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Boecker H, Daamen M, Kunz L, Geiß M, Müller M, Neuss T, Henschel L, Stirnberg R, Upadhyay N, Scheef L, Martin JA, Stöcker T, Radbruch A, Attenberger U, Axmacher N, Maurer A. Hippocampal subfield plasticity is associated with improved spatial memory. Commun Biol 2024; 7:271. [PMID: 38443439 PMCID: PMC10914736 DOI: 10.1038/s42003-024-05949-5] [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: 06/29/2023] [Accepted: 02/21/2024] [Indexed: 03/07/2024] Open
Abstract
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.
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Affiliation(s)
- Henning Boecker
- Clinical Functional Imaging Lab, Department of Diagnostic and Interventional Radiology, University Hospital Bonn, Venusberg-Campus 1, 53127, Bonn, Germany.
- German Center for Neurodegenerative Diseases, Venusberg-Campus 1/99, 53127, Bonn, Germany.
| | - Marcel Daamen
- Clinical Functional Imaging Lab, Department of Diagnostic and Interventional Radiology, University Hospital Bonn, Venusberg-Campus 1, 53127, Bonn, Germany
- German Center for Neurodegenerative Diseases, Venusberg-Campus 1/99, 53127, Bonn, Germany
| | - Lukas Kunz
- Department of Epileptology, University Hospital Bonn, Venusberg-Campus 1, 53127, Bonn, Germany
| | - Melanie Geiß
- Clinical Functional Imaging Lab, Department of Diagnostic and Interventional Radiology, University Hospital Bonn, Venusberg-Campus 1, 53127, Bonn, Germany
| | - Moritz Müller
- Clinical Functional Imaging Lab, Department of Diagnostic and Interventional Radiology, University Hospital Bonn, Venusberg-Campus 1, 53127, Bonn, Germany
| | - Thomas Neuss
- Clinical Functional Imaging Lab, Department of Diagnostic and Interventional Radiology, University Hospital Bonn, Venusberg-Campus 1, 53127, Bonn, Germany
| | - Leonie Henschel
- German Center for Neurodegenerative Diseases, Venusberg-Campus 1/99, 53127, Bonn, Germany
| | - Rüdiger Stirnberg
- German Center for Neurodegenerative Diseases, Venusberg-Campus 1/99, 53127, Bonn, Germany
| | - Neeraj Upadhyay
- Clinical Functional Imaging Lab, Department of Diagnostic and Interventional Radiology, University Hospital Bonn, Venusberg-Campus 1, 53127, Bonn, Germany
- German Center for Neurodegenerative Diseases, Venusberg-Campus 1/99, 53127, Bonn, Germany
| | - Lukas Scheef
- Clinical Functional Imaging Lab, Department of Diagnostic and Interventional Radiology, University Hospital Bonn, Venusberg-Campus 1, 53127, Bonn, Germany
| | - Jason A Martin
- Clinical Functional Imaging Lab, Department of Diagnostic and Interventional Radiology, University Hospital Bonn, Venusberg-Campus 1, 53127, Bonn, Germany
| | - Tony Stöcker
- German Center for Neurodegenerative Diseases, Venusberg-Campus 1/99, 53127, Bonn, Germany
| | - Alexander Radbruch
- Department of Neuroradiology, University Hospital Bonn, Venusberg-Campus 1, 53127, Bonn, Germany
| | - Ulrike Attenberger
- Department of Diagnostic and Interventional Radiology, University Hospital Bonn, Venusberg-Campus 1, 53127, Bonn, Germany
| | - Nikolai Axmacher
- Department of Neuropsychology, Faculty of Psychology, Ruhr University Bochum, Universitätsstr. 150, 44801, Bochum, Germany
| | - Angelika Maurer
- Clinical Functional Imaging Lab, Department of Diagnostic and Interventional Radiology, University Hospital Bonn, Venusberg-Campus 1, 53127, Bonn, Germany
- German Center for Neurodegenerative Diseases, Venusberg-Campus 1/99, 53127, Bonn, Germany
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2
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Associations between aerobic fitness, negative symptoms, cognitive deficits and brain structure in schizophrenia—a cross-sectional study. SCHIZOPHRENIA 2022; 8:63. [PMID: 35918344 PMCID: PMC9345912 DOI: 10.1038/s41537-022-00269-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Accepted: 07/12/2022] [Indexed: 11/21/2022]
Abstract
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.
