaghian Centre for Brain Health, Vancouver Coastal Health Research Institute, University of British Columbia, Vancouver, Canada
- Department of Physical Therapy, University of British Columbia, Vancouver, Canada
- Centre for SMART Aging at Vancouver Coastal Health, Vancouver Coastal Health Research Institute, Vancouver, Canada
| | - Chun-Liang Hsu
- Aging, Mobility, and Cognitive Health Laboratory, University of British Columbia, Vancouver, Canada
- Department of Rehabilitation Sciences, Hong Kong Polytechnic University, Hung Hom, Hong Kong
- Djavad Mowafaghian Centre for Brain Health, Vancouver Coastal Health Research Institute, University of British Columbia, Vancouver, Canada
- Department of Physical Therapy, University of British Columbia, Vancouver, Canada
- Centre for SMART Aging at Vancouver Coastal Health, Vancouver Coastal Health Research Institute, Vancouver, Canada
| | - Elizabeth Dao
- Djavad Mowafaghian Centre for Brain Health, Vancouver Coastal Health Research Institute, University of British Columbia, Vancouver, Canada
- Department of Radiology, University of British Columbia, Vancouver, Canada
- Centre for SMART Aging at Vancouver Coastal Health, Vancouver Coastal Health Research Institute, Vancouver, Canada
| | - Roger Tam
- Djavad Mowafaghian Centre for Brain Health, Vancouver Coastal Health Research Institute, University of British Columbia, Vancouver, Canada
- School of Biomedical Engineering, University of British Columbia, Vancouver, Canada
- Department of Radiology, University of British Columbia, Vancouver, Canada
- Centre for SMART Aging at Vancouver Coastal Health, Vancouver Coastal Health Research Institute, Vancouver, Canada
| | - Teresa Liu-Ambrose
- Aging, Mobility, and Cognitive Health Laboratory, University of British Columbia, Vancouver, Canada
- Djavad Mowafaghian Centre for Brain Health, Vancouver Coastal Health Research Institute, University of British Columbia, Vancouver, Canada
- Department of Physical Therapy, University of British Columbia, Vancouver, Canada
- Centre for SMART Aging at Vancouver Coastal Health, Vancouver Coastal Health Research Institute, Vancouver, Canada
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Chen FT, Soya H, Yassa MA, Li RH, Chu CH, Chen AG, Hung CL, Chang YK. Effects of exercise types on white matter microstructure in late midlife adults: Preliminary results from a diffusion tensor imaging study. Front Aging Neurosci 2022; 14:943992. [DOI: 10.3389/fnagi.2022.943992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2022] [Accepted: 10/17/2022] [Indexed: 11/21/2022] Open
Abstract
Higher aerobic fitness during late midlife is associated with higher white matter (WM) microstructure. Compared with individuals engaged in irregular exercise, those who engage in regular aerobic exercise show higher fractional anisotropy (FA), a diffusion tenor imaging (DTI) measure that provides an index of WM microstructural integrity. However, whether other types of exercise, such as Tai Chi, can also facilitate WM changes in adults during late midlife remains unknown. The present study compares two types of exercise, Tai Chi and walking, with a sedentary control group, in order to examine the effects of exercise on WM microstructure and determine the regional specificity of WM differences. Thirty-six healthy adults between the ages of 55 and 65 years participated in the study. Based on the participants’ exercise habits, they were allocated into three groups: Tai Chi, walking, or sedentary control. All participants were required to complete physical fitness measurements and completed magnetic reasoning imaging (MRI) scans. Our results revealed that the Tai Chi group exhibited a higher FA value in the left cerebral peduncle, compared to the sedentary control group. We also observed that both the Tai Chi and walking groups exhibited higher FA values in the right uncinate fasciculus and the left external capsule, in comparison to the sedentary control group. Increased FA values in these regions was positively correlated with higher levels of physical fitness measurements (i.e., peak oxygen uptake [VO2peak], muscular endurance/number of push-up, agility, power). These findings collectively suggest that regular exercise is associated with improved WM microstructural integrity, regardless of the exercise type, which could guide the development and application of future prevention and intervention strategies designed to address age-related cognitive impairments during late midlife.
