The effects of aerobic exercise on the structure and function of DMN-related brain regions: a systematic review

Tai Chi-Induced Exosomal LRP1 is Associated With Memory Function and Hippocampus Plasticity in aMCI Patients

OBJECTIVES

The study was designed to identify the potential peripheral processes of circulating exosome in response to Tai Chi (TC) exercise and the possibility of its loaded cargos in mediating the effects of TC training on cognitive function among older adults with amnestic mild cognitive impairment (aMCI).

DESIGN, SETTING, AND PARTICIPANTS

This was a multicenter randomized controlled trial. One hundred community-dwelling old adults with aMCI were randomly assigned (1:1) to experimental (n = 50) and control groups (n = 50).

INTERVENTION

The experimental group participated in TC exercise 5 times/week, with each session lasting 60 minutes for 12 weeks. Both experimental and control groups received health education every 4 weeks.

MEASUREMENTS

The primary outcome was global cognitive function. Neurocognitive assessments, MRI examination, and large-scale proteomics analysis of peripheric exosome were conducted at baseline and after 12-week training. Outcome assessors and statisticians were blinded to group allocation.

RESULTS

A total of 96 participants (96%) completed all outcome measurements. TC training improved global cognitive function (adjusted mean difference [MD] = 1.9, 95%CI 0.93-2.87, p <0.001) and memory (adjusted MD = 6.42, 95%CI 2.09-10.74, p = 0.004), increased right hippocampus volume (adjusted MD = 88.52, 95%CI 13.63-163.4, p = 0.021), and enhanced rest state functional connectivity (rsFC) between hippocampus and cuneus, which mediated the group effect on global cognitive function (bootstrapping CIs: [0.0208, 1.2826], [0.0689, 1.2211]) and verbal delay recall (bootstrapping CI: [0.0002, 0.6277]). Simultaneously, 24 differentially expressed exosomal proteins were detected in tandem mass tag-labelling proteomic analysis. Of which, the candidate protein low-density lipoprotein receptor-related protein 1 (LRP1) was further confirmed by parallel reaction monitoring and ELISA. Moreover, the up-regulated LRP1 was both positively associated with verbal delay recall and rsFC (left hippocampus-right cuneus).

CONCLUSION

TC promotes LRP1 release via exosome, which was associated with enhanced memory function and hippocampus plasticity in aMCI patients. Our findings provided an insight into potential therapeutic neurobiological targets focusing on peripheric exosome in respond to TC exercise.

Exercise and Schizophrenia

Schizophrenia is a complex mental disorder that affects millions of people worldwide and has a profound impact on various aspects of life, including physical activity. The relationship between schizophrenia and physical activity is an area of growing interest in medical and health research from a physical, mental, and psychosocial health perspective. Physical activity and structured exercise have been identified as promising interventions to improve physical and psychological health outcomes of people living with schizophrenia. This chapter provides a brief overview that explores various aspects of the relationship between physical activity, exercise, and schizophrenia. The impact of schizophrenia on human movement is discussed, along with an overview of physical activity and cardiorespiratory fitness levels in adults with schizophrenia. Additionally, the influence of exercise interventions on physical and psychological outcomes will be discussed, along with current physical activity recommendations for those living with schizophrenia.

Change in cardiorespiratory fitness and risk of depression, anxiety, and cerebrovascular disease

INTRODUCTION

High cardiorespiratory fitness (CRF) has been associated with a lower risk of depression, anxiety, and cerebrovascular disease. The aim was to explore CRF changes over time associated with these outcomes.

METHODS

This large-scale prospective cohort study, using data from Swedish population-wide registries and databases (during 1972-2020), included men (n=131,431), with measures of estimated CRF (estCRF) in late adolescence (maximal cycle test) and adulthood (sub-maximal cycle test) (mean years between 24.6, SD 8.8). The study explored how change in estCRF was associated with incident depression, anxiety, and cerebrovascular disease using Cox proportional hazards models. Analyses were performed in 2023.

RESULTS

Higher estCRF in late adolescence and adulthood were associated with a lower risk of incident depression, anxiety, and cerebrovascular disease later in life. For all three outcomes, an increase in estCRF (ml/min/kg and z-score) between the two time points was associated with a lower risk. Further, decreasing from moderate or high estCRF in adolescence to low estCRF in adulthood, compared to staying at a moderate or high level, was associated with a higher risk of depression and anxiety (HR:1.24 95%CI 1.07-1.45 and 1.25 95%CI 1.06-1.49, respectively). Conversely, increasing from moderate to high estCRF was associated with a lower risk of incident anxiety (HR:0.84 95%CI 0.71-0.99).

CONCLUSIONS

The findings indicate that there is a longitudinal association between negative change in estCRF and increased risk of depression, anxiety, and cerebrovascular disease later in life. Decreasing levels of estCRF could be a helpful indicator when identifying these disorders at a population level.

Effects of low-intensity home-based exercise on cognition in older persons with mild cognitive impairment: a direct comparison of aerobic versus resistance exercises using a randomized controlled trial design

Background

It has been reported that both aerobic exercise and resistance exercise can improve cognitive function in older people with mild cognitive impairment (MCI), but it is unclear which type of exercise has a higher impact on cognitive function. Additionally, low-intensity exercise is considered safe for the elderly and can be done at home. This study aimed to compare the effects of 3-month low-intensity home-based exercises, aerobic versus resistance exercises, on cognitive function in people with MCI.

Methods

This study was a single-blind randomized controlled trial conducted in a suburban community. Ninety eligible participants aged 60-80 years were randomly assigned into aerobic exercise, resistance exercise or control group (30 in each group). The aerobic and resistance exercise groups underwent 3 months of low-intensity exercise at home (35 min/day, 5 days/week). The control group performed their usual daily activities. The Montreal Cognitive Assessment Thai version (MoCA), Trail Making Test Part A and B (TMT-A, TMT-B), Stroop Color and Word Test (SCWT), forward and backward Digit Span Test (DST-F, DST-B) and Stick Design Test (SDT) were administered before training, 3-month after training and 3-month follow-up.

Results

All participants completed a 3-month exercise program, but during the follow-up, data were gathered from 28, 27, and 26 participants in the aerobic, resistance, and control groups, respectively. Both aerobic and resistance groups showed significant improvements in all outcome measures during posttraining and follow-up, except SDT, while there was no cognitive improvement in control group at posttraining and follow-up. Compared to those in the control group, the aerobic group had significant improvements in MoCA, TMT-A, TMT-B, and SCWT, while resistance group had significant improvements in MoCA and TMT-B at posttraining and follow-up. There were no differences in any outcome measures between aerobic and resistance groups, except SCWT, which was significantly greater in the aerobic group than in the resistance group posttraining.

Conclusion

Low-intensity exercise, whether aerobic or resistance training, was effective at improving cognitive function in older people with MCI, and the effects were sustained at the 3-month follow-up.Clinical trial registration:thaiclinicaltrials.org, TCTR20231110003.

Characterizing the Neurobiological Mechanisms of Action of Exercise and Cognitive-Behavioral Interventions for Rheumatoid Arthritis Fatigue: A Magnetic Resonance Imaging Brain Study

OBJECTIVE

Chronic fatigue is a major clinical unmet need among patients with rheumatoid arthritis (RA). Current therapies are limited to nonpharmacological interventions, such as personalized exercise programs (PEPs) and cognitive-behavioral approaches (CBAs); however, most patients still continue to report severe fatigue. To inform more effective therapies, we conducted a magnetic resonance imaging (MRI) brain study of PEPs and CBAs, nested within a randomized controlled trial (RCT), to identify their neurobiological mechanisms of fatigue reduction in RA.

METHODS

A subgroup of patients with RA (n = 90), participating in an RCT of PEPs and CBAs for fatigue, undertook a multimodal MRI brain scan following randomization to either usual care (UC) alone or in addition to PEPs and CBAs and again after the intervention (six months). Brain regional volumetric, functional, and structural connectivity indices were curated and then computed employing a causal analysis framework. The primary outcome was fatigue improvement (Chalder fatigue scale).

RESULTS

Several structural and functional connections were identified as mediators of fatigue improvement in both PEPs and CBAs compared to UC. PEPs had a more pronounced effect on functional connectivity than CBAs; however, structural connectivity between the left isthmus cingulate cortex (L-ICC) and left paracentral lobule (L-PCL) was shared, and the size of mediation effect ranked highly for both PEPs and CBAs (ßAverage = -0.46, SD 0.61; ßAverage = -0.32, SD 0.47, respectively).

CONCLUSION

The structural connection between the L-ICC and L-PCL appears to be a dominant mechanism for how both PEPs and CBAs reduce fatigue among patients with RA. This supports its potential as a substrate of fatigue neurobiology and a putative candidate for future targeting.

