Neuromodulation of Aerobic Exercise-A Review

Effects of activity participation and cognitive levels on depression in middle-aged and older adults with chronic illness: a national cross-sectional study

Introduction

The world population is rapidly aging, and depression mainly affects middle-aged and older adults with chronic diseases and cognitive impairments. The sample for this study was obtained from the China Health and Retirement Longitudinal Study (CHARLS) public database. The sample size for inclusion was 12,767. There were 6,773 females and 5,994 males, with an overall low level of education. This study aims to provide a theoretical and practical reference basis for the clinical non-pharmacological treatment of depression in middle-aged and older adults (age ≥ 50 years) with chronic diseases. Additionally, the study seeks to promote the development of mental health interventions for middle-aged and older adults (age ≥ 50 years) with chronic diseases, ultimately enhancing the sense of well-being and quality of life for this demographic.

Methods

Cognitive functioning and depressive symptoms of the study participants were assessed using the Mini-Mental State Examination Scale (MMSE) and the short version of the Center for Epidemiological Studies Depression Scale (CESD-10).

Results and discussion

Binary logistic regression results showed that among middle-aged and older adults (age ≥ 50 years) with chronic diseases, participation in physical activity [OR = 1.397; 95% CI (1.181-1.651); p < 0.05] was more effective than participation in social activities [OR = 0.997; 95% CI (0.924-1.076); p < 0.05] for preventing depression. Those with cognitive impairment [OR = 1.206; 95% CI (1.089-1.335); p < 0.05] were more likely to experience depression than those without cognitive impairment. Activity participation (physical activity and social activity) had a more significant effect on mild and moderate depression compared to no depression, and cognitive level had a more pronounced effect on moderate depression [OR = 1.491; 95% CI (1.278-1.740); p < 0.05] and major depression [OR = 2.231; 95% CI (1.282-3.884); p < 0.05]. Within the specific cohort of middle-aged and older adults (age ≥ 50 years) with chronic diseases, both activity participation and cognitive level exert a significant influence on the prevention and intervention of depression. Engagement in physical activity, participation in social activities, and enhanced cognitive functioning emerged as protective factors against depression. Therefore, the policy-maker should strengthen the prevention and treatment of depression in a comprehensive manner through the promotion of physical and social activities and the enhancement of cognitive level, so as to safeguard the mental health of middle-aged and older adults with chronic diseases.

A review of exercise interventions for reducing anxiety symptoms: Insights and implications

Generalized anxiety disorder (GAD) is a prevalent mental health condition affecting a significant proportion of the adult population. Despite the availability of pharmacological treatments, their long-term efficacy and potential side effects necessitate exploring alternative interventions. Aerobic exercise has emerged as a promising non-pharmacological approach for managing anxiety symptoms in individuals with GAD. This narrative review examines the efficacy of aerobic exercise interventions in alleviating symptoms of anxiety disorders, drawing on a comprehensive analysis of relevant literature. The review synthesizes findings from studies investigating various forms of aerobic exercise, including high-intensity interval training, resistance training, Pilates, and walking. The results indicate that aerobic exercise interventions demonstrate efficacy in reducing anxiety symptoms and improving overall well-being across diverse populations, including primary care patients, individuals with coronary heart disease, and older adults with cancer undergoing chemotherapy. The review discusses the neurobiological and psychological mechanisms underlying the anxiolytic effects of aerobic exercise. It highlights the implications of these findings for clinical practice, public health initiatives, and future research directions. Despite the promising evidence, limitations in study methodologies and heterogeneity across interventions warrant a cautious interpretation of the results. Further research is needed to elucidate optimal exercise modalities, dosages, and long-term effects on anxiety outcomes.

Exercise and endometriosis-is there a promising future? A narrative review

BACKGROUND

Endometriosis is the leading cause of chronic pelvic pain in women of reproductive age with debilitating effects on quality of life, yet no cure exists. Exercise yields the potential in providing women with a non-invasive, non-pharmacological method of symptom control.

AIM(S)

Present up-to-date knowledge regarding how exercise may contribute to the management of endometriosis-related symptoms.

OBJECTIVE(S)

Discuss: 1. The pathophysiology surrounding exercise and endometriosis. 2. The role of exercise in endometriosis symptom control.

RATIONALE

Scientific literature has alluded to exercise being a favourable factor in the management of endometriosis-related symptoms. Moreover, current clinical guidelines for endometriosis fail to reflect the aforementioned benefits of exercise.

SEARCH STRATEGY

A search strategy using the terms 'endometriosis', 'endometriomas', 'exercise', and 'physical activity' was devised. Pubmed, Medline, Cochrane reviews, and Embase were reviewed.

INCLUSION CRITERIA

Interventional studies, within-subjects studies, randomised-control trials, systematic reviews, meta-analysis, cohort studies, publication since 2000.

EXCLUSION CRITERIA

Non-English publications, non-human studies.

RESULTS

Numerous studies have suggested positive effects for endometriosis patients who performed exercise exclusively or in conjunction with other therapies. Improvements in pain levels, quality of life, anxiety, and depression were noted.

DISCUSSION

Current research outlines promise regarding the potential benefit of exercise prescribing in patients with endometriosis as well as a synergy between exercise and hormonal therapies for the management of endometriosis-related symptoms. However, the current paucity of high-quality robust studies investigating these aspects of endometriosis management is an apparent obstacle to progression in this area.

CONCLUSION

For clinicians to incorporate exercise in managing endometriosis, clear recommendations regarding advice and benefits are needed.

The effectiveness of exercise in alleviating long COVID symptoms: A systematic review and meta-analysis

BACKGROUND

Long COVID is prevalent in the general population. Exercise is a promising component of rehabilitation for long COVID patients.

AIM

This study examined the effects of exercise interventions on managing long COVID symptoms.

METHODS

In this systematic review and meta-analysis, a systematic search was conducted through June 2023 using keywords such as "long COVID" and "post-acute COVID-19 syndrome" among major electronic databases. Randomized controlled trials that examined the effect of exercise on patients suffering from long COVID were included. Nine studies involving 672 individuals were included in this study.

RESULTS

The main outcomes for exercise interventions in patients with long COVID were fatigue, dyspnea, anxiety, depression, and cognitive impairment. The exercise interventions comprised aerobic exercise, multimodal exercise, breathing exercise, and Taichi. Most of the included studies (6/9) were at high risk of bias. According to the meta-analyses, exercise significantly improved long COVID fatigue (ES = 0.89, 95% CI: 0.27 to 1.50) and dyspnea (ES = 1.21, 95% CI [0.33, 2.09]), whereas no significant effect was identified on long COVID anxiety, depression, and cognitive impairment. According to subgroup analyses, multimodal exercise had the broadest spectrum of benefits on long COVID symptoms (including fatigue, dyspnea, and depression), and supervised exercise, intervention frequency ≤4 times a week, the passive control group also showed a positive effect on some long COVID symptoms.

Greater physical fitness ( VO 2 max ) in healthy older adults associated with increased integrity of the locus coeruleus-noradrenergic system

AIM

Physical activity (PA) is a key component for brain health and Reserve, and it is among the main dementia protective factors. However, the neurobiological mechanisms underpinning Reserve are not fully understood. In this regard, a noradrenergic (NA) theory of cognitive reserve (Robertson, 2013) has proposed that the upregulation of NA system might be a key factor for building reserve and resilience to neurodegeneration because of the neuroprotective role of NA across the brain. PA elicits an enhanced catecholamine response, in particular for NA. By increasing physical commitment, a greater amount of NA is synthetised in response to higher oxygen demand. More physically trained individuals show greater capabilities to carry oxygen resulting in greaterVo 2 max - a measure of oxygen uptake and physical fitness (PF).