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Pani J, Eikenes L, Reitlo LS, Stensvold D, Wisløff U, Håberg AK. Effects of a 5-Year Exercise Intervention on White Matter Microstructural Organization in Older Adults. A Generation 100 Substudy. Front Aging Neurosci 2022; 14:859383. [PMID: 35847676 PMCID: PMC9278017 DOI: 10.3389/fnagi.2022.859383] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Accepted: 05/25/2022] [Indexed: 12/13/2022] Open
Abstract
Aerobic fitness and exercise could preserve white matter (WM) integrity in older adults. This study investigated the effect on WM microstructural organization of 5 years of exercise intervention with either supervised moderate-intensity continuous training (MICT), high-intensity interval training (HIIT), or following the national physical activity guidelines. A total of 105 participants (70–77 years at baseline), participating in the randomized controlled trial Generation 100 Study, volunteered to take part in this longitudinal 3T magnetic resonance imaging (MRI) study. The HIIT group (n = 33) exercised for four intervals of 4 min at 90% of peak heart rate two times a week, the MICT group (n = 24) exercised continuously for 50 min at 70% peak heart rate two times a week, and the control group (n = 48) followed the national guidelines of ≥30 min of physical activity almost every day. At baseline and at 1-, 3-, and 5-year follow-ups, diffusion tensor imaging (DTI) scans were performed, cardiorespiratory fitness (CRF) was measured as peak oxygen uptake (VO2peak) with ergospirometry, and information on exercise habits was collected. There was no group*time or group effect on any of the DTI indices at any time point during the intervention. Across all groups, CRF was positively associated with fractional anisotropy (FA) and axial diffusivity (AxD) at the follow-ups, and the effect became smaller with time. Exercise intensity was associated with mean diffusivity (MD)/FA, with the greatest effect at 1-year and no effect at 5-year follow-up. There was an association between exercise duration and FA and radial diffusivity (RD) only after 1 year. Despite the lack of group*time interaction or group effect, both higher CRF and exercise intensity was associated with better WM microstructural organization throughout the intervention, but the effect became attenuated over time. Different aspects of exercising affected the WM metrics and WM tracts differently with the greatest and most overlapping effects in the corpus callosum. The current study indicates not only that high CRF and exercise intensity are associated with WM microstructural organization in aging but also that exercise’s positive effects on WM may decline with increasing age.
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Affiliation(s)
- Jasmine Pani
- Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway.,Department of Radiology and Nuclear Medicine, St Olav's University Hospital, Trondheim, Norway
| | - Live Eikenes
- Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - Line S Reitlo
- Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - Dorthe Stensvold
- Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - Ulrik Wisløff
- Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway.,School of Human Movement and Nutrition Sciences, Faculty of Health and Behavioural Sciences, The University of Queensland, Brisbane, QLD, Australia
| | - Asta Kristine Håberg
- Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway.,Department of Radiology and Nuclear Medicine, St Olav's University Hospital, Trondheim, Norway
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8
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Hortobágyi T, Vetrovsky T, Balbim GM, Sorte Silva NCB, Manca A, Deriu F, Kolmos M, Kruuse C, Liu-Ambrose T, Radák Z, Váczi M, Johansson H, Dos Santos PCR, Franzén E, Granacher U. The impact of aerobic and resistance training intensity on markers of neuroplasticity in health and disease. Ageing Res Rev 2022; 80:101698. [PMID: 35853549 DOI: 10.1016/j.arr.2022.101698] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 07/14/2022] [Accepted: 07/15/2022] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To determine the effects of low- vs. high-intensity aerobic and resistance training on motor and cognitive function, brain activation, brain structure, and neurochemical markers of neuroplasticity and the association thereof in healthy young and older adults and in patients with multiple sclerosis, Parkinson's disease, and stroke. DESIGN Systematic review and robust variance estimation meta-analysis with meta-regression. DATA SOURCES Systematic search of MEDLINE, Web of Science, and CINAHL databases. RESULTS Fifty studies with 60 intervention arms and 2283 in-analyses participants were included. Due to the low number of studies, the three patient groups were combined and analyzed as a single group. Overall, low- (g=0.19, p = 0.024) and high-intensity exercise (g=0.40, p = 0.001) improved neuroplasticity. Exercise intensity scaled with neuroplasticity only in healthy young adults but not in healthy older adults or patient groups. Exercise-induced improvements in neuroplasticity were associated with changes in motor but not cognitive outcomes. CONCLUSION Exercise intensity is an important variable to dose and individualize the exercise stimulus for healthy young individuals but not necessarily for healthy older adults and neurological patients. This conclusion warrants caution because studies are needed that directly compare the effects of low- vs. high-intensity exercise on neuroplasticity to determine if such changes are mechanistically and incrementally linked to improved cognition and motor function.