Hippocampal subfield plasticity is associated with improved spatial memory

Physical exercise studies are generally underrepresented in young adulthood. Seventeen subjects were randomized into an intervention group (24.2 ± 3.9 years; 3 trainings/week) and 10 subjects into a passive control group (23.7 ± 4.2 years), over a duration of 6 months. Every two months, performance diagnostics, computerized spatial memory tests, and 3 Tesla magnetic resonance imaging were conducted. Here we find that the intervention group, compared to controls, showed increased cardiorespiratory fitness, spatial memory performance and subregional hippocampal volumes over time. Time-by-condition interactions occurred in right cornu ammonis 4 body and (trend only) dentate gyrus, left hippocampal tail and left subiculum. Increases in spatial memory performance correlated with hippocampal body volume changes and, subregionally, with left subicular volume changes. In conclusion, findings support earlier reports of exercise-induced subregional hippocampal volume changes. Such exercise-related plasticity may not only be of interest for young adults with clinical disorders of hippocampal function, but also for sedentary normal cohorts.

Aerobic exercise promotes emotion regulation: a narrative review

Aerobic exercise improves the three stages of emotion regulation: perception, valuation and action. It reduces the perception of negative emotions, encourages individuals to reinterpret emotional situations in a positive or non-emotional manner, and enhances control over emotion expression behaviours. These effects are generated via increased prefrontal cortex activation, the strengthening of functional connections between the amygdala and several other brain regions, and the enhancement of the plasticity of key emotion regulation pathways and nodes, such as the uncinate fasciculus. The effect of aerobic exercise on emotion regulation is influenced by the exercise intensity and duration, and by individuals' exercise experience. Future research may explore the key neural basis of aerobic exercise's promotion of emotion regulation.

Integrating Lifestyle Factor Science into Neuropsychological Practice: A National Academy of Neuropsychology Education Paper

OBJECTIVE

The primary aim of this paper is to review evidence and clinical implications related to lifestyle activities associated with promoting brain and cognitive health. Our review targets four key lifestyle factors: physical activity and exercise, social engagement, cognitively stimulating activity, and consuming Mediterranean-style diets.

METHOD

We conducted a critical review of the lifestyle factor literature in the four domains listed earlier. We contextualize this literature review by translating findings, when possible, into evidence-based recommendations to consider when providing neuropsychological services.

RESULTS

There is significant current evidence supporting the role of physical activity and exercise, social engagement, cognitively stimulating activity, and consuming Mediterranean-style diets on positive brain and cognitive health outcomes. While some null findings are present in all four areas reviewed, the weight of the evidence supports the notion that engaging in these activities may promote brain and cognitive functioning.

CONCLUSIONS

Clinical neuropsychologists can have confidence in recommending engagement in physical activity, social activity, and cognitively stimulating activity, and adhering to a Mediterranean-style diet to promote brain and cognitive health. We discuss limitations in existing lifestyle factor research and future directions to enhance the existing evidence base, including additional research with historically underrepresented groups and individuals with neurological conditions.

The Stress Phenotyping Framework: A multidisciplinary biobehavioral approach for assessing and therapeutically targeting maladaptive stress physiology

Although dysregulated stress biology is becoming increasingly recognized as a key driver of lifelong disparities in chronic disease, we presently have no validated biomarkers of toxic stress physiology; no biological, behavioral, or cognitive treatments specifically focused on normalizing toxic stress processes; and no agreed-upon guidelines for treating stress in the clinic or evaluating the efficacy of interventions that seek to reduce toxic stress and improve human functioning. We address these critical issues by (a) systematically describing key systems and mechanisms that are dysregulated by stress; (b) summarizing indicators, biomarkers, and instruments for assessing stress response systems; and (c) highlighting therapeutic approaches that can be used to normalize stress-related biopsychosocial functioning. We also present a novel multidisciplinary Stress Phenotyping Framework that can bring stress researchers and clinicians one step closer to realizing the goal of using precision medicine-based approaches to prevent and treat stress-associated health problems.

Effects of Exercise on Structural and Functional Brain Patterns in Schizophrenia-Data From a Multicenter Randomized-Controlled Study

BACKGROUND AND HYPOTHESIS

Aerobic exercise interventions in people with schizophrenia have been demonstrated to improve clinical outcomes, but findings regarding the underlying neural mechanisms are limited and mainly focus on the hippocampal formation. Therefore, we conducted a global exploratory analysis of structural and functional neural adaptations after exercise and explored their clinical implications.

STUDY DESIGN

In this randomized controlled trial, structural and functional MRI data were available for 91 patients with schizophrenia who performed either aerobic exercise on a bicycle ergometer or underwent a flexibility, strengthening, and balance training as control group. We analyzed clinical and neuroimaging data before and after 6 months of regular exercise. Bayesian linear mixed models and Bayesian logistic regressions were calculated to evaluate effects of exercise on multiple neural outcomes and their potential clinical relevance.

STUDY RESULTS

Our results indicated that aerobic exercise in people with schizophrenia led to structural and functional adaptations mainly within the default-mode network, the cortico-striato-pallido-thalamo-cortical loop, and the cerebello-thalamo-cortical pathway. We further observed that volume increases in the right posterior cingulate gyrus as a central node of the default-mode network were linked to improvements in disorder severity.

CONCLUSIONS

These exploratory findings suggest a positive impact of aerobic exercise on 3 cerebral networks that are involved in the pathophysiology of schizophrenia.

CLINICAL TRIALS REGISTRATION

The underlying study of this manuscript was registered in the International Clinical Trials Database, ClinicalTrials.gov (NCT number: NCT03466112, https://clinicaltrials.gov/ct2/show/NCT03466112?term=NCT03466112&draw=2&rank=1) and in the German Clinical Trials Register (DRKS-ID: DRKS00009804).

Electroencephalography spectral coherence analysis during cycle ergometry in low- and high-tolerant individuals

The main objective of this study was to further understanding of the patterns of spectral connectivity during exercise in low- and high-tolerant individuals. Thirty-nine healthy individuals (i.e., 17 low- and 22 high-tolerant participants) took part in the present study. A state-of-the-art portable electroencephalography system was used to measure the brain's electrical activity during an incremental exercise test performed until the point of volitional exhaustion on a cycle ergometer. Spectral coherence was used to explore the patterns of connectivity in the frontal, central, and parietal regions of the brain. Physiological, perceptual, and affective responses were assessed throughout the exercise bout. The spontaneous eyeblink rate was also calculated prior to commencement and upon completion of the exercise trial as an indirect assessment of the dopaminergic system. The present findings indicate that high-tolerant individuals reported lower levels of perceived activation, especially during the preliminary stages of the exercise test. Participants in the high-tolerance group also reported greater levels of remembered pleasure upon completion of the exercise test. The data also revealed that high-tolerant individuals exhibited increased connectivity of theta waves between frontal, central, and parietal electrode sites and increased connectivity of beta waves, primarily within the parietal cortex. Correlational analysis indicated the possibility that low- and high-tolerant individuals make use of different neural networks to process and regulate their psychophysiological state during exercise-related situations. This strategy could potentially represent a conscious decision to downregulate affective arousal and facilitate the neural control of working muscles during situations of physical stress.

Functional Connectivity Between Default Mode and Ventral Attention Networks Mediates the Effects of Chronotype on Daily Physical Activity

Daily physical activity (dPA) is closely related to circadian rhythm and chronotype. The functional connectivity (FC) within or between the default mode (DMN) and ventral attention network (vAN) were associated with dPA and chronotype. DMN-vAN FC was investigated for its role in chronotype and dPA. 153 participants completed the reduced version of the Morningness-Eveningness Questionnaire (rMEQ), dPA was measured via actigraphy (5-day), and then resting-state fMRI scans were performed. rMEQ scores and steps recorded by the actigraphic devices (with each hour as the time window to calculate steps for five consecutive days per hour, subsequently yielding the maximum number of steps and its corresponding time, ie, SM and SMT) represent chronotype and dPA respectively. The results found that the rMEQ scores were significantly negatively correlated with SMT. The positive correlation between the rMEQ scores and the DMN-vAN FC was significant. There were also significant positive correlations between SMT and DMN-vAN FC. Further analysis revealed that DMN-vAN mediates the relationship between chronotype and SMT. The FC of DMN-vAN may be the underlying neural mechanism through which chronotype influences dPA. These findings could support the development of reasonable activity schedules or specific intervention programs to improve physical health.