METHODS

We hypothesized that greaterVo 2 max would be related to greater Locus Coeruleus (LC) MRI signal intensity. In a sample of 41 healthy subjects, we performed Voxel-Based Morphometry analyses, then repeated for the other neuromodulators as a control procedure (Serotonin, Dopamine and Acetylcholine).

RESULTS

As hypothesized, greaterVo 2 max related to greater LC signal intensity, and weaker associations emerged for the other neuromodulators.

CONCLUSION

This newly established link betweenVo 2 max and LC-NA system offers further understanding of the neurobiology underpinning Reserve in relationship to PA. While this study supports Robertson's theory proposing the upregulation of the NA system as a possible key factor building Reserve, it also provides ground for increasing LC-NA system resilience to neurodegeneration viaVo 2 max enhancement.

Potential Link Between Exercise and N-Methyl-D-Aspartate Glutamate Receptors in Alcohol Use Disorder: Implications for Therapeutic Strategies

Alcohol use disorder (AUD) is a significant risk factor, accounting for approximately 13% of all deaths in the US. AUD not only destroys families but also causes economic losses due to reduced productivity, absenteeism, and healthcare expenses. Statistics revealing the sustained number of individuals affected by AUD over the years underscore the need for further understanding of the underlying pathophysiology to advance novel therapeutic strategies. Previous research has implicated the limbic brain regions N-methyl-D-aspartate glutamate receptors (NMDAR) in the emotional and behavioral effects of AUD. Given that aerobic exercise can modulate NMDAR activity and sensitivity to alcohol, this review presents a summary of clinical and basic science studies on NMDAR levels induced by alcohol consumption, as well as acute and protracted withdrawal, highlighting the potential role of aerobic exercise as an adjunctive therapy for AUD. Based on our findings, the utility of exercise in the modulation of reward-linked receptors and AUD may be mediated by its effects on NMDA signaling. These data support further consideration of the potential of aerobic exercise as a promising adjunctive therapy for AUD.

Effectiveness of Mobile-Based Progressive and Fixed Physical Activity on Depression, Stress, Anxiety, and Quality of Life Outcomes Among Adults in South Korea: Randomized Controlled Trial

BACKGROUND

Depression acts as a significant obstacle to the overall well-being of individuals. Given the significant consequences, timely recognition and proactive steps to manage symptoms of depression become essential. Such actions not only reduce personal distress but also play a crucial role in reducing its far-reaching impact on society as a whole.

OBJECTIVE

In response to this concern, the objective of this study was to explore the use of mobile-based interventions as a possible remedy. More specifically, this study aimed to investigate the effectiveness of 2 types of physical activity (PA), progressive and fixed, within a mobile-based app on depression, perceived stress, anxiety, physical health, and psychological health, aiming to contribute to the optimization of mental health benefits.

METHODS

Participants (N=60; mean age 25.29, SD 6.10 years) were recruited using a combination of web-based and offline methods, and the study lasted for 8 weeks. The baseline and posttest questionnaires were administered to all participants. The participants were randomly assigned to 1 of the 3 groups: progressive group (n=20; performing mobile-based progressive PA), fixed group (n=20; performing mobile-based fixed intensity PA), and control group C (n=20). Data analysis involved comparing scores between the experimental and control groups using a one-way ANOVA, paired sample t tests (2-tailed), and repeated measures ANOVA with a 3 (group)×2 (time) design.

RESULTS

The findings revealed significant improvements in mental health indicators among participants engaged in both fixed and progressive PA groups compared with the control group. However, the fixed PA group demonstrated more significant reductions in symptoms. Specifically, the progressive PA group showed significant reductions in depression (F1,36=6.941; P=.01; ηp2=0.16) and perceived stress (F1,36=5.47; P=.03; ηp2=0.13), while the fixed PA group exhibited significant reductions in depression (F1,37=5.36; P=.03; ηp2=0.12), perceived stress (F1,37=7.81; P=.008; ηp2=0.17), and general anxiety disorder (F1,37=5.45; P=.03; ηp2=0.13) compared with the control group.

CONCLUSIONS

This study underscores the potential of mobile-based PA in improving mental health outcomes. The findings offer significant insights for mental health professionals and researchers aiming to optimize mental well-being through innovative mobile therapies.

TRIAL REGISTRATION

Clinical Research Information Service KCT0009100; https://tinyurl.com/mr33fmur.

A Narrative Review of the Dorsal Root Ganglia and Spinal Cord Mechanisms of Action of Neuromodulation Therapies in Neuropathic Pain

Neuropathic pain arises from injuries to the nervous system in diseases such as diabetes, infections, toxicity, and traumas. The underlying mechanism of neuropathic pain involves peripheral and central pathological modifications. Peripheral mechanisms entail nerve damage, leading to neuronal hypersensitivity and ectopic action potentials. Central sensitization involves a neuropathological process with increased responsiveness of the nociceptive neurons in the central nervous system (CNS) to their normal or subthreshold input due to persistent stimuli, leading to sustained electrical discharge, synaptic plasticity, and aberrant processing in the CNS. Current treatments, both pharmacological and non-pharmacological, aim to alleviate symptoms but often face challenges due to the complexity of neuropathic pain. Neuromodulation is emerging as an important therapeutic approach for the treatment of neuropathic pain in patients unresponsive to common therapies, by promoting the normalization of neuronal and/or glial activity and by targeting cerebral cortical regions, spinal cord, dorsal root ganglia, and nerve endings. Having a better understanding of the efficacy, adverse events and applicability of neuromodulation through pre-clinical studies is of great importance. Unveiling the mechanisms and characteristics of neuromodulation to manage neuropathic pain is essential to understand how to use it. In the present article, we review the current understanding supporting dorsal root ganglia and spinal cord neuromodulation as a therapeutic approach for neuropathic pain.

Effect of aerobic exercise on the improvement of executive function in children with attention deficit hyperactivity disorder: a systematic review and meta-analysis

Objective

Aerobic exercise (AE) interventions are beginning to be used as an emerging adjunctive treatment modality in the treatment of children with Attention Deficit Hyperactivity Disorder (ADHD). However, to date, there is no substantial evidence to support the improved effects of aerobic exercise intervention in children with ADHD aged 6-12 years. This study aims to investigate the effect of aerobic exercise therapy on executive function in children with attention deficit hyperactivity disorder aged 6-12 years.

Method

We conducted a systematic review and meta-analysis using PubMed and Web of Science. The cut-off date was June 1, 2023. The aim was to assess the impact of aerobic exercise interventions on children with ADHD and all randomized controlled trials eligible for aerobic exercise interventions for children with ADHD were included. Nine randomized controlled trials were screened for eligibility for systematic evaluation, and the nine studies were assessed for risk of bias using the PEDro score and the GRADE Quality of Evidence Evaluation System for quality grading of outcome indicators. After testing for heterogeneity, a random-effects model was selected for analysis. Finally, meta-analyses and regression analyses were performed on the core functions (inhibitory control, cognitive flexibility, and working memory) and subgroups of the nine studies on executive function using Revman 5.4 and Stata 16.0.