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Choi J, Taylor B, Fiszdon JM, Kurtz MM, Tek C, Dewberry MJ, Haber LC, Shagan D, Assaf M, Pearlson GD. The synergistic benefits of physical and cognitive exercise in schizophrenia: Promoting motivation to enhance community effectiveness. SCHIZOPHRENIA RESEARCH-COGNITION 2019; 19:100147. [PMID: 31828021 PMCID: PMC6889253 DOI: 10.1016/j.scog.2019.100147] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Revised: 03/18/2019] [Accepted: 04/17/2019] [Indexed: 11/16/2022]
Abstract
Emerging research highlights the potential cognitive benefits of physical exercise (PE) programs for schizophrenia (SCZ). The few recent efficacy studies that examined augmenting cognitive training (CT) with PE suggest superior effects of the combination. The next step is to consider strategies to enhance adherence in real-world settings if this type of combined treatment is going to be effective. We present the first community effectiveness data for PE and CT that included a motivationally-enhancing, self-determined approach to exercise, in lieu of participant payment. Eighty-five outpatients with schizophrenia attending an intensive outpatient program were randomized to 18 h of either (A) self-determined PE regimen with choice from a menu of different activities; (B) tablet-based neurofeedback CT focused on processing speed (PS) and working memory (WM), or (C) a time-matched combination of PE and CT. Assessments were conducted at baseline, post, and follow-up (2 mo). All groups improved in WM from baseline to post, with greatest gains in the PE only group. At follow-up, cognitive gains originally observed in the PE-only group disappeared, while the PE + CT group evidenced improvements in WM and psychotic symptoms. Notably, attrition for PE was only 7%. Our data shows that combining PE and CT leads to lasting effects that are superior to those of either intervention alone. The low PE drop-out rate suggests a self-determined approach to the exercise regimen was tolerable, and may be an important component of future community implementation efforts.
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Affiliation(s)
- Jimmy Choi
- The Institute of Living at Hartford Hospital, 200 Retreat Ave, Hartford, CT 06106, United States of America
| | - Beth Taylor
- UCONN Institute for Collaboration on Health, Intervention and Policy, Storrs, CT, United States of America
| | - Joanna M Fiszdon
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States of America.,Psychology Service, VA Connecticut Healthcare System, West Haven, CT, United States of America
| | - Matthew M Kurtz
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States of America.,Department of Psychology and Neuroscience, Wesleyan University, Middletown, CT, United States of America
| | - Cenk Tek
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States of America
| | | | - Lawrence C Haber
- The Institute of Living at Hartford Hospital, 200 Retreat Ave, Hartford, CT 06106, United States of America
| | - Dana Shagan
- The Institute of Living at Hartford Hospital, 200 Retreat Ave, Hartford, CT 06106, United States of America
| | - Michal Assaf
- The Institute of Living at Hartford Hospital, 200 Retreat Ave, Hartford, CT 06106, United States of America.,Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States of America
| | - Godfrey D Pearlson
- The Institute of Living at Hartford Hospital, 200 Retreat Ave, Hartford, CT 06106, United States of America.,Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States of America
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Maurus I, Hasan A, Röh A, Takahashi S, Rauchmann B, Keeser D, Malchow B, Schmitt A, Falkai P. Neurobiological effects of aerobic exercise, with a focus on patients with schizophrenia. Eur Arch Psychiatry Clin Neurosci 2019; 269:499-515. [PMID: 31115660 DOI: 10.1007/s00406-019-01025-w] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2018] [Accepted: 05/15/2019] [Indexed: 02/08/2023]
Abstract
Schizophrenia is a severe neuropsychiatric disease that is associated with neurobiological alterations in multiple brain regions and peripheral organs. Negative symptoms and cognitive deficits are present in about half of patients and are difficult to treat, leading to an unfavorable functional outcome. To investigate the impact of aerobic exercise on various neurobiological parameters, we conducted a narrative review. Add-on aerobic exercise was shown to be effective in improving negative and general symptoms, cognition, global functioning, and quality of life in schizophrenia patients. Based on findings in healthy individuals and animal models, this qualitative review gives an overview of different lines of evidence on how aerobic exercise impacts brain structure and function and