Hippocampal Resting State Functional Connectivity Associated with Physical Activity in Periadolescent Children

Periadolescence is a neurodevelopmental period characterized by structural and functional brain changes that are associated with cognitive maturation. The development of the functional connectivity of the hippocampus contributes to cognitive maturation, especially memory processes. Notably, hippocampal development is influenced by lifestyle factors, including physical activity. Physical activity has been associated with individual variability in hippocampal functional connectivity. However, this relationship has not been characterized in a developmental cohort. In this study, we aimed to fill this gap by investigating the relationship between physical activity and the functional connectivity of the hippocampus in a cohort of periadolescents aged 8-13 years (N = 117). The participants completed a physical activity questionnaire, reporting the number of days per week they performed 60 min of physical activity; then, they completed a resting-state functional MRI scan. We observed that greater physical activity was significantly associated with differences in hippocampal functional connectivity in frontal and temporal regions. Greater physical activity was associated with decreased connectivity between the hippocampus and the right superior frontal gyrus and increased connectivity between the hippocampus and the left superior temporal sulcus. Capturing changes in hippocampal functional connectivity during key developmental periods may elucidate how lifestyle factors including physical activity influence brain network connectivity trajectories, cognitive development, and future disease risk.

Aerobic Training Increases Hippocampal Volume and Protects Cognitive Function for Type 2 Diabetes Patients with Normal Cognition

AIM

To evaluate the effects of aerobic training on hippocampal volume and cognitive function in patients with type 2 diabetes mellitus (T2DM) with normal cognition.

MATERIALS AND METHODS

One hundred patients with T2DM aged 60-75 years who met inclusion criteria were randomized into the aerobic training group (n=50) and control group (n=50). The aerobic training group received 1 year of aerobic training, while the control group maintained their lifestyle without additional exercise intervention. The primary outcomes were hippocampal volume measured by MRI and Mini-mental State Examination (MMSE) score or Montreal Cognitive Assessment scale (MoCA) scores.

RESULTS

Eighty-two participants completed the study (aerobic training group, n=40; control group, n=42). There was no significant difference between the two groups at baseline (P>0.05). After one year of moderate aerobic training, increase in total and right hippocampal volume in the aerobic training group were significantly higher than in the control group (P=0.027, P=0.043, respectively). In the aerobic group, total hippocampal volume significantly increased after the intervention compared with baseline (P=0.034). The between-group difference in the change of MMSE and MoCA scores was statistically significant (P=0.015, P=0.027, respectively). Logistic regression showed strong correlations between aerobic training and increase in total hippocampal volume (OR:1.091, [95%CI 0.969, 1.228], P=0.002), improvement of MMSE scores (OR:1.127, [95%CI 1.005, 1.263], P=0.041) or MoCA scores (OR:2.564, [95%CI 2.098.2.973], P=0.045).

CONCLUSIONS

One-year moderate aerobic training increased total and right hippocampal volume and protected cognitive function for T2DM patients with normal cognition. Early intervention focusing on cognition protection should be considered for T2DM patients in clinical settings.

Hippocampal, Whole Midbrain, Red Nucleus, and Ventral Tegmental Area Volumes Are Increased by Selective Breeding for High Voluntary Wheel-Running Behavior

Uncovering relationships between neuroanatomy, behavior, and evolution are important for understanding the factors that control brain function. Voluntary exercise is one key behavior that both affects, and may be affected by, neuroanatomical variation. Moreover, recent studies suggest an important role for physical activity in brain evolution. We used a unique and ongoing artificial selection model in which mice are bred for high voluntary wheel-running behavior, yielding four replicate lines of high runner (HR) mice that run ∼3-fold more revolutions per day than four replicate nonselected control (C) lines. Previous studies reported that, with body mass as a covariate, HR mice had heavier whole brains, non-cerebellar brains, and larger midbrains than C mice. We sampled mice from generation 66 and used high-resolution microscopy to test the hypothesis that HR mice have greater volumes and/or cell densities in nine key regions from either the midbrain or limbic system. In addition, half of the mice were given 10 weeks of wheel access from weaning, and we predicted that chronic exercise would increase the volumes of the examined brain regions via phenotypic plasticity. We replicated findings that both selective breeding and wheel access increased total brain mass, with no significant interaction between the two factors. In HR compared to C mice, adjusting for body mass, both the red nucleus (RN) of the midbrain and the hippocampus (HPC) were significantly larger, and the whole midbrain tended to be larger, with no effect of wheel access nor any interactions. Linetype and wheel access had an interactive effect on the volume of the periaqueductal gray (PAG), such that wheel access increased PAG volume in C mice but decreased volume in HR mice. Neither linetype nor wheel access affected volumes of the substantia nigra, ventral tegmental area, nucleus accumbens, ventral pallidum (VP), or basolateral amygdala. We found no main effect of either linetype or wheel access on neuronal densities (numbers of cells per unit area) for any of the regions examined. Taken together, our results suggest that the increased exercise phenotype of HR mice is related to increased RN and hippocampal volumes, but that chronic exercise alone does not produce such phenotypes.

Hippocampal Subfield Volumes in Amateur Marathon Runners

PURPOSE

Numerous studies have implicated the involvement of structure and function of the hippocampus in physical exercise, and the larger hippocampal volume is one of the relevant benefits reported in exercise. It remains to be determined how the different subfields of hippocampus respond to physical exercise.

METHODS

A 3D T1-weighted magnetic resonance imaging was acquired in 73 amateur marathon runners (AMR) and 52 healthy controls (HC) matched with age, sex, and education. The Montreal Cognitive Assessment, the Pittsburgh Sleep Quality Index (PSQI), and the Fatigue Severity Scale were assessed in all participants. We obtained hippocampal subfield volumes using FreeSurfer 6.0. We compared the volumes of the hippocampal subfield between the two groups and ascertained correlation between the significant subfield metrics and the significant behavioral measure in AMR group.

RESULTS

The AMR had significantly better sleep than HC, manifested as with lower score of PSQI. Sleep duration in AMR and HC was not significantly different from each other. In the AMR group, the left and right hippocampus, cornu ammonis 1 (CA1), CA4, granule cell and molecular layers of the dentate gyrus, molecular layer, left CA2-3, and left hippocampal-amygdaloid transition area volumes were significantly larger compared with those in the HC group. In AMR group, the correlations between the PSQI and the hippocampal subfield volumes were not significant. No correlations were found between hippocampal subfield volumes and sleep duration in AMR group.

CONCLUSIONS

We reported larger volumes of specific hippocampal subfields in AMR, which may provide a hippocampal volumetric reserve that protects against age-related hippocampal deterioration. These findings should be further investigated in longitudinal studies.

Move Your Body, Boost Your Brain: The Positive Impact of Physical Activity on Cognition across All Age Groups

While the physical improvements from exercise have been well documented over the years, the impact of physical activity on mental health has recently become an object of interest. Physical exercise improves cognition, particularly attention, memory, and executive functions. However, the mechanisms underlying these effects have yet to be fully understood. Consequently, we conducted a narrative literature review concerning the association between acute and chronic physical activity and cognition to provide an overview of exercise-induced benefits during the lifetime of a person. Most previous papers mainly reported exercise-related greater expression of neurotransmitter and neurotrophic factors. Recently, structural and functional magnetic resonance imaging techniques allowed for the detection of increased grey matter volumes for specific brain regions and substantial modifications in the default mode, frontoparietal, and dorsal attention networks following exercise. Here, we highlighted that physical activity induced significant changes in functional brain activation and cognitive performance in every age group and could counteract psychological disorders and neural decline. No particular age group gained better benefits from exercise, and a specific exercise type could generate better cognitive improvements for a selected target subject. Further research should develop appropriate intervention programs concerning age and comorbidity to achieve the most significant cognitive outcomes.

Combining exercise with cognitive training and vitamin D3 to improve functional brain connectivity (FBC) in older adults with mild cognitive impairment (MCI). Results from the SYNERGIC trial

Changes in functional brain connectivity (FBC) may indicate how lifestyle modifications can prevent the progression to dementia; FBC identifies areas that are spatially separate but temporally synchronized in their activation and is altered in those with mild cognitive impairment (MCI), a prodromal state between healthy cognitive aging and dementia. Participants with MCI were randomly assigned to one of five study arms. Three times per week for 20-weeks, participants performed 30-min of (control) cognitive training, followed by 60-min of (control) physical exercise. Additionally, a vitamin D₃ (10,000 IU/pill) or a placebo capsule was ingested three times per week for 20-weeks. Using the CONN toolbox, we measured FBC change (Post-Pre) across four statistical models that collapsed for and/or included some or all study arms. We conducted Pearson correlations between FBC change and changes in physical and cognitive functioning. Our sample included 120 participants (mean age: 73.89 ± 6.50). Compared to the pure control, physical exercise (model one; p-False Discovery Rate (FDR) < 0.01 & < 0.05) with cognitive training (model two; p-FDR =  < 0.001), and all three interventions combined (model four; p-FDR =  < 0.01) demonstrated an increase in FBC between regions of the Default-Mode Network (i.e., hippocampus and angular gyrus). After controlling for false discovery rate, there were no significant correlations between change in connectivity and change in cognitive or physical function. Physical exercise alone appears to be as efficacious as combined interventional strategies in altering FBC, but implications for behavioral outcomes remain unclear.

