Effects of Combined Aerobic Exercise and Cognitive Training on Verbal Fluency in Older Adults

Examination of acute spin exercise on GABA levels in aging and stroke: The EASE study protocol

BACKGROUND

Changes in regional levels of the inhibitory neurotransmitter gamma-aminobutyric acid (GABA) may indicate the potential for favorable responses to the treatment of stroke affecting the upper extremity. By selectively altering GABA levels during training, we may induce long-term potentiation and adjust excitatory/inhibitory balance (E/I balance). However, the impact of this alteration may be limited by neural damage or aging. Aerobic exercise has been shown to increase GABA levels in the sensorimotor cortex and improve motor learning by widening the dynamic range of E/I balance. The cross-sectional project, Effects of Acute Exercise on Functional Magnetic Resonance Spectroscopy Measures of GABA in Aging and Chronic Stroke (EASE), is designed to assess the functional relevance of changes in GABA concentration within the sensorimotor cortex before and after an acute aerobic exercise session.

METHODS/DESIGN

EASE will enroll 30 participants comprised of healthy younger adults (18-35 years; n = 10), older adults (60+ years; n = 10), and persons with chronic stroke (n = 10) affecting distal upper extremity function. We will use resting magnetic resonance spectroscopy to measure all participants' GABA levels at rest before and after aerobic exercise. In addition, we will employ functional magnetic resonance spectroscopy using motor skill acquisition and recall tasks in healthy adults. We hypothesize that acute aerobic exercise will increase resting sensorimotor GABA concentration and that higher GABA resting levels will predict better motor learning performance on measures taken both inside and outside the magnet. We also hypothesize that a higher dynamic range of GABA during task-based spectroscopy in healthy adults will predict better motor skill acquisition and recall.

DISCUSSION

The EASE project will evaluate the effect of acute exercise on GABA levels as a biomarker of upper extremity motor skill learning with two populations (aging adults and those with chronic stroke). We predict that acute exercise, higher sensorimotor GABA levels, and broader dynamic range will be related to better motor skill acquisition.

Executive function and spatial abilities in physically active children: an explorative study

BACKGROUND

Regular physical activity has consistently shown promise in improving cognitive functioning among children. However, there is a shortage of comprehensive studies that delve into these benefits across various cognitive domains. This preliminary investigation aimed to discern potential disparities in cognitive performance between active and sedentary children, with a specific focus on inhibitory control, cognitive flexibility, and visuo-spatial working memory abilities.

METHODS

The study employed a cross-sectional design encompassing 26 children (mean age 9.53 ± 2.20 years), categorized into two groups: Active and Sedentary. Executive functions were assessed using the NEPSY-II, while visuo-spatial working memory abilities were evaluated through the table version of the Radial Arm Maze (table-RAM) task. All outputs were analyzed with One-way ANOVAS or Kruskal-Wallis Tests to assess differences between Active and Sedentary children in both executive functioning and visuo-spatial working memory processes.

RESULTS

The findings revealed that the Active group outperformed the sedentary group in inhibitory control (F1,23 = 4.99, p = 0.03*), cognitive flexibility (F1,23 = 5.77, p = 0.02*), spatial span (F1,23 = 4.40, p = 0.04*), and working memory errors (F1,23 = 8.59, p = 0.01**). Both spatial span and working memory errors are parameters closely associated with visuo-spatial working memory abilities.

CONCLUSIONS

Although preliminary, these results offer evidence of a positive link between physical activity and cognitive functioning in children. This indicates the importance of promoting active behaviors, especially within educational environments.

Relation of Aerobic Activity to Cognition and Well-being in Chronic Mild Traumatic Brain Injury: A LIMBIC-CENC Study

INTRODUCTION

Because chronic difficulties with cognition and well-being are common after mild traumatic brain injury (mTBI) and aerobic physical activity and exercise (PAE) is a potential treatment and mitigation strategy, we sought to determine their relationship in a large sample with remote mTBI.