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Affiliation(s)
- Tibor Hortobágyi
- Center for Human Movement Sciences, University of Groningen Medical Center, Groningen, the Netherlands; Somogy County Kaposi Mór Teaching Hospital, Kaposvár, Hungary; Department of Sport Biology, Institute of Sport Sciences and Physical Education, University of Pécs, Hungary; Division of Training and Movement Sciences, Research Focus Cognition Sciences, University of Potsdam, Potsdam, Germany; Hungarian University of Sports Science, Department of Kinesiology, Budapest, Hungary.
| | - Tomas Vetrovsky
- Faculty of Physical Education and Sport, Charles University, Prague, Czech Republic
| | - Guilherme Moraes Balbim
- Department of Physical Therapy, Faculty of Medicine, University of British Columbia, Vancouver, Canada; Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, Canada
| | - Nárlon Cássio Boa Sorte Silva
- Department of Physical Therapy, Faculty of Medicine, University of British Columbia, Vancouver, Canada; Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, Canada
| | - Andrea Manca
- Department of Biomedical Sciences, University of Sassari, Sassari, Italy
| | - Franca Deriu
- Department of Biomedical Sciences, University of Sassari, Sassari, Italy; Unit of Endocrinology, Nutritional and Metabolic Disorders, AOU Sassari, Sassari, Italy
| | - Mia Kolmos
- Neurovascular Research Unit, Department of Neurology, Herlev Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Christina Kruuse
- Neurovascular Research Unit, Department of Neurology, Herlev Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Teresa Liu-Ambrose
- Department of Physical Therapy, Faculty of Medicine, University of British Columbia, Vancouver, Canada; Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, Canada
| | - Zsolt Radák
- Research Center of Molecular Exercise Science, Hungarian University of Sport Science, Budapest, Hungary
| | - Márk Váczi
- Department of Sport Biology, Institute of Sport Sciences and Physical Education, University of Pécs, Hungary
| | - Hanna Johansson
- Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, Stockholm, Sweden; Women's Health and Allied Health Professionals Theme, Medical Unit Occupational Therapy & Physiotherapy, Karolinska University Hospital, Stockholm, Sweden
| | | | - Erika Franzén
- Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, Stockholm, Sweden; Women's Health and Allied Health Professionals Theme, Medical Unit Occupational Therapy & Physiotherapy, Karolinska University Hospital, Stockholm, Sweden
| | - Urs Granacher
- Division of Training and Movement Sciences, Research Focus Cognition Sciences, University of Potsdam, Potsdam, Germany
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9
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Maleki S, Hendrikse J, Chye Y, Caeyenberghs K, Coxon JP, Oldham S, Suo C, Yücel M. Associations of cardiorespiratory fitness and exercise with brain white matter in healthy adults: A systematic review and meta-analysis. Brain Imaging Behav 2022; 16:2402-2425. [PMID: 35773556 PMCID: PMC9581839 DOI: 10.1007/s11682-022-00693-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/31/2022] [Indexed: 11/25/2022]
Abstract
Magnetic resonance imaging (MRI) studies have revealed positive associations between brain structure and physical activity, cardiorespiratory fitness, and exercise (referred to here as PACE). While a considerable body of research has investigated the effects of PACE on grey matter, much less is known about effects on white matter (WM). Hence, we conducted a systematic review of peer-reviewed literature published prior to 5th July 2021 using online databases (PubMed and Scopus) and PRISMA guidelines to synthesise what is currently known about the relationship between PACE and WM in healthy adults. A total of 60 studies met inclusion criteria and were included in the review. Heterogeneity across studies was calculated using Qochran's q test, and publication bias was assessed for each meta-analysis using Begg and Mazumdar rank correlation test. A meta-regression was also conducted to explore factors contributing to any observed heterogeneity. Overall, we observed evidence of positive associations between PACE and global WM volume (effect size (Hedges's g) = 0.137, p < 0.001), global WM anomalies (effect size = 0.182, p < 0.001), and local microstructure integrity (i.e., corpus callosum: effect size = 0.345, p < 0.001, and anterior limb of internal capsule: effect size = 0.198, p < 0.001). These findings suggest that higher levels of PACE are associated with improved global WM volume and local integrity. We appraise the quality of evidence, and discuss the implications of these findings for the preservation of WM across the lifespan. We conclude by providing recommendations for future research in order to advance our understanding of the specific PACE parameters and neurobiological mechanisms underlying these effects.