New principles, the benefits, and practices for fostering a physically active lifestyle

The modern environment has led to an increased risk and incidence of sedentary lifestyles. When physical activity (PA) becomes insufficient, pathophysiological pathways are invoked and the future risk for chronic diseases and premature mortality increases. As a consequence, since the 1970s governmental agencies and medical societies have published guidelines to promote PA. The 2018 Guidelines for Physical Activity for Americans contain important updated guidelines, but many of these guidelines are not yet sufficiently known by the public or health providers. In addition, to make use of these guidelines, they need to be integrated with optimal behavioral interventions. Accordingly, this narrative review critically assesses five tenets that stem from the 2018 Guidelines and illustrates how these tenets can be integrated with tools and techniques for motivating individuals to initiate and maintain a more physically active lifestyle. The first tenet indicates that there is no lower threshold of PA that must be obtained before health benefits begin to accrue. Second, it is no longer required that PA be obtained in bouts of 10 min or more to "count". Bouts of lesser duration also count. Pending further study, new accelerometry data suggest that vigorous intermittent PA of just 1-2 min may also benefit health, such as that acquired by stair climbing or carrying heavy groceries. This has led to a new concept of promoting "lifestyle physical activity". Third, excessive sitting is health damaging if it is not accompanied by sufficient daily life PA or accrues over long uninterrupted bouts. Fourth, it is essential to incorporate resistance exercises for optimal health and to promote successful aging. Fifth, a wealth of new evidence indicates that PA strongly protects and promotes all aspects of brain health and may improve cognition even after a single bout of exercise.

The effects of repetitive transcranial magnetic stimulation and aerobic exercise on cognition, balance and functional brain networks in patients with Alzheimer's disease

The purpose of this study was to investigate the effects of high-frequency repetitive Transcranial Magnetic Stimulation (rTMS) and aerobic exercises (AE) in addition to the pharmacological therapy (PT) in Alzheimer's Disease (AD). Twenty-seven patients with AD aged ≥ 60 years were included in the study and divided into 3 groups (rTMS, AE and control). All groups received PT. rTMS group (n = 10) received 20 Hz rTMS over dorsolateral prefrontal cortex (dlPFC) bilaterally and AE group (n = 9) received the structured moderate-intensity AE for 5 consecutive days/week over 2 weeks. Control group (n = 8) only received PT. Cognition, balance, mobility, quality of life (QoL), and resting state functional brain activity were evaluated one week before and one week after the interventions. (ClinicalTrials.gov ID:NCT05102045). Significant improvements were found in executive functions, behavior, and QoL in the rTMS group, in balance and mobility in the AE group, and in the visual memory and behavior in the control group (p < 0.05). Significant differences were found in the behavior in favor of the rTMS group, and balance in favor of the AE group (p < 0.05). There was a significant increase in activation on middle temporal gyrus, intra calcarine, central opercular cortex, superior parietal lobule, and paracingulate cortex in Default Mode Network (DMN) in the rTMS group (p < 0.05). High-frequency rTMS over bilateral dlPFC may improve executive functions and behavior and lead to increased activation in DMN, structured moderate-intensity AE may improve balance and mobility, and PT may improve memory and behaviour compared to pretreatment in AD.

Brief diesel exhaust exposure acutely impairs functional brain connectivity in humans: a randomized controlled crossover study

BACKGROUND

While it is known that exposure to traffic-related air pollution causes an enormous global toll on human health, neurobiological underpinnings therein remain elusive. The study addresses this gap in knowledge.

METHODS

We performed the first controlled human exposure study using functional MRI with an efficient order-randomized double-blind crossover study of diesel exhaust (DE) and control (filtered air; FA) in 25 healthy adults (14 males, 11 females; 19-49 years old; no withdrawals). Analyses were carried out using a mixed effects model in FLAME. Z (Gaussianised T/F) statistic images were thresholded non-parametrically using clusters determined by Z > 2.3 and a (corrected) cluster significance threshold of p = 0.05.

RESULTS

All 25 adults went through the exposures and functional MRI imaging were collected. Exposure to DE yielded a decrease in functional connectivity compared to exposure to FA, shown through the comparison of DE and FA in post-exposure measurement of functional connectivity.

CONCLUSION

We observed short-term pollution-attributable decrements in default mode network functional connectivity. Decrements in brain connectivity causes many detrimental effects to the human body so this finding should guide policy change in air pollution exposure regulation.

TRIAL REGISTRATION

University of British Columbia Clinical Research Ethics Board (# H12-03025), Vancouver Coastal Health Ethics Board (# V12-03025), and Health Canada's Research Ethics Board (# 2012-0040).

Exercise improves depression through positive modulation of brain-derived neurotrophic factor (BDNF). A review based on 100 manuscripts over 20 years

The aim of this review was to explore the relevant neurobiology and the association between peripheral levels of brain-derived neurotrophic factor (BDNF) and acute and short to long-term exercise regimes, as well as its relation to depression and antidepressant treatment. A 20-year literature search was conducted. The screening process resulted in 100 manuscripts. Antidepressants as well as acute exercise, particularly high-intensity, elevates BDNF in healthy humans and clinical populations, as evidenced from aerobic and resistance-based studies. Although exercise is increasingly recognised in the management of depression, acute and short-term exercise studies have failed to establish a relationship between the severity of depression and changes in peripheral BDNF. The latter rapidly returns to baseline, possibly indicating a quick re-uptake by the brain, aiding its neuroplasticity functions. The timescale of administration needed for the antidepressants to stimulate biochemical changes is longer than similar increases with acute exercise.

Randomized Controlled Trial of Social Ballroom Dancing and Treadmill Walking: Preliminary Findings on Executive Function and Neuroplasticity From Dementia-at-Risk Older Adults

This randomized controlled trial (NCT03475316) examined the relative efficacy of 6 months of social ballroom dancing and treadmill walking on a composite executive function score, generated from digit symbol substitution test, flanker interference, and walking while talking tasks. Brain activation during functional magnetic resonance imaging (fMRI) versions of these executive function tasks were secondary outcomes. Twenty-five dementia-at-risk older adults (memory impairment screen score of ≥3 to ≤6 and/or an Alzheimer's disease-8 Dementia Screening Interview of ≥1) were randomized in June 2019 to March 2020-16 completed the intervention before study termination due to the COVID-19 (eight in each group). Composite executive function scores improved post-intervention in both groups, but there was no evidence for between-group differences. Social dancing, however, generated greater improvements on digit symbol substitution test than treadmill walking. No intervention-related differences were observed in brain activation-although less hippocampal atrophy (tertiary) was observed following social dancing than treadmill walking. These preliminary findings are promising but need to be confirmed in future large-scale and sufficiently powered randomized controlled trials.

Effect of physical exercise on the hippocampus and global grey matter volume in breast cancer patients: A randomized controlled trial (PAM study)

BACKGROUND

Physical exercise in cancer patients is a promising intervention to improve cognition and increase brain volume, including hippocampal volume. We investigated whether a 6-month exercise intervention primarily impacts total hippocampal volume and additionally hippocampal subfield volumes, cortical thickness and grey matter volume in previously physically inactive breast cancer patients. Furthermore, we evaluated associations with verbal memory.

METHODS

Chemotherapy-exposed breast cancer patients (stage I-III, 2-4 years post diagnosis) with cognitive problems were included and randomized in an exercise intervention (n = 70, age = 52.5 ± 9.0 years) or control group (n = 72, age = 53.2 ± 8.6 years). The intervention consisted of 2x1 hours/week of supervised aerobic and strength training and 2x1 hours/week Nordic or power walking. At baseline and at 6-month follow-up, volumetric brain measures were derived from 3D T1-weighted 3T magnetic resonance imaging scans, including hippocampal (subfield) volume (FreeSurfer), cortical thickness (CAT12), and grey matter volume (voxel-based morphometry CAT12). Physical fitness was measured with a cardiopulmonary exercise test. Memory functioning was measured with the Hopkins Verbal Learning Test-Revised (HVLT-R total recall) and Wordlist Learning of an online cognitive test battery, the Amsterdam Cognition Scan (ACS Wordlist Learning). An explorative analysis was conducted in highly fatigued patients (score of ≥ 39 on the symptom scale 'fatigue' of the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire), as previous research in this dataset has shown that the intervention improved cognition only in these patients.