Results

The risk of bias evaluation showed a mean PEDro score of 7.78, and of the nine studies, two were rated as having excellent methodological quality, while the remaining seven had a good level of evidence, and the GRADE evidence evaluation showed that the outcome indicators were all of moderate quality. Inhibitory control [SMD = 0.83,95% CI (0.37-1.29), Z = 3.51, p = 0.0005], cognitive flexibility [SMD = 0.65,95% CI (0.37-0.93), Z = 4.58, p < 0.00001], and working memory [SMD = 0.48,95% CI (0.02-0.95), Z = 2.03, p = 0.04] were statistically significant, with effect sizes of moderate or higher; furthermore, in subgroup analyses type of intervention, duration, intensity, and medication use had different effects on inhibitory control and cognitive flexibility, and the combined IC, CF statistic found that a single category of aerobic exercise ( β = 0.867, p < 0.001), moderate intensity ( β = 0.928, p < 0.001), 6-12 weeks (β = 0.804, p < 0.001), 60-90 min ( β = 0.894, p < 0.001), and the use of medication ( β = 1.202, p = 0.002) were better for overall improvement in EF.

Conclusion

Aerobic exercise therapy significantly improved executive functioning in children with ADHD, showing above moderate effect sizes especially in inhibitory control, cognitive flexibility, and working memory. Aerobic exercise therapy can be used as a reference in improving executive function in children with ADHD, but given the limitations of this study, it should be used with caution when applied in clinical settings.

The Effect of Physical Activity Levels on Cognitive Performance: Research in Portuguese Adolescents

The literature unequivocally acknowledges the numerous health benefits that physical activity (PA) provides. However, in other variables, such as cognitive performance (CP), the PA characteristics required to elicit favorable benefits remain controversial, particularly among adolescents. The aim was to investigate the evolution of CP in adolescents over the school year, as well as the role of regular PA levels. The study included 366 adolescents (boys n = 154), between 12 and 20 years old (15.46 ± 1.63), from middle school (n = 123) and high school (n = 243). CP was assessed through a face-to-face interview employing the Cognitive Telephone Screening Instrument. The variation in CP (∆CP) was determined by the difference between the value of the final assessment (end of the school year) and the initial assessment (start of the school year). PA was assessed using accelerometry (ActiGraph GT3X+). The CP score improved from the initial to the final assessment (37.80 ± 9.26 vs. 40.45 ± 10.05) (t = -6.135; p < 0.001; Glass's Delta = 0.37. Multiple linear regression revealed that age (ß = -0.332; t = -4.255; p < 0.001) and high-intensity PA (ß = 0.283; t = 3.627; p < 0.001) accounted for 17.2% of the variation in ∆CP. CP improved significantly over the school year, emphasizing the significance of age and vigorous PA in ∆CP in adolescents.

Revitalizing the Gut Microbiome in Chronic Kidney Disease: A Comprehensive Exploration of the Therapeutic Potential of Physical Activity

Both physical inactivity and disruptions in the gut microbiome appear to be prevalent in patients with chronic kidney disease (CKD). Engaging in physical activity could present a novel nonpharmacological strategy for enhancing the gut microbiome and mitigating the adverse effects associated with microbial dysbiosis in individuals with CKD. This narrative review explores the underlying mechanisms through which physical activity may favorably modulate microbial health, either through direct impact on the gut or through interorgan crosstalk. Also, the development of microbial dysbiosis and its interplay with physical inactivity in patients with CKD are discussed. Mechanisms and interventions through which physical activity may restore gut homeostasis in individuals with CKD are explored.

An investigation of the acute effects of aerobic exercise on executive function and cortical excitability in adolescents with attention deficit hyperactivity disorder (ADHD)

Previous studies have shown that aerobic exercise has beneficial effects on executive function in adolescents with attention-deficit hyperactivity disorder (ADHD). The underlying mechanisms could be partially due to aerobic exercise-induced cortical excitability modulation. The aim of this study was to explore the effects of acute aerobic exercise on executive functions and cortical excitability and the association between these phenomena in adolescents with ADHD. The study was conducted using a complete crossover design. Executive functions (inhibitory control, working memory, and planning) and cortical excitability were assessed in twenty-four drug-naïve adolescents with ADHD before and after acute aerobic exercise or a control intervention. Inhibitory control, working memory, and planning improved after acute aerobic exercise in adolescents with ADHD. Moreover, cortical excitability monitored by transcranial magnetic stimulation (TMS) decreased after intervention in this population. Additionally, improvements in inhibitory control and working memory performance were associated with enhanced cortical inhibition. The findings provide indirect preliminary evidence for the assumption that changes in cortical excitability induced by aerobic exercise partially contribute to improvements in executive function in adolescents with ADHD.

Combined associations of regular exercise and work-related moderate-to-vigorous physical activity with occupational stress responses: a cross-sectional study

Objective

The association between work-related moderate-to-vigorous physical activity (MVPA) and higher levels of stress response is recognized, but whether this association is moderated by regular exercise remains unclear. This cross-sectional study investigated whether exercise-based physical activity (PA) associates with lower levels of stress responses moderated by work-related MVPA.

Methods

The study participants comprised 863 workers from 35 small and medium-sized enterprises in Shimane prefecture, Japan, collected through convenient sampling from April 2021 to August 2022. The Brief Job Stress Questionnaire was used to assess stress responses. Work-related MVPA and exercise-based PA were measured using questionnaires. Multiple linear regression was used to analyze the combined variables of work-related MVPA and exercise-based PA. The reference group had no weekly exercise-based PA and >60 min of work-related MVPA.

Results

When work-related MVPA exceeded 60 min/day, flexibility activity or walking for ≥5 days/week (B = -3.53, 95% CI = -5.96, -1.11; B = -2.53, 95% CI = -4.90, -0.16) and muscle-strengthening activity 1-3 times/week (B = -3.52, 95% CI = -6.91, -0.12) were significantly associated with lower psychological stress response. Flexibility activity (B = -1.74, 95% CI = -3.01, -0.46) showed a similar link with physical stress response. When work-related MVPA was below 60 min/day, flexibility activity (B = -3.23, 95% CI = -6.01, -0.44; B = -3.29, 95% CI = -5.94, -0.63) or walking (B = -4.03, 95% CI = -6.62, -1.45; B = -3.10, 95% CI = -5.76, -0.44) practice 1-4 times/week and ≥5 times/week was significantly associated with lower psychological stress response.

Conclusion

Exercise-based PA greatly and consistently associates with a lower level of stress responses moderated by work-related MVPA.