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Affiliation(s)
- Suzan Maleki
- BrainPark, Turner Institute for Brain and Mental Health, School of Psychological Sciences and Monash Biomedical Imaging Facility, Monash University, 770 Blackburn RD, Clayton, VIC, 3168, Australia
| | - Joshua Hendrikse
- Movement and Exercise Neuroscience Laboratory, Turner Institute for Brain and Mental Health, School of Psychological Sciences and Monash Biomedical Imaging Facility, Monash University, Clayton, Australia
| | - Yann Chye
- BrainPark, Turner Institute for Brain and Mental Health, School of Psychological Sciences and Monash Biomedical Imaging Facility, Monash University, 770 Blackburn RD, Clayton, VIC, 3168, Australia
| | - Karen Caeyenberghs
- Cognitive Neuroscience Unit, School of Psychology, Deakin University, Geelong, Australia
| | - James P Coxon
- Movement and Exercise Neuroscience Laboratory, Turner Institute for Brain and Mental Health, School of Psychological Sciences and Monash Biomedical Imaging Facility, Monash University, Clayton, Australia
| | - Stuart Oldham
- Neural Systems and Behaviour, Turner Institute for Brain and Mental Health, School of Psychological Sciences and Monash Biomedical Imaging Facility, Monash University, Clayton, Australia.,Developmental Imaging, Murdoch Children's Research Institute, Melbourne, Australia
| | - Chao Suo
- BrainPark, Turner Institute for Brain and Mental Health, School of Psychological Sciences and Monash Biomedical Imaging Facility, Monash University, 770 Blackburn RD, Clayton, VIC, 3168, Australia.
| | - Murat Yücel
- BrainPark, Turner Institute for Brain and Mental Health, School of Psychological Sciences and Monash Biomedical Imaging Facility, Monash University, 770 Blackburn RD, Clayton, VIC, 3168, Australia.
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10
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Castells-Sánchez A, Roig-Coll F, Dacosta-Aguayo R, Lamonja-Vicente N, Torán-Monserrat P, Pera G, García-Molina A, Tormos JM, Montero-Alía P, Heras-Tébar A, Soriano-Raya JJ, Cáceres C, Domènech S, Via M, Erickson KI, Mataró M. Molecular and Brain Volume Changes Following Aerobic Exercise, Cognitive and Combined Training in Physically Inactive Healthy Late-Middle-Aged Adults: The Projecte Moviment Randomized Controlled Trial. Front Hum Neurosci 2022; 16:854175. [PMID: 35529777 PMCID: PMC9067321 DOI: 10.3389/fnhum.2022.854175] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Accepted: 03/16/2022] [Indexed: 12/12/2022] Open
Abstract
Behavioral interventions have shown promising neuroprotective effects, but the cascade of molecular, brain and behavioral changes involved in these benefits remains poorly understood. Projecte Moviment is a 12-week (5 days per week—45 min per day) multi-domain, single-blind, proof-of-concept randomized controlled trial examining the cognitive effect and underlying mechanisms of an aerobic exercise (AE), computerized cognitive training (CCT) and a combined (COMB) groups compared to a waitlist control group. Adherence was > 80% for 82/109 participants recruited (62% female; age = 58.38 ± 5.47). In this study we report intervention-related changes in plasma biomarkers (BDNF, TNF-α, HGF, ICAM-1, SDF1-α) and structural-MRI (brain volume) and how they related to changes in physical activity and individual variables (age and sex) and their potential role as mediators in the cognitive changes. Our results show that although there were no significant changes in molecular biomarker concentrations in any intervention group, changes in ICAM-1 and SDF1-α were negatively associated with changes in physical activity outcomes in AE and COMB groups. Brain volume changes were found in the CCT showing a significant increase in precuneus volume. Sex moderated the brain volume change in the AE and COMB groups, suggesting that men may benefit more than women. Changes in molecular biomarkers and brain volumes did not significantly mediate the cognitive-related benefits found previously for any group. This study shows crucial initial molecular and brain volume changes related to lifestyle interventions at early stages and highlights the value of examining activity parameters, individual difference characteristics and using a multi-level analysis approach to address these questions.