RESULTS

Multiple regression analyses and voxel-based morphometry revealed no significant intervention effects on brain volume, although at baseline increased physical fitness was significantly related to larger brain volume (e.g., total hippocampal volume: R = 0.32, B = 21.7 mm3, 95 % CI = 3.0 - 40.4). Subgroup analyses showed an intervention effect in highly fatigued patients. Unexpectedly, these patients had significant reductions in hippocampal volume, compared to the control group (e.g., total hippocampal volume: B = -52.3 mm3, 95 % CI = -100.3 - -4.4)), which was related to improved memory functioning (HVLT-R total recall: B = -0.022, 95 % CI = -0.039 - -0.005; ACS Wordlist Learning: B = -0.039, 95 % CI = -0.062 - -0.015).

CONCLUSIONS

No exercise intervention effects were found on hippocampal volume, hippocampal subfield volumes, cortical thickness or grey matter volume for the entire intervention group. Contrary to what we expected, in highly fatigued patients a reduction in hippocampal volume was found after the intervention, which was related to improved memory functioning. These results suggest that physical fitness may benefit cognition in specific groups and stress the importance of further research into the biological basis of this finding.

Walking, Running, Swimming: An Analysis of the Effects of Land and Water Aerobic Exercises on Cognitive Functions and Neural Substrates

In the brain and cognitive reserves framework, aerobic exercise is considered as a protective lifestyle factor able to induce positive effects on both brain structure and function. However, specific aspects of such a beneficial effect still need to be completely clarified. To this aim, the present narrative review focused on the potential brain/cognitive/neural reserve-construction mechanisms triggered by different aerobic exercise types (land activities; such as walking or running; vs. water activities; such as swimming), by considering human and animal studies on healthy subjects over the entire lifespan. The literature search was conducted in PubMed database. The studies analyzed here indicated that all the considered kinds of activities exert a beneficial effect on cognitive/behavioral functions and on the underlying brain neurobiological processes. In particular, the main effects observed involve the cognitive domains of memory and executive functions. These effects appear related to structural and functional changes mainly involving the fronto-hippocampal axis. The present review supports the requirement of further studies that investigate more specifically and systematically the effects of each type of aerobic activity, as a basis to plan more effective and personalized interventions on individuals as well as prevention and healthy promotion policies for the general population.

Shared brain and genetic architectures between mental health and physical activity

Physical activity is correlated with, and effectively treats various forms of psychopathology. However, whether biological correlates of physical activity and psychopathology are shared remains unclear. Here, we examined the extent to which the neural and genetic architecture of physical activity and mental health are shared. Using data from the UK Biobank (N = 6389), we applied canonical correlation analysis to estimate associations between the amplitude and connectivity strength of subnetworks of three major neurocognitive networks (default mode, DMN; salience, SN; central executive networks, CEN) with accelerometer-derived measures of physical activity and self-reported mental health measures (primarily of depression, anxiety disorders, neuroticism, subjective well-being, and risk-taking behaviors). We estimated the genetic correlation between mental health and physical activity measures, as well as putative causal relationships by applying linkage disequilibrium score regression, genomic structural equational modeling, and latent causal variable analysis to genome-wide association summary statistics (GWAS N = 91,105-500,199). Physical activity and mental health were associated with connectivity strength and amplitude of the DMN, SN, and CEN (r's ≥ 0.12, p's < 0.048). These neural correlates exhibited highly similar loading patterns across mental health and physical activity models even when accounting for their shared variance. This suggests a largely shared brain network architecture between mental health and physical activity. Mental health and physical activity (including sleep) were also genetically correlated (|rg| = 0.085-0.121), but we found no evidence for causal relationships between them. Collectively, our findings provide empirical evidence that mental health and physical activity have shared brain and genetic architectures and suggest potential candidate subnetworks for future studies on brain mechanisms underlying beneficial effects of physical activity on mental health.

Can exercise attenuate the negative effects of long COVID syndrome on brain health?

The impetus for many governments globally to treat the novel coronavirus (COVID-19) as an endemic warrant more research into the prevention, and management of long COVID syndrome (LCS). Whilst the data on LCS remains scarce, reports suggest a large proportion of recovered individuals will experience ongoing neuropsychological symptoms, even with mild disease severity. The pathophysiology underlying LCS is multifaceted. Evidence suggests that altered inflammatory, neurotrophic, and neurotransmitter pathways within the brain contribute to neuropsychological symptoms reported following COVID-19. Exercise or regular physical activity has long been shown to have positive effects on brain health and cognition through exerting positive effects on inflammatory markers, neurotransmitters, and neurotropic factors analogous to the neurophysiological pathways proposed to be disrupted by COVID-19 infection. Thus, exercise may serve as an important lifestyle behavior in the management of LCS. In this opinion article, we present the evidence to support the positive role of exercise in the management of cognitive symptom that manifest with LCS and discuss important considerations and interactions with cardiorespiratory and exercise tolerance complications that often present for individuals experiencing LCS. We highlight the need for more research and training of sports medicine practitioners and clinical exercise physiologists in the management of LCS with exercise and call for further research to understand the optimal dose-responses and exercise prescription guidelines for cognitive benefits and minimizing other complications.

Brain default mode network mediates the association between negative perfectionism and exercise dependence

BACKGROUND AND AIMS

Perfectionism is correlated with the occurrence of exercise dependence. We aim to reveal the role of functional connectivity (FC) between gray matter (GM) and white matter (WM) networks in the association between perfectionism and exercise dependence.

METHODS

In this cross-sectional study, one hundred ten participants with exercise dependence underwent behavioral evaluation and resting-state functional magnetic resonance imaging. Perfectionism and exercise dependence were quantified using the Frost Multidimensional Perfectionism Scale (FMPS) and Exercise Dependence Scale (EDS). We used a K-means clustering algorithm to identify functional GM and WM networks and obtained the FCs of the GM-GM, GM-WM, and WM-WM networks. Partial correlation and mediation analyses were performed to explore the relationships among FCs, FMPS, and EDS.

RESULTS

We identified ten stable GM networks and nine WM networks. Of these, FCs existed between the corona radiata network (WM1) and default mode network (DMN, GM8), WM1 network and WM DMN (WM4), WM1 network and midbrain WM network (WM7), and WM4 network and inferior longitudinal fasciculus network (WM9). The WM1-GM8 and WM1-WM4 FCs were positively correlated with the EDS and negative FMPS. The mediating effects of the WM1-GM8 and WM1-WM4 FCs were established in the association between the negative dimensional FMPS and EDS.

DISCUSSION AND CONCLUSIONS

The WM1 network anatomically linked the subregions within the GM8 and WM4 networks, and WM1-GM8 and WM1-WM4 FCs mediated the association between negative dimensional FMPS and EDS. These findings indicated that DMN function might be involved in the increased risks of exercise dependence promoted by negative perfectionism.

Fitness is positively associated with hippocampal formation subfield volumes in schizophrenia: a multiparametric magnetic resonance imaging study

Hippocampal formation (HF) volume loss is a well-established finding in schizophrenia, with select subfields, such as the cornu ammonis and dentate gyrus, being particularly vulnerable. These morphologic alterations are related to functional abnormalities and cognitive deficits, which are at the core of the insufficient recovery frequently seen in this illness. To counteract HF volume decline, exercise to improve aerobic fitness is considered as a promising intervention. However, the effects of aerobic fitness levels on HF subfields are not yet established in individuals with schizophrenia. Therefore, our study investigated potential associations between aerobic fitness and HF subfield structure, functional connectivity, and related cognitive impact in a multiparametric research design. In this cross-sectional study, 53 participants diagnosed with schizophrenia (33 men, 20 women; mean [SD] age, 37.4 [11.8] years) underwent brain structural and functional magnetic resonance imaging and assessments of aerobic fitness and verbal memory. Multivariate multiple linear regressions were performed to determine whether aerobic fitness was associated with HF subfield volumes and functional connections. In addition, we explored whether identified associations mediated verbal memory functioning. Significant positive associations between aerobic fitness levels and volumes were demonstrated for most HF subfields, with the strongest associations for the cornu ammonis, dentate gyrus, and subiculum. No significant associations were found for HF functional connectivity or mediation effects on verbal memory. Aerobic fitness may mitigate HF volume loss, especially in the subfields most affected in schizophrenia. This finding should be further investigated in longitudinal studies.Clinical Trials Registration: The study on which the manuscript is based was registered in the International Clinical Trials Database, ClinicalTrials.gov (NCT number: NCT03466112 ) and in the German Clinical Trials Register (DRKS-ID: DRKS00009804).