MATERIALS AND METHODS

The Long-Term Impact of Military-Relevant Brain Injury Consortium-Chronic Effects of Neurotrauma Consortium prospective longitudinal study is a national multicenter observational study of combat-exposed service members and veterans. Study participants with positive mTBI histories (n = 1,087) were classified as "inactive" (23%), "insufficiently active" (46%), "active" (19%), or "highly active" (13%) based on the aerobic PAE level. The design was a cross-sectional analysis with multivariable regression. PAE was reported on the Behavioral Risk Factor Surveillance System. Preselected primary outcomes were seven well-validated cognitive performance tests of executive function, learning, and memory: The California Verbal Learning Test-Second Edition Long-Delay Free Recall and Total Recall, Brief Visuospatial Memory Test-Revised Total Recall, Trail-Making Test-Part B, and NIH Toolbox for the Assessment of Neurological Behavior and Function Cognition Battery Picture Sequence Memory, Flanker, and Dimensional Change Card Sort tests. Preselected secondary outcomes were standardized self-report questionnaires of cognitive functioning, life satisfaction, and well-being.

RESULTS

Across the aerobic activity groups, cognitive performance tests were not significantly different. Life satisfaction and overall health status scores were higher for those engaging in regular aerobic activity. Exploratory analyses also showed better working memory and verbal fluency with higher aerobic activity levels.

CONCLUSIONS

An association between the aerobic activity level and the preselected primary cognitive performance outcome was not demonstrated using this study sample and methods. However, higher aerobic activity levels were associated with better subjective well-being. This supports a clinical recommendation for regular aerobic exercise among persons with chronic or remote mTBI. Future longitudinal analyses of the exercise-cognition relationship in chronic mTBI populations are recommended.

Effect of a combined program of running exercise and environmental enrichment on memory function and neurogenesis markers in amyloid-beta-induced Alzheimer-like model

Objectives

It is urgent to develop non-pharmacological interventions or multifactor combination approaches to combat Alzheimer's disease (AD). The effect of exercise (EX) combined with environmental enrichment (EE) on behavioral phenotypes and neurogenesis markers in an Alzheimer-like rat model was investigated.

Materials and Methods

The groups consisted of AD, sham-operated, AD+EX, AD+EE, and AD+EX+EE. AD was produced by injection of amyloid-beta (1-42, 6 µg) intrahippocampally, and a daily treadmill for 3 consecutive weeks was used for EX animals. EE was a large cage (50× 50× 50 cm) containing differently shaped objects. Spatial learning and memory were evaluated in the Morris water maze (MWM), and a shuttle box was used to evaluate inhibitory avoidance memory. RT-PCR was performed to assess the expression of early neurogenesis markers, DCX, and Sox2 within the hippocampus.

Results

Pretreatment with exercise and EE, both individually and in combination, could provide protection from memory impairments in AD rats. Combined treatment led to a significantly more pronounced improvement in memory deficits of AD rats than either paradigm alone. Combination therapy with exercise and EE could also reverse the passive avoidance memory impairment and hippocampal DCX expression of AD rats to the control levels.

Conclusion

These data suggest that exercise in combination with cognitive engagement can provide a non-pharmacological and multidomain policy that may prevent or delay AD symptoms.

The Effect of Aerobic Exercise on Cognitive Function in People with Alzheimer's Disease: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

A growing body of research has examined the effect of aerobic exercise on cognitive function in people with Alzheimer's Disease (AD), but the findings of the available studies were conflicting. The aim of this study was to explore the effect of aerobic exercise on cognitive function in AD patients. Searches were performed in PubMed, Web of Science, and EBSCO databases from the inception of indexing until 12 November 2021. Cochrane risk assessment tool was used to evaluate the methodological quality of the included literature. From 1942 search records initially identified, 15 randomized controlled trials (RCTs) were considered eligible for systematic review and meta-analysis. Included studies involved 503 participants in 16 exercise groups (mean age: 69.2-84 years) and 406 participants (mean age: 68.9-84 years) in 15 control groups. There was a significant effect of aerobic exercise on increasing mini-mental state examination (MMSE) score in AD patients [weighted mean difference (WMD), 1.50 (95% CI, 0.55 to 2.45), p = 0.002]. Subgroup analyses showed that interventions conducted 30 min per session [WMD, 2.52 (95% CI, 0.84 to 4.20), p = 0.003], less than 150 min per week [WMD, 2.10 (95% CI, 0.84 to 3.37), p = 0.001], and up to three times per week [WMD, 1.68 (95% CI, 0.46 to 2.89), p = 0.007] increased MMSE score significantly. In addition, a worse basal cognitive status was associated with greater improvement in MMSE score. Our analysis indicated that aerobic exercise, especially conducted 30 min per session, less than 150 min per week, and up to three times per week, contributed to improving cognitive function in AD patients. Additionally, a worse basal cognitive status contributed to more significant improvements in cognitive function.