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Affiliation(s)
- Alba Castells-Sánchez
- Department of Clinical Psychology and Psychobiology, University of Barcelona, Barcelona, Spain
- Institut de Neurociències, University of Barcelona, Barcelona, Spain
| | - Francesca Roig-Coll
- Department of Clinical Psychology and Psychobiology, University of Barcelona, Barcelona, Spain
- Institut de Neurociències, University of Barcelona, Barcelona, Spain
| | - Rosalía Dacosta-Aguayo
- Department of Clinical Psychology and Psychobiology, University of Barcelona, Barcelona, Spain
- Unitat de Suport a la Recerca Metropolitana Nord, Fundació Institut Universitari per a la Recerca a l’Atenció Primària de Salut Jordi Gol i Gurina, Mataró, Spain
- Institut d’Investigació en Ciències de la Salut Germans Trias i Pujol (IGTP), Badalona, Spain
- *Correspondence: Rosalía Dacosta-Aguayo,
| | - Noemí Lamonja-Vicente
- Department of Clinical Psychology and Psychobiology, University of Barcelona, Barcelona, Spain
- Institut de Neurociències, University of Barcelona, Barcelona, Spain
- Unitat de Suport a la Recerca Metropolitana Nord, Fundació Institut Universitari per a la Recerca a l’Atenció Primària de Salut Jordi Gol i Gurina, Mataró, Spain
- Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain
| | - Pere Torán-Monserrat
- Unitat de Suport a la Recerca Metropolitana Nord, Fundació Institut Universitari per a la Recerca a l’Atenció Primària de Salut Jordi Gol i Gurina, Mataró, Spain
- Department of Medicine, Universitat de Girona, Girona, Spain
| | - Guillem Pera
- Unitat de Suport a la Recerca Metropolitana Nord, Fundació Institut Universitari per a la Recerca a l’Atenció Primària de Salut Jordi Gol i Gurina, Mataró, Spain
| | - Alberto García-Molina
- Institut d’Investigació en Ciències de la Salut Germans Trias i Pujol (IGTP), Badalona, Spain
- Institut Guttmann, Institut Universitari de Neurorehabilitació, Universitat Autònoma de Barcelona, Badalona, Spain
| | - José Maria Tormos
- Institut d’Investigació en Ciències de la Salut Germans Trias i Pujol (IGTP), Badalona, Spain
- Institut Guttmann, Institut Universitari de Neurorehabilitació, Universitat Autònoma de Barcelona, Badalona, Spain
| | - Pilar Montero-Alía
- Unitat de Suport a la Recerca Metropolitana Nord, Fundació Institut Universitari per a la Recerca a l’Atenció Primària de Salut Jordi Gol i Gurina, Mataró, Spain
| | - Antonio Heras-Tébar
- Unitat de Suport a la Recerca Metropolitana Nord, Fundació Institut Universitari per a la Recerca a l’Atenció Primària de Salut Jordi Gol i Gurina, Mataró, Spain
| | - Juan José Soriano-Raya
- Department of Clinical Psychology and Psychobiology, University of Barcelona, Barcelona, Spain
- Institut de Neurociències, University of Barcelona, Barcelona, Spain
| | - Cynthia Cáceres
- Department of Neurosciences, Hospital Universitari Germans Trias i Pujol, Badalona, Spain
| | - Sira Domènech
- Institut de Diagnòstic per la Imatge, Hospital Germans Trias i Pujol, Badalona, Spain
| | - Marc Via
- Department of Clinical Psychology and Psychobiology, University of Barcelona, Barcelona, Spain
- Institut de Neurociències, University of Barcelona, Barcelona, Spain
- Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain
| | - Kirk I. Erickson
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, United States
- Discipline of Exercise Science, College of Science, Health, Engineering and Education, Murdoch University, Murdoch, WA, Australia