molecular mechanisms in patients with schizophrenia and how its effects could be related to clinical and functional outcomes. Structural magnetic resonance imaging studies showed a volume increase in the hippocampus and cortical regions in schizophrenia patients and healthy controls after endurance training. However, results are inconsistent and individual risk factors may influence neuroplastic processes. Animal studies indicate that alterations in epigenetic mechanisms and synaptic plasticity are possible underlying mechanisms, but that differentiation of glial cells, angiogenesis, and possibly neurogenesis may also be involved. Clinical and animal studies also revealed effects of aerobic exercise on the hypothalamus-pituitary-adrenal axis, growth factors, and immune-related mechanisms. Some findings indicate effects on neurotransmitters and the endocannabinoid system. Further research is required to clarify how individual risk factors in schizophrenia patients mediate or moderate the neurobiological effects of exercise on brain and cognition. Altogether, aerobic exercise is a promising candidate in the search for pathophysiology-based add-on interventions in schizophrenia.
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Affiliation(s)
- Isabel Maurus
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Nussbaumstrasse 7, 80336, Munich, Germany.
| | - Alkomiet Hasan
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Nussbaumstrasse 7, 80336, Munich, Germany
| | - Astrid Röh
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Nussbaumstrasse 7, 80336, Munich, Germany
| | - Shun Takahashi
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Nussbaumstrasse 7, 80336, Munich, Germany.,Department of Neuropsychiatry, Wakayama Medical University, Wakayama, Japan
| | - Boris Rauchmann
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Nussbaumstrasse 7, 80336, Munich, Germany
| | - Daniel Keeser
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Nussbaumstrasse 7, 80336, Munich, Germany.,Department of Radiology, University Hospital, LMU Munich, Munich, Germany
| | - Berend Malchow
- Department of Psychiatry and Psychotherapy, University Hospital Jena, Jena, Germany
| | - Andrea Schmitt
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Nussbaumstrasse 7, 80336, Munich, Germany.,Laboratory of Neuroscience (LIM27), Institute of Psychiatry, University of Sao Paulo, São Paulo, Brazil
| | - Peter Falkai
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Nussbaumstrasse 7, 80336, Munich, Germany
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Farioli Vecchioli S, Sacchetti S, Nicolis di Robilant V, Cutuli D. The Role of Physical Exercise and Omega-3 Fatty Acids in Depressive Illness in the Elderly. Curr Neuropharmacol 2018; 16:308-326. [PMID: 28901279 PMCID: PMC5843982 DOI: 10.2174/1570159x15666170912113852] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2017] [Revised: 06/20/2017] [Accepted: 07/30/2017] [Indexed: 02/07/2023] Open
Abstract
Background: In adulthood, depression is the most common type of mental illness and will be the second leading cause of disease by 2020. Major depression dramatically affects the function of the central nervous system and degrades the quality of life, especially in old age. Several mechanisms underlie the pathophysiology of depressive illness, since it has a multifactorial etiology. Human and an-imal studies have demonstrated that depression is mainly associated with imbalances in neurotransmitters and neurotrophins, hypothalamic-pituitary-adrenal axis alterations, brain volume changes, neurogenesis dysfunction, and dysregulation of in-flammatory pathways. Also the gut microbiota may influence mental health outcomes. Although depression is not a consequence of normal aging, depressive disorders are common in later life, even if often undi-agnosed or mis-diagnosed in old age. When untreated, depression reduces life expectancy, worsens medical illnesses, en-hances health care costs and is the primary cause of suicide among older people. To date, the underpinnings of depression in the elderly are still to be understood, and the pharmacological treatment is the most commonly used therapy. Objective: Since a sedentary lifestyle and poor eating habits have recently emerged as crucial contributors to the genesis and course of depression, in the present review, we have focused on the effects of physical activity and omega-3 fatty acids on depressive illness in the elderly. Results: A growing literature indicates that both exercise and dietary interventions can promote mental health throughout one’s lifespan. Conclusion: There thus emerges the awareness that an active lifestyle and a balanced diet may constitute valid low-cost pre-vention strategies to counteract depressive illness in the elderly.