Aerobic Exercise and Endocannabinoids: A Narrative Review of Stress Regulation and Brain Reward Systems

Aerobic exercise is a widely adopted practice, not solely for enhancing fitness and reducing the risk of various diseases but also for its ability to uplift mood and aid in addressing depression and anxiety disorders. Within the scope of this narrative review, we seek to consolidate current insights into the endocannabinoid-mediated regulation of stress and the brain's reward mechanism resulting from engaging in aerobic exercise. A comprehensive search was conducted across Medline, SPORTDiscus, Pubmed, and Scopus, encompassing data available until November 30, 2023. This review indicates that a bout of aerobic exercise, particularly of moderate intensity, markedly augments circulating levels of endocannabinoids - N-arachidonoyl-ethanolamine (AEA) and 2-acylglycerol (2-AG), that significantly contributes to mood elevation and reducing stress in healthy individuals.  The current understanding of how aerobic exercise impacts mental health and mood improvement is still unclear. Moderate and high-intensity aerobic exercise modulates stress through a negative feedback mechanism targeting both the hypothalamus-pituitary-adrenal (HPA) axis and the sympathetic nervous system, thereby facilitating stress regulation crucial role in endocannabinoid synthesis, ultimately culminating in the orchestration of negative feedback across multiple tiers of the HPA axis, coupled with its influence over cortical and subcortical brain structures. The endocannabinoid has been observed to govern the release of neurotransmitters from diverse neuronal populations, implying a universal mechanism that fine-tunes neuronal activity and consequently modulates both emotional and stress-related responses. Endocannabinoids further assume a pivotal function within brain reward mechanisms, primarily mediated by CB1 receptors distributed across diverse cerebral centers. Notably, these endocannabinoids partake in natural reward processes, as exemplified in aerobic exercise, by synergizing with the dopaminergic reward system. The genesis of this reward pathway can be traced to the ventral tegmental area, with dopamine neurons predominantly projecting to the nucleus accumbens, thereby inciting dopamine release in response to rewarding stimuli.

Physical Activity and Mental Health in Children and Adolescents With Neurodevelopmental Disorders: A Systematic Review and Meta-Analysis

Importance

Children and adolescents with neurodevelopmental disorders experience mental health issues and are encouraged to be brought together in real-life treatment. However, physical activity, which is a promising method for boosting mental health, has only been examined in children and adolescents with certain types of neurodevelopmental disorders.

Objective

To examine the association of physical activity interventions with mental health (ie, cognitive function, psychological well-being, internalizing, and externalizing problems) in children and adolescents with neurodevelopmental disorders and to identify possible moderators.

Data Sources

Studies were searched from inception to May 2023 through Web of Science, PsycINFO, SPORTDiscus, MEDLINE, CINAHL, and ERIC.

Study Selection

Randomized clinical trials or nonrandomized designs applying physical activity interventions and reporting at least 1 mental health outcome in children and adolescents aged 5 to 17 years with neurodevelopmental disorders were included. Two independent reviewers selected and assessed the studies.

Data Extraction and Synthesis

Random multilevel meta-analysis using Hedges g was performed. Data extraction and risk-of-bias assessment were conducted by multiple reviewers. Heterogeneity, publication bias, sensitivity analysis, and moderator analysis were examined to substantiate the results.

Main Outcomes and Measures

The main outcomes were mental health related to cognitive function, psychological well-being, internalizing, or externalizing problems measured by neurocognitive tasks or subjective questionnaires.

Results

A total of 76 studies involving 3007 participants were included in systematic review, 59 of which were used for meta-analysis. The findings indicated that physical activity interventions were associated with significant benefits for overall mental health (g, 0.67; 95% CI, 0.50-0.85), cognitive function (g, 0.74; 95% CI, 0.53-0.95), psychological well-being (g, 0.56; 95% CI, 0.16-0.96), internalizing (g, 0.72; 95% CI, 0.34-1.10), and externalizing problems (g, 0.58; 95% CI, 0.28-0.89). Moderators were also identified: frequency, total sessions, and total duration for overall mental health; total sessions, and total duration for cognitive function; session duration and frequency for psychological well-being; physical activity type for internalizing problems; and session duration for externalizing problems. Moderator analyses showed that type of neurodevelopmental disorder did not modify the associations between physical activity and overall mental health or its subgroups.

Conclusions and Relevance

The findings in this study suggest that children and adolescents with different types of neurodevelopmental disorders may be grouped together when performing physical activity interventions, which were confirmed to be beneficial to overall mental health and its subgroups in this new diagnostic population, but that physical activity interventions should be tailored when targeting different mental health domains.

Estrogen-mediated individual differences in female rat voluntary running behavior

Regular exercise has numerous health benefits, but the human population displays significant variability in exercise participation. Rodent models, such as voluntary wheel running (VWR) in rats, can provide insight into the underlying mechanisms of exercise behavior and its regulation. In this study, we focused on the role of estrogen on VWR in female rats. Female rats run more than males, and we aimed to determine to what extent running levels in females were regulated by estrogen signaling. The running behavior of rats (duration, speed, and total distance run) was measured under normal physiological conditions, ovariectomy (OVX), and estrogen replacement in an OVX background. Results show cyclic variations in running linked to the estrous cycle. Ovariectomy markedly reduced running and eliminated the cyclic pattern. Estrogen replacement through estradiol benzoate (EB) injections and osmotic minipumps reinstated running activity to pre-OVX levels and restored the cyclic pattern. Importantly, individual differences and ranking are preserved such that high versus low runners before OVX remain high and low runners after treatment. Further analysis revealed that individual variation in running distance was primarily caused by rats running different speeds, but rats also varied in running duration. However, it is noteworthy that this model also displays features distinct from estrogen-driven running behavior under physiological conditions, notably a delayed onset and a broader duration of running activity. Collectively, this estrogen causality VWR model presents a unique opportunity to investigate sex-specific mechanisms that control voluntary physical activity.NEW & NOTEWORTHY This study investigates estrogen's role in voluntary wheel running (VWR) behavior in female rats. Female rats exhibit greater running than males, with estrogen signaling regulating this activity. The estrous cycle influences running, whereas ovariectomy reduces it, and estrogen replacement restores it, maintaining individual differences under all conditions. Both running speed and duration contribute to VWR variations. These findings emphasize individual estrogen regulation in female exercise and provide an estrogen replacement animal model for investigating neurobiological underpinnings that drive voluntary exercise behavior.

Sweating for Sobriety: Exploring the Relationship Between Exercise Engagement and Substance Use Disorders

Despite various interventions available for substance use disorders, relapse rates remain substantial and, therefore, alternative strategies for attenuating dependence are needed. This study examined the associations between exercise frequency, illicit substance use, and dependence severity among a large sample of people who use drugs. The study utilized data from the Global Drug Survey 2018 (N = 57,110) to investigate the relationship between exercise frequency, illicit substance use, and substance dependence severity. Binomial regressions were employed to examine the relationship between exercise and SDS scores for 9 drugs. Greater exercise frequency correlated with reduced severity of substance dependence for specific drugs: cannabis (χ2 = 14.75, p < .001), MDMA (χ2 = 4.73, p = .029), cocaine (χ2 = 8.37, p = .015), amphetamine powder (χ2 = 6.39, p = .041), and methamphetamine (χ2 = 15.17, p < .001). These findings suggest a potential link between exercise and reduced substance use dependency. Further research is needed to understand the complex dynamics between exercise and substance use, considering potential bidirectional relationships and concurrent factors.

Differences in risk of generalized anxiety disorder according to physical activity type in Korea adolescents: The Korea youth risk behavior web-based survey, 2020-2021

Objective

This study aimed to analyze the association between the types of physical activity (PA) and the level of generalized anxiety disorder (GAD) in Korean adolescents.

Methods

This study analyzed data from the Korea Youth Risk Behavior Web-based Survey (KYRBS) for, 2020-2021. The dependent variable was the level of generalized anxiety disorder-7 (GAD-7). The GAD-7 scores were divided into four levels: normal, mild, moderate, and severe. The independent variables were moderate PA, vigorous PA, and strength exercises. Sex, school grade, body mass index, stress, depression, suicidal thoughts, violent victimization, drinking, smoking, substance abuse, sleep satisfaction, and sedentary time were selected as confounding variables.