Boosting effect of regular sport practice in young adults: Preliminary results on cognitive and emotional abilities

Several studies have shown that physical exercise (PE) improves behavior and cognitive functioning, reducing the risk of various neurological diseases, protecting the brain from the detrimental effects of aging, facilitating body recovery after injuries, and enhancing self-efficacy and self-esteem. Emotion processing and regulation abilities are also widely acknowledged to be key to success in sports. In this study, we aim to prove that regular participation in sports enhances cognitive and emotional functioning in healthy individuals. A sample of 60 students (mean age = 22.12; SD = 2.40; M = 30), divided into sportive and sedentary, were subjected to a neuropsychological tests battery to assess their overall cognitive abilities (Raven's Advanced Progressive Matrices, APM), verbal and graphic fluency (Word Fluency Task and modified Five Point Test, m-FPT), as well as their emotional awareness skills (Toronto Alexithymia Scale, TAS-20). Our results showed that sportive students performed better than sedentary ones in all cognitive tasks. Regarding emotional processing abilities, significant differences were found in the TAS-20 total score as well as in the Difficulty Describing Feelings (DDF) subscale and the Difficulty Identifying Feeling (DIF) subscale. Lastly, gender differences were found in the External-Oriented Thinking (EOT) subscale. Overall, our findings evidence that PE has positive effects on cognitive functioning and emotion regulation, suggesting how sports practice can promote mental health and wellbeing.

The Effects of Combined Cognitive-Physical Interventions on Cognitive Functioning in Healthy Older Adults: A Systematic Review and Multilevel Meta-Analysis

Research has shown that both physical exercise and cognitive training help to maintain cognition in older adults. The question is whether combined training might produce additive effects when the group comparisons are equated in terms of exercise intensity and modality. We conducted a systematic electronic search in MEDLINE, PsycInfo, and Cochrane Central Register of Controlled Trials (CENTRAL) databases to identify relevant studies published up to February 2021. Seven hundred and eighty-three effect sizes were obtained from 50 published intervention studies, involving 6,164 healthy older adults, and submitted to a three-level meta-analysis. Results showed that combined training produced a small advantage in comparison to single cognitive training on executive functions, whereas both types of training achieved similar effects on attention, memory, language, processing speed, and global cognition. Combined training achieved higher training gains in balance than single physical training, indicating a transfer from cognitive training to balance. Performing cognitive and physical exercise simultaneously, and interactive training (e.g., exergames, square stepping) produced the largest gains in executive functions, speed, and global cognition, as well as the largest improvements in physical functions. Aerobic training was associated with higher effects in attention and fitness, whereas non-aerobic training produced larger effects in global cognition and balance. For all cognitive and physical outcomes, training resulted more advantageous when performed in a social context, even though individual training obtained similar results in balance as group training.

Systematic Review Registration:www.crd.york.ac.uk/prospero/, identifier: CRD42020175632.

Reduced Interference and Serial Dependency Effects for Naming in Older but Not Younger Adults after 1 Hz rTMS of Right Pars Triangularis

1 Hz repetitive transcranial magnetic stimulation (rTMS) was used to decrease excitability of right pars triangularis (R PTr) to determine whether increased R PTr activity during picture naming in older adults hampers word finding. We hypothesized that decreasing R PTr excitability would reduce interference with word finding, facilitating faster picture naming. 15 older and 16 younger adults received two rTMS sessions. In one, speech onset latencies for picture naming were measured after both sham and active R PTr stimulation. In the other session, sham and active stimulation of a control region, right pars opercularis (R POp), were administered before picture naming. Order of active vs. sham stimulation within session was counterbalanced. Younger adults showed no significant effects of stimulation. In older adults, a trend indicated that participants named pictures more quickly after active than sham R PTr stimulation. However, older adults also showed longer responses during R PTr than R POp sham stimulation. When order of active vs. sham stimulation was modeled, older adults receiving active stimulation first had significantly faster responding after active than sham R PTr stimulation and significantly faster responding after R PTr than R POp stimulation, consistent with experimental hypotheses. However, older adults receiving sham stimulation first showed no significant differences between conditions. Findings are best understood, based on previous studies, when the interaction between the excitatory effects of picture naming and the inhibitory effects of 1 Hz rTMS on R PTr is considered. Implications regarding right frontal activity in older adults and for design of future experiments are discussed.