| | - Maria Mataró
- Department of Clinical Psychology and Psychobiology, University of Barcelona, Barcelona, Spain
- Institut de Neurociències, University of Barcelona, Barcelona, Spain
- Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain
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11
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Comparing the effect of cognitive vs. exercise training on brain MRI outcomes in healthy older adults: A systematic review. Neurosci Biobehav Rev 2021; 128:511-533. [PMID: 34245760 DOI: 10.1016/j.neubiorev.2021.07.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Revised: 06/30/2021] [Accepted: 07/05/2021] [Indexed: 11/21/2022]
Abstract
Aging is associated with cognitive decline. Importantly cognition and cerebral health is enhanced with interventions like cognitive (CT) and exercise training (ET). However, effects of CT and ET interventions on brain magnetic resonance imaging outcomes have never been compared systematically. Here, the primary objective was to critically and systematically compare CT to ET in healthy older adults on brain MRI outcomes. A total of 38 studies were included in the final review. Although results were mixed, patterns were identified: CT showed improvements in white matter microstructure, while ET demonstrated macrostructural enhancements, and both demonstrated changes to task-based BOLD signal changes. Importantly, beneficial effects for cognitive and cerebral outcomes were observed by almost all, regardless of intervention type. Overall, it is suggested that future work include more than one MRI outcome, and report all results including null. To better understand the MRI changes associated with CT or ET, more studies explicitly comparing interventions within the same domain (i.e. resistance vs. aerobic) and between domains (i.e. CT vs. ET) are needed.
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12
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Aghjayan SL, Lesnovskaya A, Esteban-Cornejo I, Peven JC, Stillman CM, Erickson KI. Aerobic exercise, cardiorespiratory fitness, and the human hippocampus. Hippocampus 2021; 31:817-844. [PMID: 34101305 PMCID: PMC8295234 DOI: 10.1002/hipo.23337] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Revised: 04/22/2021] [Accepted: 04/25/2021] [Indexed: 01/27/2023]
Abstract
The hippocampus is particularly susceptible to neurodegeneration. Physical activity, specifically increasing cardiorespiratory fitness via aerobic exercise, shows promise as a potential method for mitigating hippocampal decline in humans. Numerous studies have now investigated associations between the structure and function of the hippocampus and engagement in physical activity. Still, there remains continued debate and confusion about the relationship between physical activity and the human hippocampus. In this review, we describe the current state of the physical activity and exercise literature as it pertains to the structure and function of the human hippocampus, focusing on four magnetic resonance imaging measures: volume, diffusion tensor imaging, resting-state functional connectivity, and perfusion. We conclude that, despite significant heterogeneity in study methods, populations of interest, and scope, there are consistent positive findings, suggesting a promising role for physical activity in promoting hippocampal structure and function throughout the lifespan.