Results

The independent variable and all confounding variables showed significant differences with the level of GAD-7 (all p < .001). After adjusting for all confounding variables, we observed a 1.062 elevation in mild anxiety disorders, a 1.147 increase in moderate anxiety disorders, and a 1.218 increased incidence of severe anxiety disorders in the absence of vigorous PA. In the absence of strength exercises, there was a 1.057 elevation in mild anxiety disorders, a 1.110 increase in moderate anxiety disorders, and a 1.351 increased incidence of severe anxiety disorders. However, in the case of moderate PA, after adjusting for confounding variables, there was no significant association with GAD-7 levels.

Conclusion

To prevent anxiety disorders among Korean adolescents, the type of PA should be considered. Vigorous PA or strength exercises may help prevent GAD in Korean adolescents.

Physical Activity and Neuropsychological Functioning in Older Adults

Research has identified a positive relationship between physical activity and neuropsychological functioning across the lifespan. The present study further examined the relationship between physical activity, depression, anxiety, and cognitive functioning in community-dwelling older adults (ages 65-96) who completed an outpatient neuropsychological evaluation (N = 526). Psychometrically sound and validated measures were used to assess depression, anxiety, and cognitive functioning. Analyses of covariance (ANCOVA) were conducted to examine differences between individuals who reported regularly engaging in physical activity and those who did not, after adjusting for demographic variables (age, education, and gender). Results indicated that physical activity was associated with better scores on measures of depression, anxiety, and cognitive functioning. Effect sizes for total scores on all measures were large, but there was a sizeable range of effect sizes (from small to large) for various cognitive domains. Smallest effect sizes were observed for subtests measuring language skills and visuospatial abilities, whereas largest effect sizes were seen in processing speed and memory. Results suggest that engaging in physical activity may be a beneficial non-pharmacological intervention for older adults. These findings underscore the importance of integrating physical activity programs in community and healthcare settings to foster mental and cognitive health in older populations.

Exercise is inversely associated with functional dyspepsia among a sample of Chinese male armed police recruits

BACKGROUND

There is no study evaluating the association between exercise and functional dyspepsia (FD) based on the Rome IV criteria. We aimed to investigate the prevalence of FD and evaluate the association between exercise and FD based on Rome IV criteria among a sample of Chinese armed police recruits.

METHODS

An on-site questionnaire survey on FD among a sample of Chinese armed police recruits was conducted based on the Rome IV criteria in 2021. Potential confounders included age, body mass index (BMI), race, marriage, education, smoking, and drinking variables were adjusted.

RESULTS

A total of 2594 recruits were enrolled, including 46 FD participants and 2548 non-FD participants. In the model adjusted for all demographic variables among participants excluding irritable bowel syndrome (IBS) and functional constipation (FC), compared with no exercise participants, 1 h < each exercise time ≤ 2 h (OR = 0.15, 95% CI: 0.03-0.77, P = 0.0230) was inversely associated with FD and compared with no exercise participants, mild exercise (OR = 0.09, 95% CI: 0.01-0.71, P = 0.0220) was significantly inversely associated with FD.

CONCLUSIONS

The incidence rate of FD in this sample Chinese armed police recruits was 1.77%, and 1 h < each exercise time ≤ 2 h and mild intensity exercise were independently inversely associated with FD. However, the causal relationship needs to be verified by further randomized controlled trials.

Physical Exercise Promotes Beneficial Changes on Neurotrophic Factors in Mesolimbic Brain Areas After AMPH Relapse: Involvement of the Endogenous Opioid System

Addiction is a serious public health problem, and the current pharmacotherapy is unable to prevent drug use reinstatement. Studies have focused on physical exercise as a promising coadjuvant treatment. Our research group recently showed beneficial neuroadaptations in the dopaminergic system related to amphetamine-relapse prevention involving physical exercise-induced endogenous opioid system activation (EXE-OS activation). In this context, additional mechanisms were explored to understand the exercise benefits on drug addiction. Male rats previously exposed to amphetamine (AMPH, 4.0 mg/kg) for 8 days were submitted to physical exercise for 5 weeks. EXE-OS activation was blocked by naloxone administration (0.3 mg/kg) 5 min before each physical exercise session. After the exercise protocol, the rats were re-exposed to AMPH for 3 days, and in sequence, euthanasia was performed and the VTA and NAc were dissected. In the VTA, our findings showed increased immunocontent of proBDNF, BDNF, and GDNF and decreased levels of AMPH-induced TrkB; therefore, EXE-OS activation increased all these markers and naloxone administration prevented this exercise-induced effect. In the NAc, the same molecular markers were also increased by AMPH and decreased by EXE-OS activation. In this study, we propose a close relation between EXE-OS activation beneficial influence and a consequent neuroadaptation on neurotrophins and dopaminergic system levels in the mesolimbic brain area, preventing the observed AMPH-relapse behavior. Our outcomes bring additional knowledge concerning addiction neurobiology understanding and show that EXE-OS activation may be a potential adjuvant tool in drug addiction therapy.

Independent and joint associations of aerobic and muscle-strengthening exercise with mental health in adolescents: A cross-sectional analysis before and during COVID-19 using the 2015-2021 National Youth Risk Behavior Survey

PURPOSE

COVID-19 led to social isolation that may have compromised adolescent mental health. This study examined the independent and joint associations of aerobic physical activity (PA) and muscle-strengthening exercise (MSE) with mental health problems in adolescents.

METHODS

Participants were US adolescents who completed the 2015-2021 National Youth Risk Behavior Survey (N = 61,298; 45.7% female). Data were collected between 2015 and 2021 and analyzed in 2023. Outcomes were binary response items asking about feeling sad/hopeless, having difficulty concentrating, remembering, or making decisions, and having a suicidal ideation. Preventive exposure variables were items asking about frequencies of aerobic PA and MSE with responses dichotomized to align with recommendations. Independent and joint associations were examined using robust Poisson regression with covariates selected using double selection lasso. Structural equation models examined the associations treating PA and MSE as continuous predictors and poor mental health as a latent dependent variable.

RESULTS

Meeting either recommendation alone associated with a 4-10% lower prevalence of mental health problems (APR = 0.90-0.96, p < 0.05), and meeting both recommendations associated with a 15%-20% lower prevalence of mental health problems (APR = 0.80-0.85, p < 0.001). Although categorical joint associations were stronger in males (p < 0.05), multiplicative interactions were observed in females using continuous variables for PA and MSE (β = -0.09, p < 0.001).

CONCLUSION

Meeting aerobic PA and MSE recommendations associated with lower prevalence of mental health problems. Participation in MSE below recommended levels may be beneficial for females when combined with aerobic PA. Future research should examine these associations by acquiring contextual information and device-based assessments.

Physical activity interventions for cardiopulmonary fitness in obese children and adolescents: a systematic review and meta-analysis

PURPOSE

This study [PROSPERO CRD42023416272] systematically analysed the effects of a physical activity intervention on cardiorespiratory fitness in obese children and adolescents and elucidated the factors that influenced those effects.

METHODS

A systematic review of the literature on physical activity interventions for improving cardiopulmonary fitness in obese children and adolescents from January 1, 2011, to March 1, 2023, was conducted. The search was performed on the Web of Science and PubMed databases, and the selected literature was first screened and then assessed for quality. Finally, a systematic review was conducted.