Comparing the Cognitive Functioning Effects of Aerobic and Pilates Exercises for Inactive Young Adults: A Randomized Controlled Trial

Aerobic exercises (AE) have been found to have short-term positive effects on certain aspects of cognitive functioning. Pilates exercises (PE) may have similar benefits. In this randomized controlled study, we compared the effectiveness of PE and AE on participants' cognitive functions. We randomly assigned 52 physically inactive young adult volunteers into either a PE group (Mage = 20.85, SD = 2.11 years; 18 females and 8 males) or an AE group (Mage = 19.88, SD = 0.91 years; 18 females and 8 males). In both groups, participants engaged in a moderately intense exercise program three days a week for four weeks. We tested participants on cognitive measures of selective attention and inhibitory control (Stroop test), verbal fluency (verbal fluency tests (letter and category); VFTs), and speed of movement (Nelson's Speed of Movement Test; NSMT). There were no group differences on the Stroop and the VFTs (p>0.05). However, there was a significant pre- to post-exercise difference for participants in both groups with a medium-large effect size (ES) on Stroop sections 1, 3, 4, and 5, respectively (PE: p < 0.001, ES = 0.58, p = 0.001, ES = 0.54, p < 0.001, ES = 0.88, p = 0.001, ES = 0.60; AE: p < 0.001, ES = 0.70, p < 0.001, ES = 0.89, p < 0.001, ES = 0.86, p = 0.006, ES = 0.65). There was a large effect size pre- to post-exercise detected for VFT sections labeled letter (PE: p < 0.001, ES = 1.45; AE: p < 0.001, ES = 1.11), and category (PE: p < 0.001, ES = 1.11; AE: p < 0.001, ES = 0.83), and there was a large ES for NSMT in the PE group (p < 0.001, ES = 1.07). Both PE and AE may lead to short-term improvements in selective attention, verbal fluency, and executive control in inactive young adults, and PE may benefit speed of movement.

The Effect of Aerobic Exercise on Physical and Cognitive Outcomes in a Small Cohort of Outpatients with Schizophrenia

Background:

Schizophrenia (SCZ) is a severe, chronic illness characterized by psychotic symptoms and impairments in many cognitive domains. Dysregulation of brain derived neurotrophic factor (BDNF) is associated with the cognitive impairments seen in patients with SCZ. Given the growing literature supporting a positive effect of aerobic exercise on cognition in other populations, we hypothesized that a structured aerobic exercise program would improve cognitive and functional outcomes in subjects with SCZ, potentially mediated by increases in BDNF.

Methods:

The study was a small randomized parallel group clinical trial of subjects with SCZ comparing 12 weeks of aerobic exercise (AE) against control (CON) stretching and balance training. At Baseline, Week 12, and Week 20 we collected serum samples for analysis of brain derived neurotrophic factor (BDNF), and assessed functional, physical, and cognitive outcomes. Linear regression models were used to compare change scores between timepoints.

Results:

We randomized 21 subjects to AE and 17 to CON; however, only 9 AE and 6 CON completed their programs. Subjects in both groups were slower at the 400 m walk in Week 12 compared to Baseline, but the AE group had significantly less slowing than the CON group (B = –28.32, p = 0.011). Between Week 12 and Week 20, the AE group had a significantly greater change score on the Composite and Visual Learning Domain of the MATRICS Consensus Cognitive Battery (B = 5.11, p = 0.03; B = 13.96, p = 0.006).

Conclusion:

These results indicate that participation in a structured aerobic exercise paradigm may modestly blunt physical function decline and enhance cognitive function in individuals with SCZ.