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Affiliation(s)
- Sarah L Aghjayan
- Department of Psychology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.,Center for the Neural Basis of Cognition, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Alina Lesnovskaya
- Department of Psychology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.,Center for the Neural Basis of Cognition, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Irene Esteban-Cornejo
- PROFITH "PROmoting FITness and Health Through Physical Activity" Research Group, Sport and Health University Research Institute (iMUDS), Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, Granada, Spain.,College of Science, Health, Engineering, and Education, Murdoch University, Perth, Western Australia
| | - Jamie C Peven
- Department of Psychology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.,Center for the Neural Basis of Cognition, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Chelsea M Stillman
- Department of Psychology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Kirk I Erickson
- Department of Psychology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.,Center for the Neural Basis of Cognition, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.,College of Science, Health, Engineering, and Education, Murdoch University, Perth, Western Australia
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13
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d'Arbeloff T, Elliott ML, Knodt AR, Sison M, Melzer TR, Ireland D, Ramrakha S, Poulton R, Caspi A, Moffitt TE, Hariri AR. Midlife Cardiovascular Fitness Is Reflected in the Brain's White Matter. Front Aging Neurosci 2021; 13:652575. [PMID: 33889085 PMCID: PMC8055854 DOI: 10.3389/fnagi.2021.652575] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Accepted: 03/05/2021] [Indexed: 12/18/2022] Open
Abstract
Disappointing results from clinical trials designed to delay structural brain decline and the accompanying increase in risk for dementia in older adults have precipitated a shift in testing promising interventions from late in life toward midlife before irreversible damage has accumulated. This shift, however, requires targeting midlife biomarkers that are associated with clinical changes manifesting only in late life. Here we explored possible links between one putative biomarker, distributed integrity of brain white matter, and two intervention targets, cardiovascular fitness and healthy lifestyle behaviors, in midlife. At age 45, fractional anisotropy (FA) derived from diffusion weighted MRI was used to estimate the microstructural integrity of distributed white matter tracts in a population-representative birth cohort. Age-45 cardiovascular fitness (VO2Max; N = 801) was estimated from heart rates obtained during submaximal exercise tests; age-45 healthy lifestyle behaviors were estimated using the Nyberg Health Index (N = 854). Ten-fold cross-validated elastic net predictive modeling revealed that estimated VO2Max was modestly associated with distributed FA. In contrast, there was no significant association between Nyberg Health Index scores and FA. Our findings suggest that cardiovascular fitness levels, but not healthy lifestyle behaviors, are associated with the distributed integrity of white matter in the brain in midlife. These patterns could help inform future clinical intervention research targeting ADRDs.
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Affiliation(s)
- Tracy d'Arbeloff
- Department of Psychology & Neuroscience, Duke University, Durham, NC, United States
| | - Maxwell L Elliott
- Department of Psychology & Neuroscience, Duke University, Durham, NC, United States
| | - Annchen R Knodt
- Department of Psychology & Neuroscience, Duke University, Durham, NC, United States
| | - Maria Sison
- Department of Psychology & Neuroscience, Duke University, Durham, NC, United States
| | - Tracy R Melzer
- New Zealand Brain Research Institute, Christchurch, New Zealand.,Department of Medicine, University of Otago, Christchurch, New Zealand
| | - David Ireland
- Dunedin Multidisciplinary Health and Development Research Unit, Department of Psychology, University of Otago, Dunedin, New Zealand
| | - Sandhya Ramrakha
- Dunedin Multidisciplinary Health and Development Research Unit, Department of Psychology, University of Otago, Dunedin, New Zealand
| | - Richie Poulton
- Dunedin Multidisciplinary Health and Development Research Unit, Department of Psychology, University of Otago, Dunedin, New Zealand
| | - Avshalom Caspi
- Department of Psychology & Neuroscience, Duke University, Durham, NC, United States.,Social, Genetic, & Developmental Psychiatry Research Centre, Institute of Psychiatry, Psychology, & Neuroscience, King's College London, London, United Kingdom.,Department of Psychiatry & Behavioral Sciences, Duke University School of Medicine, Durham, NC, United States.,Center for Genomic and Computational Biology, Duke University, Durham, NC, United States
| | - Terrie E Moffitt
- Department of Psychology & Neuroscience, Duke University, Durham, NC, United States.,Social, Genetic, & Developmental Psychiatry Research Centre, Institute of Psychiatry, Psychology, & Neuroscience, King's College London, London, United Kingdom.,Department of Psychiatry & Behavioral Sciences, Duke University School of Medicine, Durham, NC, United States.,Center for Genomic and Computational Biology, Duke University, Durham, NC, United States
| | - Ahmad R Hariri
- Department of Psychology & Neuroscience, Duke University, Durham, NC, United States
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