RESULTS

Out of the initially identified 1424 search records, 28 studies were eventually included in the systematic review. These studies encompassed a total of 2724 participants aged 5 to 18 years, with the publication dates of the literature primarily ranging from 2011 to 2023. Physical activity was found to effectively improve the following parameters in obese children and adolescents: weight [mean difference (MD), -2.03 (95% confidence interval, -2.59 to -1.47), p < 0.00001], maximal oxygen consumption [MD, -1.95 (95% CI, -1.06 to -2.84), p < 0.0001], heart rate [MD, -2.77 (95% CI, -4.88 to -0.67), p = 0.010], systolic blood pressure [MD, -8.11 (95% CI, -11.41 to -4.81), p < 0.00001], and diastolic blood pressure [MD, -4.18 (95% CI, -5.32 to -3.03), p < 0.00001]. High-intensity exercise was found to yield greater improvements than low- to moderate-intensity exercise in maximal oxygen consumption [MD, 1.43 (95% CI, 0.04 to 2.82), p = 0.04] and diastolic blood pressure [MD, -6.94 (95% CI, -10.61 to -3.26), p = 0.0002] in obese children and adolescents.

CONCLUSION

Physical activity can effectively improve the body weight, maximal oxygen consumption, heart rate, systolic blood pressure, and diastolic blood pressure of obese children and adolescents. The type of physical activity directly influences the participation interest of obese children and adolescents, with moderate- to high-intensity physical activity showing the most significant impact on intervention outcomes. High-frequency, long-term interventions yield better results than short-term interventions.

The impact of physical exercise on the consolidation of fear extinction memories

Based on the mechanisms of fear extinction, exposure therapy is the most common treatment for anxiety disorders. However, extinguished fear responses can reemerge even after successful treatment. Novel interventions enhancing exposure therapy efficacy are therefore critically needed. Physical exercise improves learning and memory and was also shown to enhance extinction processes. This study tested whether physical exercise following fear extinction training improves the consolidation of extinction memories. Sixty healthy men underwent a differential fearconditioning paradigm with fear acquisition training on day 1 and fear extinction training followed by an exercise or resting control intervention on day 2. On day 3, retrieval and reinstatement were tested including two additional but perceptually similar stimuli to explore the generalization of exercise effects. Exercise significantly increased heart rate, salivary alpha amylase, and cortisol, indicating successful exercise manipulation. Contrary to our expectations, exercise did not enhance but rather impaired extinction memory retrieval on the next day, evidenced by significantly stronger differential skin conductance responses (SCRs) and pupil dilation (PD). Importantly, although conditioned fear responses were successfully acquired, they did not fully extinguish, explaining why exercise might have boosted the consolidation of the original fear memory trace instead. Additionally, stronger differential SCRs and PD toward the novel stimuli suggest that the memory enhancing effects of exercise also generalized to perceptually similar stimuli. Together, these findings indicate that physical exercise can facilitate both the long-term retrievability and generalization of extinction memories, but presumably only when extinction was successful in the first place.

Changes in stress pathways as a possible mechanism of aerobic exercise training on brain health: a scoping review of existing studies

Physical activity (PA) in the form of aerobic exercise (AE) preserves and improves neurocognitive function across the lifespan. However, a mechanistic understanding of the pathways by which aerobic exercise impacts brain health is still lacking, particularly with respect to stress-related pathways. One mechanistic hypothesis is that AE improves neurocognitive health in part by modifying circulating levels of stress-related hormones and signaling factors associated with the hypothalamic-pituitary-adrenal (HPA) axis and autonomic nervous system (ANS), as commonly measured by the biomarkers cortisol (CORT) and salivary α-amylase (sAA). Thus, this hypothesis predicts that changes in stress biomarkers, such as CORT and sAA, are possible explanatory pathways mediating the positive effects of AE on neurocognitive health. In the present review article, we provide a summary of available studies examining the possibility that exercise-induced changes to stress biomarkers could partly account for exercise-related improvements in neurocognitive health. Our review indicates that despite the intuitive appeal of this hypothesis, there is insufficient evidence available to conclude that chronic and habitual AE affects neurocognitive health by altering stress biomarker pathways. The cross-sectional nature of the majority of reviewed studies highlights the need for well-controlled studies to adequately test this hypothesis.

Treadmill Exercise Improves Behavioral and Neurobiological Alterations in Restraint-Stressed Rats

Stress is a state that is known to impact an organism's physiological and psychological balance as well as the morphology and functionality of certain brain areas. In the present work, chronic restraint stress (CRS) model rats treated with treadmill exercise were used to examine anomalies associated to emotion and mood as well as molecular changes in the brain. Forty male Sprague-Dawley rats were divided into control, stress, exercise, and stress+exercise groups. CRS were exposed to stress group rats and exercise group underwent a chronic treadmill exercise. Depressive-like behavior was evaluated with the forced swim test (FST) and tail suspension test (TST). For assessing anxiety-like behavior, the light-dark test (LDT) and the open field test (OFT) were used. The Morris water maze test (MWMT) was used for testing memory and learning. Brain's monoamine level and the expression of genes related to stress were measured. It was discovered that CRS lengthens latency in the MWMT, increases immobility in the FST and TST, decreases time in the light compartment, and causes hypoactivity in the OFT. CRS reduced the dopamine levels in the nucleus accumbens(NAc). Brain-derived neurotrophic factor (BDNF), dopamine receptors, and serotonin receptor (HTR2A) gene expression in the prefrontal cortex, corpus striatum, and hypothalamus were decreased by CRS. Exercise on a treadmill leads to increase NAc's dopamine and noradrenaline levels and prevented behavioral alterations. Exercise increased the alterations of BDNF expressions in the brain in addition to improving behavior. As a result, CRS-induced behavioral impairments were effectively reversed by chronic treadmill exercise with molecular alterations in the brain.

Greater physical fitness (Vo2Max) in healthy older adults associated with increased integrity of the Locus Coeruleus-Noradrenergic system

Physical activity (PA) is a key component for brain health and Reserve, and it is among the main dementia protective factors. However, the neurobiological mechanisms underpinning Reserve are not fully understood. In this regard, a noradrenergic (NA) theory of cognitive reserve (Robertson, 2013) has proposed that the upregulation of NA system might be a key factor for building reserve and resilience to neurodegeneration because of the neuroprotective role of NA across the brain. PA elicits an enhanced catecholamine response, in particular for NA. By increasing physical commitment, a greater amount of NA is synthetised in response to higher oxygen demand. More physically trained individuals show greater capabilities to carry oxygen resulting in greater Vo2max - a measure of oxygen uptake and physical fitness (PF). In the current study, we hypothesised that greater Vo2 max would be related to greater Locus Coeruleus (LC) MRI signal intensity. As hypothesised, greater Vo2max related to greater LC signal intensity across 41 healthy adults (age range 60-72). As a control procedure, in which these analyses were repeated for the other neuromodulators' seeds (for Serotonin, Dopamine and Acetylcholine), weaker associations emerged. This newly established link between Vo2max and LC-NA system offers further understanding of the neurobiology underpinning Reserve in relationship to PA. While this study supports Robertson's theory proposing the upregulation of the noradrenergic system as a possible key factor building Reserve, it also provide grounds for increasing LC-NA system resilience to neurodegeneration via Vo2max enhancement.