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Affiliation(s)
- Stefano Farioli Vecchioli
- Institute of Cell Biology and Neurobiology, CNR/Fondazione Santa Lucia, Via del Fosso di Fiorano 64, 00143, Rome, Italy
| | - Stefano Sacchetti
- Laboratory of Experimental and Behavioral Neurophysiology, Fondazione Santa Lucia, Via del Fosso di Fiorano 64, 00143, Rome, Italy.,Department of Psychology, University Sapienza of Rome, Via dei Marsi 78, 00185, Rome, Italy
| | - V Nicolis di Robilant
- Institute of Cell Biology and Neurobiology, CNR/Fondazione Santa Lucia, Via del Fosso di Fiorano 64, 00143, Rome, Italy
| | - Debora Cutuli
- Laboratory of Experimental and Behavioral Neurophysiology, Fondazione Santa Lucia, Via del Fosso di Fiorano 64, 00143, Rome, Italy.,Department of Psychology, University Sapienza of Rome, Via dei Marsi 78, 00185, Rome, Italy
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6
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Abstract
Schizophrenia is a devastating mental illness that has profound effects on a person's health and quality of life. Exercise represents a promising new treatment option that may supplement current psychosocial and pharmacological interventions for psychosis. A large body of work suggests that exercise can improve cardio-metabolic and health behavior and facilitate neurogenesis in areas of the brain that are notably impacted by psychosis. Recent efforts to incorporate exercise as either stand-alone or adjunctive treatment for individuals with schizophrenia range from yoga and light stretching to moderately intense walking, bike riding, or team sports. These interventions suggest that moderately intense exercise may be beneficial for improving both positive and negative symptomatology, cognition and functioning. Indeed, exercise may be beneficial for decreasing risk factors for a wide range of health problems often observed in patients with schizophrenia, including weight gain and metabolic syndrome as well as tobacco and substance use. Given the positive results from interventions in schizophrenia patients, there is an impetus for incorporating exercise in the early stages of the disorder. Notably, individuals at ultrahigh risk (UHR) for psychosis report more sedentary behavior and perceive less benefit from exercise; interventions prior to the onset of the disorder may be helpful for increasing health behaviors, perhaps delaying or preventing the onset of psychosis. Taken together, for individuals with psychosis, exercise may provide holistic benefits for the neural to the social impairments.