Associations between aerobic fitness, negative symptoms, cognitive deficits and brain structure in schizophrenia-a cross-sectional study

Negative symptoms and cognitive deficits are common in individuals with schizophrenia, greatly affect their outcome, and have been associated with alterations in cerebral gray and white matter volume (GMV, WMV). In the last decade, aerobic endurance training has emerged as a promising intervention to alleviate these symptoms and improved aerobic fitness has been suggested as a key moderator variable. In the present study, we investigated, whether aerobic fitness is associated with fewer cognitive deficits and negative symptoms and with GMVs and WMVs in individuals with schizophrenia in a cross-sectional design. In the largest study to date on the implications of fitness in individuals with schizophrenia, 111 participants at two centers underwent assessments of negative symptoms, cognitive functioning, and aerobic fitness and 69 underwent additional structural magnetic resonance imaging. Multilevel Bayesian partial correlations were computed to quantify relationships between the variables of interest. The main finding was a positive association of aerobic fitness with right hippocampal GMV and WMVs in parahippocampal and several cerebellar regions. We found limited evidence for an association of aerobic fitness with cognitive functioning and negative symptoms. In summary, our results strengthen the notion that aerobic fitness and hippocampal plasticity are interrelated which holds implications for the design of exercise interventions in individuals with schizophrenia.

Effects of Exercise on Neural Changes in Inhibitory Control: An ALE Meta-Analysis of fMRI Studies

It is widely known that exercise improves inhibitory control; however, the mechanisms behind the cognitive improvement remain unclear. This study analyzes the extant literature on the neuronal effects of exercise on inhibitory control functions. We searched four online databases (Pubmed, Scopus, PsycINFO, and Web of Science) for relevant peer-reviewed studies to identify eligible studies published before September 1, 2021. Among the 4,090 candidate studies identified, 14 meet the inclusion criteria, and the results of 397 participants in these 14 studies are subsequently analyzed. We quantify the neural effects on the entire brain by using GingerALE software and identify 10 clusters of exercise-induced neuronal with either increases/decreases in the superior temporal gyrus (BA 22), precuneus (BA 7), superior frontal gyrus (BA 10), cuneus (BA 19), precuneus (BA 19), caudate, posterior cingulate (BA 19), middle temporal gyrus (B 37), parahippocampal gyrus (BA 30), precentral gyrus (BA 6). Meta-analytic coactivation map (MACM) showed that multiple functional networks overlap with brain regions with activation likelihood estimation (ALE) results. We propose the effect of exercise on neural activity is related to inhibitory control in the extended frontoparietal, default mode network (DMN), visual network, and other pathways. These results provide preliminary evidence of the neural effects of exercise on inhibitory control.

Non-Modifiable Factors as Moderators of the Relationship Between Physical Activity and Brain Volume: A Cross-Sectional UK Biobank Study

BACKGROUND

Previous research suggests physical activity attenuates grey and white matter loss; however, there appears to be individual variability in this effect. Understanding factors that can influence the relationship between physical activity and brain volume may enable prediction of individual response.

OBJECTIVE

The current study examined the relationship between objectively-measured physical activity and brain volume; and whether this relationship is moderated by age, sex, or a priori candidate genetic factors, brain-derived neurotrophic factor (BDNF) Val66Met, or apolipoprotein (APOE) ɛ4 allele carriage.

METHODS

Data from 10,083 men and women (50 years and over) of the UK Biobank were used to examine the study objectives. All participants underwent a magnetic resonance imaging scan to quantify grey and white matter volumes, physical activity monitoring via actigraphy, and genotyping.

RESULTS

Physical activity was associated with total grey matter volume, total white matter volume, and right hippocampal volume. Only males had an association between higher physical activity levels and greater cortical grey matter volume, total grey matter volume, and right hippocampal volume. Age moderated the relationship between physical activity and white matter volume.

CONCLUSION

Our results indicate that in males, but not females, an association exists between objectively-measured physical activity and grey matter volume. Age may also play a role in impacting the relationship between physical activity and brain volume. Future research should evaluate longitudinal brain volumetrics to better understand the nature of age and sex-effects on the physical activity and brain volume relationship.

Aerobic Physical Exercise as a Non-medical Intervention for Brain Dysfunction: State of the Art and Beyond

Brain disorders, including stroke, Alzheimer's disease, depression, and chronic pain, are difficult to effectively treat. These major brain disorders have high incidence and mortality rates in the general population, and seriously affect not only the patient's quality of life, but also increases the burden of social medical care. Aerobic physical exercise is considered an effective adjuvant therapy for preventing and treating major brain disorders. Although the underlying regulatory mechanisms are still unknown, systemic processes may be involved. Here, this review aimed to reveal that aerobic physical exercise improved depression and several brain functions, including cognitive functions, and provided chronic pain relief. We concluded that aerobic physical exercise helps to maintain the regulatory mechanisms of brain homeostasis through anti-inflammatory mechanisms and enhanced synaptic plasticity and inhibition of hippocampal atrophy and neuronal apoptosis. In addition, we also discussed the cross-system mechanisms of aerobic exercise in regulating imbalances in brain function, such as the “bone-brain axis.” Furthermore, our findings provide a scientific basis for the clinical application of aerobic physical exercise in the fight against brain disorders.

Associations Between Age and Resting State Connectivity Are Partially Dependent Upon Cardiovascular Fitness

Previous research suggests a marked impact of aging on structural and functional connectivity within the frontoparietal control network (FPCN) and default mode network (DMN). As aging is also associated with reductions in cardiovascular fitness, age-related network connectivity differences reported by past studies could be partially due to age-related declines in fitness. Here, we use data collected as part of a 16-week exercise intervention to explore relationships between fitness and functional connectivity. Young and older adults completed baseline assessments including cardiovascular fitness, health and functioning measures, and an fMRI session. Scan data were acquired on a Siemens 3T MRI scanner with a 32-channel head coil. Results from regression analyses indicated that average connectivity did not differ between young and older adults. However, individual ROI-to-ROI connectivity analyses indicated weaker functional correlations for older adults between specific regions in the FPCN and DMN and, critically, many of these differences were attenuated when fitness was accounted for. Taken together, findings suggest that fitness exerts regional rather than global effects on network connectivity.

Exercise to spot the differences: a framework for the effect of exercise on hippocampal pattern separation in humans

Exercise has a beneficial effect on mental health and cognitive functioning, but the exact underlying mechanisms remain largely unknown. In this review, we focus on the effect of exercise on hippocampal pattern separation, which is a key component of episodic memory. Research has associated exercise with improvements in pattern separation. We propose an integrated framework mechanistically explaining this relationship. The framework is divided into three pathways, describing the pro-neuroplastic, anti-inflammatory and hormonal effects of exercise. The pathways are heavily intertwined and may result in functional and structural changes in the hippocampus. These changes can ultimately affect pattern separation through direct and indirect connections. The proposed framework might guide future research on the effect of exercise on pattern separation in the hippocampus.

Interrelationships between exercise, functional connectivity, and cognition among healthy adults: A systematic review

The main purpose of this systematic review was to examine past literature focusing on the potential relationship between exercise (or physical activity or cardiorespiratory fitness [CRF]) and functional brain connectivity in healthy adults. Among the studies meeting this purpose, we also evaluated studies investigating whether, and how, functional connectivity may influence the exercise-cognition relationship. A systematic review was employed through several electronic databases (PsychInfo, PubMed, and Google Scholar) in accordance with PRISMA guidelines. The literature search identified 656 records, and a total of 12 studies met the inclusion criteria. Among these 12 studies, there were 4, 7, and 1 study, respectively, examining the relationship between exercise and frontal lobe connectivity, temporal lobe connectivity, and whole-brain connectivity. Also, 7 studies examined the relationship between functional connectivity and cognitive performance across multiple brain regions as a function of exercise. Existing literature suggests that CRF, habitual physical activity, and varying intensities of acute exercise can strengthen functional connections among a wide variety of regions and subcortical structures of the human brain. These exercise-induced functional connectivity changes within and between specific brain structures/networks supporting cognitive processing may improve various domains of cognitive function. Given these complex associations, a thorough understanding of how functional connectivity plays a mediating role in the exercise-cognition interaction is needed in future studies.

Traditional Chinese Mind-Body Exercise Baduanjin Modulate Gray Matter and Cognitive Function in Older Adults with Mild Cognitive Impairment: A Brain Imaging Study

Background:

Previous studies found traditional Chinese mind-body exercise Baduanjin could modulate cognition of community older adults.

Objective:

This study aims to investigate the effect of 6 months of Baduanjin exercise on brain structure and cognitive function in older adults with mild cognitive impairment (MCI).

Methods:

The MCI older adults were randomly assigned into either Baduanjin training, brisk walking training or usual physical activity control group. Magnetic Resonance Imaging (MRI), Montreal Cognitive Assessment (MoCA) and Wechsler Memory Scale-Chinese Revised (WMS-CR) were applied to measure gray matter volume (GMV), global cognitive ability and memory at baseline and end of intervention.