Greater physical fitness (Vo2Max) in healthy older adults associated with increased integrity of the Locus Coeruleus-Noradrenergic system

Physical activity (PA) is a key component for brain health and Reserve, and it is among the main dementia protective factors. However, the neurobiological mechanisms underpinning Reserve are not fully understood. In this regard, a noradrenergic (NA) theory of cognitive reserve (Robertson, 2013) has proposed that the upregulation of NA system might be a key factor for building reserve and resilience to neurodegeneration because of the neuroprotective role of NA across the brain. PA elicits an enhanced catecholamine response, in particular for NA. By increasing physical commitment, a greater amount of NA is synthetised in response to higher oxygen demand. More physically trained individuals show greater capabilities to carry oxygen resulting in greater Vo2max - a measure of oxygen uptake and physical fitness (PF). In the current study, we hypothesised that greater Vo2 max would be related to greater Locus Coeruleus (LC) MRI signal intensity. As hypothesised, greater Vo2max related to greater LC signal intensity across 41 healthy adults (age range 60-72). As a control procedure, in which these analyses were repeated for the other neuromodulators' seeds (for Serotonin, Dopamine and Acetylcholine), weaker associations emerged. This newly established link between Vo2max and LC-NA system offers further understanding of the neurobiology underpinning Reserve in relationship to PA. While this study supports Robertson's theory proposing the upregulation of the noradrenergic system as a possible key factor building Reserve, it also provide grounds for increasing LC-NA system resilience to neurodegeneration via Vo2max enhancement.

Examining the Interaction between Exercise, Gut Microbiota, and Neurodegeneration: Future Research Directions

Physical activity has been demonstrated to have a significant impact on gut microbial diversity and function. Emerging research has revealed certain aspects of the complex interactions between the gut, exercise, microbiota, and neurodegenerative diseases, suggesting that changes in gut microbial diversity and metabolic function may have an impact on the onset and progression of neurological conditions. This study aimed to review the current literature from several databases until 1 June 2023 (PubMed/MEDLINE, Web of Science, and Google Scholar) on the interplay between the gut, physical exercise, microbiota, and neurodegeneration. We summarized the roles of exercise and gut microbiota on neurodegeneration and identified the ways in which these are all connected. The gut-brain axis is a complex and multifaceted network that has gained considerable attention in recent years. Research indicates that gut microbiota plays vital roles in metabolic shifts during physiological or pathophysiological conditions in neurodegenerative diseases; therefore, they are closely related to maintaining overall health and well-being. Similarly, exercise has shown positive effects on brain health and cognitive function, which may reduce/delay the onset of severe neurological disorders. Exercise has been associated with various neurochemical changes, including alterations in cortisol levels, increased production of endorphins, endocannabinoids like anandamide, as well as higher levels of serotonin and dopamine. These changes have been linked to mood improvements, enhanced sleep quality, better motor control, and cognitive enhancements resulting from exercise-induced effects. However, further clinical research is necessary to evaluate changes in bacteria taxa along with age- and sex-based differences.

Effect of Exercise on Chemotherapy-Induced Peripheral Neuropathy Among Patients Treated for Ovarian Cancer: A Secondary Analysis of a Randomized Clinical Trial

Importance

Chemotherapy-induced peripheral neuropathy (CIPN), one of the most common and severe adverse effects of chemotherapy, is associated with worse quality of life among survivors of ovarian cancer. Currently, there is no effective treatment for CIPN.

Objective

To evaluate the effect of a 6-month aerobic exercise intervention vs attention-control on CIPN among women treated for ovarian cancer in the Women's Activity and Lifestyle Study in Connecticut (WALC) to provide evidence to inform the guidelines and recommendations for prevention or treatment of CIPN.

Design, Setting, and Participants

This prespecified secondary analysis evaluated the Women's Activity and Lifestyle Study in Connecticut (WALC), a multicentered, open-label, population-based, phase 3 randomized clinical trial of an aerobic exercise intervention vs attention control for CIPN in patients who were diagnosed with ovarian cancer. Only WALC participants who received chemotherapy were included in this analysis. Participants were randomized 1:1 to either a 6-month aerobic exercise intervention or to attention control. All analyses were conducted between September 2022 and January 2023.

Interventions

The exercise intervention consisted of home-based moderate-intensity aerobic exercise facilitated by weekly telephone counseling from an American College of Sports Medicine/American Cancer Society-certified cancer exercise trainer. Attention control involved weekly health education telephone calls from a WALC staff member.

Main Outcomes and Measure

Change in CIPN was the primary outcome in this secondary analysis. This outcome was represented by CIPN severity, which was self-measured by participants at baseline and 6 months using the Functional Assessment of Cancer Therapy/Gynecologic Oncology Group-Neurotoxicity scale, with a score range of 0 to 44. A mixed-effects model was used to assess the 6-month change in CIPN between the exercise intervention and attention control arms.

Results

Of the 134 participants (all females; mean [SD] age, 57.5 [8.3] years) included in the analysis, 69 were in the exercise intervention arm and 65 were in the attention control arm. The mean (SD) time since diagnosis was 1.7 (1.0) years. The mean (SD) baseline CIPN scores were 8.1 (5.6) in the exercise intervention arm and 8.8 (7.9) in the attention control arm (P = .56). At 6 months, the self-reported CIPN score was reduced by 1.3 (95% CI, -2.3 to -0.2) points in the exercise intervention arm compared with an increase of 0.4 (95% CI, -0.8 to 1.5) points in the attention control arm. The between-group difference was -1.6 (95% CI, -3.1 to -0.2) points. The point estimate was larger among the 127 patients with CIPN symptoms at enrollment (-2.0; 95% CI, -3.6 to -0.5 points).

Conclusions and Relevance

Findings of this secondary analysis of the WALC trial indicate that a 6-month aerobic exercise intervention vs attention control significantly improved self-reported CIPN among patients who were treated for ovarian cancer. While replication of the findings in other studies is warranted, incorporating referrals to exercise programs into standard oncology care could reduce CIPN symptoms and increase quality of life in patients with ovarian cancer.

Trial Registration

ClinicalTrials.gov Identifier: NCT02107066.

Association between aerobic fitness and attentional functions in Egyptian preadolescent children

Growing evidence indicates that culture and education can influence cognitive constructs. Studies targeting Western and Asian populations have shown a positive relationship between aerobic fitness and cognitive control in children; however, this association has yet to be explored in the Arab world. The current study aimed to investigate the relationship between aerobic fitness and attentional networks in Egyptian preadolescent children. In total, 103 preadolescent children (9.76 ± 0.11) completed an assessment of aerobic fitness using a 6-min running test and a computerized attention network test that allowed for assessing alerting, orienting, and executive networks. The results revealed that higher aerobic fitness was associated with shorter response time and higher response accuracy in a more cognitively demanding task condition (i.e., incongruent trials). Furthermore, higher aerobic fitness was associated with a more efficient executive network. No associations were observed for alerting and orienting networks. These findings corroborate growing evidence indicating the importance of aerobic fitness for cognitive development and extend the literature by suggesting that the positive association between aerobic fitness and cognitive control might be generalized to the Arab population and not significantly change across cultures.

Sex-based differences in the association of leisure-time physical activity with the risk of depression: the Ansan and Ansung study of the Korean Genome and Epidemiology Study (KoGES)

Objective

Depression is a serious mental disorder which is the leading cause of suicide. This study investigated the association between incident depression and 4-year leisure-time physical activity (PA) levels and/or resistance training (RT).