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Krogh J, Rostrup E, Thomsen C, Elfving B, Videbech P, Nordentoft M. The effect of exercise on hippocampal volume and neurotrophines in patients with major depression--a randomized clinical trial. J Affect Disord 2014; 165:24-30. [PMID: 24882173 DOI: 10.1016/j.jad.2014.04.041] [Citation(s) in RCA: 71] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2014] [Revised: 04/15/2014] [Accepted: 04/15/2014] [Indexed: 01/15/2023]
Abstract
BACKGROUND The hippocampal volume is reduced in patients with major depression. Exercise leads to an increased hippocampal volume in schizophrenia and in healthy old adults. The effect of exercise on hippocampal volume is potentially mediated by brain derived neurotrophic factor (BDNF), vascular endothelial growth factor (VEGF), and insulin like growth factor 1 (IGF-1). The aim of this trial was to assess the effect of an aerobic exercise intervention on hippocampal volume and serum BDNF, VEGF, and IGF-1 in patients with major depression. METHODS Patients were randomized to an aerobic exercise intervention (n=41) or a control condition (n=38). Both interventions consisted of three supervised sessions per week during a three months period. RESULTS Post-intervention the increase in maximal oxygen uptake was 3.90 ml/kg/min (SD 5.1) in the aerobic exercise group and 0.95 ml/kg/min (SD 6.2) in the control group (p=0.03). The hippocampal volume, BDNF, VEGF, or IGF-1 did not differ between the two groups. Post-hoc we found a positive association between change in hippocampal volume and verbal memory (Rho=0.27; p=0.05) and change in hippocampal volume and depressive symptoms (Rho=0.30; p=0.03). LIMITATIONS Participation was low in both groups corresponding to an average participation of one session per week. CONCLUSION Despite a significant increase in maximal oxygen uptake, a pragmatic exercise intervention did not increase hippocampal volume or resting levels of neurotrophines in out-patients with mild to moderate major depression. Trial identifier: ClinicalTrials.gov (NCT00695552).
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Affiliation(s)
- Jesper Krogh
- Mental Health Centre Copenhagen, Mental Health Services in the Capital Region of Denmark, University of Copenhagen, Copenhagen, Denmark.
| | - Egill Rostrup
- Functional Imaging Unit, Department of Diagnostics, Copenhagen University Hospital, Glostrup Hospital, Denmark
| | - Carsten Thomsen
- Department of Radiology, Rigshospitalet, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Betina Elfving
- Translational Neuropsychiatry Unit, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Poul Videbech
- Department for Depression and Anxiety Q, Aarhus University Hospital, Risskov, Denmark
| | - Merete Nordentoft
- Mental Health Centre Copenhagen, Mental Health Services in the Capital Region of Denmark, University of Copenhagen, Copenhagen, Denmark
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Mittal VA, Gupta T, Orr JM, Pelletier-Baldelli A, Dean DJ, Lunsford-Avery JR, Smith AK, Robustelli BL, Leopold DR, Millman ZB. Physical activity level and medial temporal health in youth at ultra high-risk for psychosis. JOURNAL OF ABNORMAL PSYCHOLOGY 2014; 122:1101-10. [PMID: 24364613 DOI: 10.1037/a0034085] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
A growing body of evidence suggests that moderate to vigorous activity levels can affect quality of life, cognition, and brain structure in patients diagnosed with schizophrenia. However, physical activity has not been systematically studied during the period immediately preceding the onset of psychosis. Given reports of exercise-based neurogenesis in schizophrenia, understanding naturalistic physical activity levels in the prodrome may provide valuable information for early intervention efforts. The present study examined 29 ultra high-risk (UHR) and 27 matched controls to determine relationships between physical activity level, brain structure (hippocampus and parahippocampal gyrus), and symptoms. Participants were assessed with actigraphy for a 5-day period, MRI, and structured clinical interviews. UHR participants showed a greater percentage of time in sedentary behavior while healthy controls spent more time engaged in light to vigorous activity. There was a strong trend to suggest the UHR group showed less total physical activity. The UHR group exhibited smaller medial temporal volumes when compared with healthy controls. Total level of physical activity in the UHR group was moderately correlated with parahippocampal gyri bilaterally (right: r = .44, left: r = .55) and with occupational functioning (r = -.36; of negative symptom domain), but not positive symptomatology. Results suggest that inactivity is associated with medial temporal lobe health. Future studies are needed to determine if symptoms are driving inactivity, which in turn may be affecting the health of the parahippocampal structure and progression of illness. Although causality cannot be determined from the present design, these findings hold important implications for etiological conceptions and suggest promise for an experimental trial.