Results:

Compared to usual physical activity, Baduanjin exercise significantly improved MoCA, WMS-CR scores, WMS-MQ, and mental control and comprehension memory subscores of the WMS-CR; significantly increased the GMV in the temporal gyrus, frontal gyrus, parietal gyrus, medial occipital gyrus, cingulate gyrus and angular gyrus after 6 months of intervention. Compared to brisk walking, Baduanjin significantly improved MoCA scores and picture reproduction subscores of memory, and significantly increased the GMV in the right frontal gyrus, precentral gyrus, occipital gyrus. Furthermore, the increased GMV in the right medial temporal gyrus was significantly associated with improvement in the MoCA scores.

Conclusion:

The present study suggested that regular Baduanjin training could have a positive effect in increasing brain gray matter and improving cognitive function in older adults with MCI.

Active Life for Brain Health: A Narrative Review of the Mechanism Underlying the Protective Effects of Physical Activity on the Brain

A growing body of evidence clearly indicates the beneficial effects of physical activity (PA) on cognition. The importance of PA is now being reevaluated due to the increase in sedentary behavior in older adults during the COVID-19 pandemic. Although many studies in humans have revealed that PA helps to preserve brain health, the underlying mechanisms have not yet been fully elucidated. In this review, which mainly focuses on studies in humans, we comprehensively summarize the mechanisms underlying the beneficial effects of PA or exercise on brain health, particularly cognition. The most intensively studied mechanisms of the beneficial effects of PA involve an increase in brain-derived neurotrophic factor (BDNF) and preservation of brain volume, especially that of the hippocampus. Nonetheless, the mutual associations between these two factors remain unclear. For example, although BDNF presumably affects brain volume by inhibiting neuronal death and/or increasing neurogenesis, human data on this issue are scarce. It also remains to be determined whether PA modulates amyloid and tau metabolism. However, recent advances in blood-based biomarkers are expected to help elucidate the beneficial effects of PA on the brain. Clinical data suggest that PA functionally modulates cognition independently of neurodegeneration, and the mechanisms involved include modulation of functional connectivity, neuronal compensation, neuronal resource allocation, and neuronal efficiency. However, these mechanisms are as yet not fully understood. A clear understanding of the mechanisms involved could help motivate inactive persons to change their behavior. More accumulation of evidence in this field is awaited.

Dance Intervention Impact on Brain Plasticity: A Randomized 6-Month fMRI Study in Non-expert Older Adults

Background: Dance is a complex activity combining physical exercise with cognitive, social, and artistic stimulation.

Objectives: We aimed to assess the effects of dance intervention (DI) on intra and inter-network resting-state functional connectivity (rs-FC) and its association to cognitive changes in a group of non-demented elderly participants.

Methods: Participants were randomly assigned into two groups: DI and life as usual (LAU). Six-month-long DI consisted of supervised 60 min lessons three times per week. Resting-state fMRI data were processed using independent component analysis to evaluate the intra and inter-network connectivity of large-scale brain networks. Interaction between group (DI, LAU) and visit (baseline, follow-up) was assessed using ANOVA, and DI-induced changes in rs-FC were correlated with cognitive outcomes.

Results: Data were analyzed in 68 participants (DI; n = 36 and LAU; n = 32). A significant behavioral effect was found in the attention domain, with Z scores increasing in the DI group and decreasing in the LAU group (p = 0.017). The DI as compared to LAU led to a significant rs-FC increase of the default mode network (DMN) and specific inter-network pairings, including insulo-opercular and right frontoparietal/frontoparietal control networks (p = 0.019 and p = 0.023), visual and language/DMN networks (p = 0.012 and p = 0.015), and cerebellar and visual/language networks (p = 0.015 and p = 0.003). The crosstalk of the insulo-opercular and right frontoparietal networks were associated with attention/executive domain Z-scores (R = 0.401, p = 0.015, and R = 0.412, p = 0.012).

Conclusion: The DI led to intervention-specific complex brain plasticity changes that were of cognitive relevance.

Change in cardiorespiratory fitness on self-rated health: prospective cohort study in 98 718 Swedish adults

Aim: To study how change in cardiorespiratory fitness over time is associated with the development of poor self-rated health in healthy Swedish adults, and whether this association varies with sex, age, body mass index and cardiorespiratory fitness at baseline. A secondary aim was to study the influence of other predictors of self-rated health. Methods: A total of 98,718 participants (45% women, mean age 42.2 years) with two assessments from occupational health service screenings between 1988 and 2019 (mean duration 4.3 years), with good self-rated health at baseline were included. Cardiorespiratory fitness was assessed as estimated maximal oxygen consumption using submaximal cycle testing. Change in cardiorespiratory fitness was expressed as percentage annual change. Poor self-rated health at follow-up was defined as percieving self-rated health as 'poor' or 'very poor'. Results: A large decrease in cardiorespiratory fitness (⩾-3%) was associated with a 34% higher risk of poor self-rated health compared to maintainers (-1 to +1%) after multi-adjustment including change in body mass index, back/neck pain, stress, exercise habits and sleep quality or sleep problems. The associations for decreasers were stronger with longer follow-up time (>10 years). Preserving, or changing to, risk level for body mass index, back/neck pain, stress, exercise and sleep quality/problems were associated with a higher risk of poor self-rated health. Conclusions: Preserving or increasing cardiorespiratory fitness is associated with a lower risk of poor self-rated health, independently of change in other health-related variables, which may act as a protection against future poor self-rated health. This is of high clinical value, and strategies for maintaining or improving cardiorespiratory fitness have the potential to influence both disease and mortality.

The Effects of Combined Physical and Cognitive Training on Inhibitory Control: A Systematic Review and Meta-Analysis

While strong inhibitory control is critical for health and wellbeing, there are no broadly applicable effective behavioural interventions that enhance it. This meta-analysis examined the neurocognitive rationale for combined physical and cognitive training and synthesised the rapidly growing body of evidence examining combined paradigms to enhance inhibitory control. Across the research to date, there was a small positive effect (n studies = 16, n participants = 832) of combined training on improving inhibitory control. Sub-group analyses showed small-moderate positive effects when the physical component of the combined training was moderately intense, as opposed to low or vigorous intensities; moderate positive effects were found in older adults, as compared to adolescents and adults; and healthy individuals and those with vascular cognitive impairment, as compared to ADHD, ASD, mild cognitive impairment and cancer survivors. This is the first meta-analysis to provide evidence that combined physical, specifically when moderately intense, and cognitive training has the capacity to improve inhibitory control, particularly when delivered to healthy individuals and those experiencing age-related decline.

Be Fit, Be Sharp, Be Well: The Case for Exercise as a Treatment for Cognitive Impairment in Late-life Depression

OBJECTIVE

To lay out the argument that exercise impacts neurobiological targets common to both mood and cognitive functioning, and thus more research should be conducted on its use as an alternative or adjunctive treatment for cognitive impairment in late-life depression (LLD).

METHOD

This narrative review summarizes the literature on cognitive impairment in LLD, describes the structural and functional brain changes and neurochemical changes that are linked to both cognitive impairment and mood disruption, and explains how exercise targets these same neurobiological changes and can thus provide an alternative or adjunctive treatment for cognitive impairment in LLD.

RESULTS

Cognitive impairment is common in LLD and predicts recurrence of depression, poor response to antidepressant treatment, and overall disability. Traditional depression treatment with medication, psychotherapy, or both, is not effective in fully reversing cognitive impairment for most depressed older adults. Physical exercise is an ideal treatment candidate based on evidence that it 1) is an effective treatment for depression, 2) enhances cognitive functioning in normal aging and in other patient populations, and 3) targets many of the neurobiological mechanisms that underlie mood and cognitive functioning. Results of the limited existing clinical trials of exercise for cognitive impairment in depression are mixed but overall support this contention.

CONCLUSIONS

Although limited, existing evidence suggests exercise may be a viable alternative or adjunctive treatment to address cognitive impairment in LLD, and thus more research in this area is warranted. Moving forward, additional research is needed in large, diverse samples to translate the growing research findings into clinical practice.