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Affiliation(s)
| | - Tina Gupta
- Department of Psychology and Neuroscience
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Gregory SM, Parker B, Thompson PD. Physical activity, cognitive function, and brain health: what is the role of exercise training in the prevention of dementia? Brain Sci 2012; 2:684-708. [PMID: 24961266 PMCID: PMC4061820 DOI: 10.3390/brainsci2040684] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2012] [Revised: 10/22/2012] [Accepted: 11/13/2012] [Indexed: 12/20/2022] Open
Abstract
Tor preventive measures are necessary to attenuate the increased economic and social burden of dementia. This review will focus on the potential for physical activity and exercise training to promote brain health and improve cognitive function via neurophysiological changes. We will review pertinent animal and human research examining the effects of physical activity on cognitive function and neurophysiology. We will discuss cross-sectional and longitudinal studies addressing the relationship between neurocognitive health and cardiorespiratory fitness or habitual activity level. We will then present and discuss longitudinal investigations examining the effects of exercise training on cognitive function and neurophysiology. We will conclude by summarizing our current understanding of the relationship between physical activity and brain health, and present areas for future research given the current gaps in our understanding of this issue.
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Affiliation(s)
- Sara M Gregory
- Department of Preventive Cardiology, Hartford Hospital, 80 Seymour Street, Hartford, CT 06102, USA.
| | - Beth Parker
- Department of Preventive Cardiology, Hartford Hospital, 80 Seymour Street, Hartford, CT 06102, USA.
| | - Paul D Thompson
- Department of Preventive Cardiology, Hartford Hospital, 80 Seymour Street, Hartford, CT 06102, USA.
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Krogh J, Videbech P, Thomsen C, Gluud C, Nordentoft M. DEMO-II trial. Aerobic exercise versus stretching exercise in patients with major depression-a randomised clinical trial. PLoS One 2012; 7:e48316. [PMID: 23118981 PMCID: PMC3485141 DOI: 10.1371/journal.pone.0048316] [Citation(s) in RCA: 74] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2012] [Accepted: 09/14/2012] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND The effect of referring patients from a clinical setting to a pragmatic exercise intervention for depressive symptoms, cognitive function, and metabolic variables has yet to be determined. METHODS Outpatients with major depression (DSM-IV) were allocated to supervised aerobic or stretching exercise groups during a three months period. The primary outcome was the Hamilton depression score (HAM-D(17)). Secondary outcomes were cognitive function, cardiovascular risk markers, and employment related outcomes. RESULTS 56 participants were allocated to the aerobic exercise intervention versus 59 participants to the stretching exercise group. Post intervention the mean difference between groups was -0.78 points on the HAM-D(17) (95% CI -3.2 to 1.6; P = .52). At follow-up, the participants in the aerobic exercise group had higher maximal oxygen uptake (mean difference 4.4 l/kg/min; 95% CI 1.7 to 7.0; P = .001) and visuospatial memory on Rey's Complex Figure Test (mean difference 3.2 points; 95% CI 0.9 to 5.5; P = .007) and lower blood glucose levels (mean difference 0.2 mmol/l; 95% CI 0.0 to 0.5; P = .04) and waist circumference (mean difference 2.2 cm; 95% CI 0.3 to 4.1; P = .02) compared with the stretching exercise group. CONCLUSIONS The results of this trial does not support any antidepressant effect of referring patients with major depression to a three months aerobic exercise program. Due to lower recruitment than anticipated, the trial was terminated prior to reaching the pre-defined sample size of 212 participants; therefore the results should be interpreted in that context. However, the DEMO-II trial does suggest that an exercise program for patients with depression offer positive short-term effects on maximal oxygen uptake, visuospatial memory, fasting glucose levels, and waist circumference. TRIAL REGISTRATION ClinicalTrials.gov NCT00695552.
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Affiliation(s)
- Jesper Krogh
- Mental Health Centre Copenhagen, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark.
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