Brain microstructural changes in mice persist in adulthood and are modulated by the palmitoyl acyltransferase ZDHHC7

For a long time, mice have been classified as adults with completely mature brains at 8 weeks of age, but recent research suggests that developmental brain changes occur for up to 6 months. In particular, adolescence coincides with dramatic changes of neuronal structure and function in the brain that influence the connectivity between areas like hippocampus and medial prefrontal cortex (mPFC). Neuronal development and plasticity are regulated in part by the palmitoyl acyltransferase ZDHHC7, which modulates structural connectivity between hippocampus and mPFC. The aim of the current study was to investigate whether developmental changes take place in hippocampus and mPFC microstructure even after 8 weeks of age and whether deficiency of ZDHHC7 impacts such age-dependent alterations. Altogether, 46 mice at 11, 14 or 17 weeks of age with a genetic Zdhhc7 knockout (KO) or wild type (WT) were analysed with neuroimaging and diffusion tensor-based fibre tractography. The hippocampus and mPFC regions were compared regarding fibre metrics, supplemented by volumetric and immunohistological analyses of the hippocampus. In WT animals, we identified age-dependent changes in hippocampal fibre lengths that followed a U-shaped pattern, whereas in mPFC, changes were linear. In Zdhhc7-deficient animals, the fibre statistics were reduced in both regions, whereas the hippocampus volume and the intensities of myelin and neurofilament were higher in 11-week-old KO mice compared to WTs. Our results confirmed ongoing changes of microstructure in mice up to 17 weeks old and demonstrate that deleting the Zdhhc7 gene impairs fibre development, suggesting that palmitoylation is important in this process.

Physical activity and moving more for health

Non-communicable diseases are a leading cause of death and levels are rising. Lifestyle changes, including physical activity, have benefits in all-cause mortality, cardiovascular and metabolic disease, respiratory conditions and cognitive and mental health. In some cancers, particularly colon, prostate and breast, physical activity improves quality of life and outcomes before, during and after treatment. Sedentary time is an independent risk factor with adverse effects in hospitalised patients. Mechanisms include anti-inflammatory effects and augmentation of physiological and neuroendocrine responses to stressors. Engaging patients is affected by barriers: for clinicians, awareness of guidelines and personal physical activity levels are important factors; for patients, barriers are influenced by life events, socioeconomic and cultural factors. Interventions to increase activity levels are effective in the short- and medium-term, including brief interventions. Face-to-face is more effective than remote advice and behavioural interventions are more effective than cognitive. There are no published guidelines for physical activity in hospitalised patients.

Swimming exercise improves short- and long-term memories: Time-course changes

The beneficial effects of exercise training on memory formation are well documented. However, the memory enhancement profile following the time-course of exercise training remains unknown. In this investigation, changes in the spatial hippocampal memory following a time-course of swimming exercise training were examined. Young adult Wistar rats were tested for both short-term and long-term memories using the radial arm water maize (RAWM) paradigm following 0, 1, 7, 14, and 28 days of swimming exercise training (60 min per day, 5 days/week)s. The mean total errors on RAWM during the learning phase and memory testing remained the same (p > 0.5) after 1 day of swimming exercise. On the other hand, swimming exercise-induced significant enhancement to the learning phase and memory formation after 7 days of training (p < 0.01). Errors decreased (p < 0.0001) after 7 days of training and remained lower (p < 0.0001) than baseline without differences between 7, 14, and 28 days (p > 0.5). Similarly, short- and long-term memories improved after 7 days (p < 0.05) of training as compared to the baseline without differences between 7, 14, and 28 days (p > 0.05). The time course of improvement of learning and both short- and long-term memories after swimming exercise were evident after 7 days and plateaued thereafter. Results of the current study could form the base for future utilization of exercises to enhance cognitive function in healthy individuals.

Eight-week high-intensity interval training is associated with improved sleep quality and cardiorespiratory fitness in patients with depressive disorders

PURPOSE

This study aimed to examine the effect of high-intensity interval training (HIIT) on both sleep and cardiorespiratory fitness in patients with depression.

METHODS

Using a single pre- and post-test study design with no control group, 82 patients diagnosed with depressive disorders underwent HIIT comprising a total of 24 15-min sessions, three times per week for 8 weeks. Depressive symptoms, sleep quality, and cardiorespiratory fitness were evaluated using the Beck depression inventory-II, the Pittsburgh sleep quality index (PSQI), and cardiopulmonary exercise testing (CPET) in the form of maximum oxygen uptake (VO₂ max), respectively.

RESULTS

All 82 patients completed the intervention. HIIT training was associated with significant improvements in BDI-II score (diff =  - 1.57 [95% CI - 2.40 to - 0.73], P = 0.001), PSQI score (diff =  - 1.20 [95% CI - 2.10 to - 0.32], P = 0.008), and CPET VO₂ max (diff = 0.95 [95% CI 0.62-1.28], P = 0.001). Effect size calculations revealed that the greatest improvement occurred in CPET VO₂ max (Cohen's d = 0.64) and that improvements in the BDI-II and PSQI scores were somewhat smaller in magnitude (Cohen's d =  - 0.41 and - 0.30, respectively). Sleep quality improvements were observed in sleep latency, habitual sleep efficiency, and the use of sleep-promoting medications (Cohen's d = 0.18, 0.19, and 0.25, respectively). Change in cardiorespiratory fitness successfully predicted change in sleep quality but not in depressive symptoms. Adverse effects were limited to minor injuries which did not interfere with completion of training.

CONCLUSIONS

HIIT training delivered over 8 weeks was associated with improvements in depression symptoms, sleep quality, and cardiorespiratory fitness in patients with depressive disorders.

The effect of physical exercise on functional brain network connectivity in older adults with and without cognitive impairment. A systematic review

INTRODUCTION

Neurodegeneration is a biproduct of aging that results in concomitant cognitive decline. Physical exercise is an emerging intervention to improve brain health. The underlying neural mechanisms linking exercise to neurodegeneration, however, are unclear. Functional brain network connectivity (FBNC) refers to neural regions that are anatomically separate but temporally synched in functional signalling. FBNC can be measured using functional Magnetic Resonance Imaging (fMRI) and is affected by neurodegeneration.

METHODS

We conducted a systematic review using PubMed and EMBASE to assess the effect of physical exercise on FBNC in older adults with and without cognitive impairment.

RESULTS

Our search yielded 1474 articles; after exclusion, 13 were included in the final review, 8 of which focused on cognitively healthy older adults. 10 studies demonstrated an increase in FBNC post-exercise intervention, while 11 studies showed improvements in secondary outcomes (cognitive and/or physical performance). One study showed significant correlations between FBNC and cognitive performance measures that significantly improved post-intervention.

DISCUSSION

We found evidence that physical exercise increases FBNC. When assessing the association between FBNC with physical and cognitive functioning, careful consideration must be given to variability in exercise parameters, neural regions of interest and networks examined, and heterogeneity in methodological approaches.

A Critical Systematic Review of Current Evidence on the Effects of Physical Exercise on Whole/Regional Grey Matter Brain Volume in Populations at Risk of Neurodegeneration

BACKGROUND

Despite the intriguing potential of physical exercise being able to preserve or even restore brain volume (grey matter volume in particular)-a tissue essential for both cognitive and physical function-no reviews have so far synthesized the existing knowledge from randomized controlled trials investigating exercise-induced changes of the brain's grey matter volume in populations at risk of neurodegeneration. Our objective was to critically review the existing evidence regarding this topic.

METHODS

A systematic search was carried out in MEDLINE and EMBASE databases primo April 2020, to identify randomized controlled trials evaluating the effects of aerobic training, resistance training or concurrent training on brain grey volume changes (by MRI) in adult clinical or healthy elderly populations.

RESULTS

A total of 20 articles (from 19 RCTs) evaluating 3-12 months of aerobic, resistance, or concurrent training were identified and included, involving a total of 1662 participants (populations: healthy older adults, older adults with mild cognitive impairment or Alzheimer's disease, adults with schizophrenia or multiple sclerosis or major depression). While few studies indicated a positive effect-although modest-of physical exercise on certain regions of brain grey matter volume, the majority of study findings were neutral (i.e., no effects/small effect sizes) and quite divergent across populations. Meta-analyses showed that different exercise modalities failed to elicit any substantial effects on whole brain grey volume and hippocampus volume, although with rather large confidence interval width (i.e., variability).

CONCLUSION

Altogether, the current evidence on the effects of physical exercise on whole/regional grey matter brain volume appear sparse and inconclusive, and does not support that physical exercise is as potent as previously proposed when it comes to affecting brain grey matter volume.

[Sport and physical exercise in unipolar depression : Prevention, therapy, and neurobiological mechanisms of action]

There is increasing consensus on the relevance of exercise interventions for the treatment and prevention of unipolar depression. The present review article aims to provide a practitioner-friendly overview of recent insights into the underlying neurobiological mechanisms of exercise interventions in depression in order to enhance their dissemination and acceptance. Exercise has proven antidepressive efficacy in major depressive disorders. Furthermore, it has demonstrated a protective effect on the development of depressive symptoms. Neurobiological research has shown that exercise increases the volume of gray matter in the brain, improves the microstructure of white matter and leads to a higher functional connectivity in brain regions implicated in major depressive disorders. On a molecular level, preliminary findings indicate that exercise has anti-inflammatory, neuroplastic and antioxidative effects, which could represent the basis for the effects observed on a brain structural and functional level. Exercise interventions should be recommended as an adjunct therapy for all patients with major depressive disorder.