Methods

This community-based Korean cohort included 3,967 participants without depression at baseline. The average PA-time (the total duration of moderate-intensity leisure-time PA) up to 4 years prior to baseline enrollment was calculated to evaluate the cumulative levels of PA. Participants were divided into four groups based on their average PA-time: "Non-PA," " <150 min/week," "150-299 min/week," and "≥300 min/week." Furthermore, based on compliance to PA guidelines (≥150 min/week of PA-time) and participation in RT, the participants were categorized into four subgroups: "Low-PA," "Low-PA+RT," "High-PA," and "High-PA+RT." A multivariate Cox proportional hazards regression model was used to assess the 4-year incidence of depression according to leisure-time PA levels and/or regularity of RT.

Results

During the mean 3.72 ± 0.69 years of follow-up, 432 participants (10.89%) developed depression. In women, performing 150-299 min/week of moderate-intensity leisure-time PA was associated with a 38% risk reduction for incident depression (HR, 0.62; CI, 0.43-0.89; p < 0.05), whereas more than 300 min/week of that was related to a 44% risk reduction for incident depression (HR, 0.56; CI, 0.35-0.89; p < 0.05) as compared to that in the Non-PA group. However, in men, there was no significant relationship between the amount of leisure-time PA per week and the risk of incident depression. Moreover, in both sexes, RT had no significant effect on depression in either the Low-PA or High-PA group.

Conclusions

There was an inverse dose-response association between leisure-time PA levels and incident depression only in women, whereas adding RT to high levels of PA had no significant effect on depression in either sex.

Effects of aerobic exercise on global cognitive function and sleep in older adults with mild cognitive impairment: A systematic review and meta-analysis

We conducted a systematic review and meta-analysis to determine the integrated effect of aerobic exercise on cognitive function and sleep in older adults with mild cognitive impairment (MCI) and to optimize exercise methods for improving cognitive function. We searched multiple databases from January 1, 2011, to August 31, 2022, and analyzed 11 studies. Global cognitive function in older adults with MCI undergoing aerobic exercise training was significantly improved (standardized mean difference [SMD]=0.76, 95% confidence interval [CI]:0.37, 1.14), while sleep improvement was not significant (SMD= -2.07 [95% CI: -6.76, 2.62]). In the moderator analysis, aerobic exercise types with cognitive factors, exercise time of 30-50 min per session, and exercise frequency of 5-7 times per week had statistically significant effects on cognitive function improvement. However, meta-regression identified only exercise frequency as a significant moderator of the mean effect size of cognitive function.

The Endocannabinoid System and Physical Exercise

The endocannabinoid system (ECS) is involved in various processes, including brain plasticity, learning and memory, neuronal development, nociception, inflammation, appetite regulation, digestion, metabolism, energy balance, motility, and regulation of stress and emotions. Physical exercise (PE) is considered a valuable non-pharmacological therapy that is an immediately available and cost-effective method with a lot of health benefits, one of them being the activation of the endogenous cannabinoids. Endocannabinoids (eCBs) are generated as a response to high-intensity activities and can act as short-term circuit breakers, generating antinociceptive responses for a short and variable period of time. A runner's high is an ephemeral feeling some sport practitioners experience during endurance activities, such as running. The release of eCBs during sustained physical exercise appears to be involved in triggering this phenomenon. The last decades have been characterized by an increased interest in this emotional state induced by exercise, as it is believed to alleviate pain, induce mild sedation, increase euphoric levels, and have anxiolytic effects. This review provides information about the current state of knowledge about endocannabinoids and physical effort and also an overview of the studies published in the specialized literature about this subject.

Effects of Depression, Anxiety, and Pain Catastrophizing on Total Hip Arthroplasty Patient Activity Level

BACKGROUND

Improvements in psychological factors are strongly associated with increased physical activity in the general population. The effects of depression, anxiety, and pain catastrophizing on activity level have not been thoroughly explored in patients undergoing total hip arthroplasty (THA). Mental health markedly influences patient perspectives on treatment success and quality of life. We hypothesized that improvements in screenings for depression, anxiety, and catastrophizing correlate with improvements in activity levels after THA.

METHODS

Two hundred ninety two patients (313 hips) who underwent THA with a minimum 1-year (mean 615 ± 270 days) follow-up completed preoperative and postoperative surveys containing the University of California Los Angeles (UCLA) Activity Score, Hospital Anxiety Depression Scale (HADS), Pain Catastrophizing Scale (PCS), and Depression Anxiety Stress Scale-21 (DASS). Wilcoxon signed-rank tests were performed between preoperative and postoperative times for outcome measures. Partial Spearman's rank-order correlations were performed between the change in UCLA Score and the change in HADS, PCS, and DASS.

RESULTS

There were significant improvements in UCLA Score (P value < .0001) and every subscale of PCS, HADS, and DASS (P values < .0001). Significant negative correlations existed between change in UCLA Score and change in HADS-anxiety (r_s = -0.21, P value < .001), change in HADS-depression (r_s = -0.23, P value < .001), and change in DASS-anxiety (r_s = -0.22, P value = .004) following THA. Weaker significant negative correlations existed between change in UCLA Score and change in the remaining PCS (P values = .006) and DASS-depression(P value = .037) subscales.

CONCLUSION

Improvements in patient-reported depression, anxiety, and pain catastrophizing screenings following THA were associated with increased activity levels. Patients who were screened for catastrophizing, depression, and anxiety achieved statistically and clinically meaningful improvements in symptoms following THA. Addressing patient mental health provides another avenue for holistic care of THA patients.

Pattern of serum brain-derived neurotrophic factor levels after acute interval exercise versus acute continuous exercise in obese adolescent females

Obesity has been linked to lower cognitive function, while exercise is known to be beneficial in enhancing the cognitive function. Exercise is also known to increase brain-derived neurotrophic factor (BDNF), as the biological marker of cognitive function. This study aimed to analyse the pattern of serum BDNF levels after acute interval exercise (MIE) versus acute continuous exercise (MCE) in obese adolescent females. A total of 24 obese females were enrolled in this study and given acute interval exercise and acute continuous exercise with moderate intensity. The serum level of BDNF in all samples was quantified using ELISA. Statistical analysis was performed using two-way repeated measures ANOVA, and LSD post-hoc test with a 5% significance level. The results revealed pre-exercise mean serum BDNF levels of 254.17±86.90 pg/ml (Control), 263.21±79.82 pg/ml (MIE) and 266.01±33.29 pg/ml (MCE) (P=0.948). The mean serum BDNF levels at 10 min post-exercise were 248.84±44.42 pg/ml (Control), 397.00±31.36 pg/ml (MIE), and 582.82±79.24 pg/ml (MCE) (P=0.000). The mean serum BDNF levels at 6 h post-exercise were 250.05±70.44 pg/ml (Control), 344.50±68.84 pg/ml (MIE), and 364.42±100.87 pg/ml (MCE) (P=0.029). The mean serum BDNF levels at 24 h post-exercise were 244.20±48.55 pg/ml (Control), 252.49±89.11 pg/ml (MIE), and 250.99±65.86 pg/ml (MCE) (P=0.986). It was concluded that serum BDNF in obese adolescent females increased but transiently. Serum BDNF levels increased by acute exercise in both MIE and MCE at 10 min and 6 h post-exercise. However, serum BDNF level at 24 h post-exercise decreased close to the pre-exercise serum BDNF level in all groups. Further research is needed studying the effect of chronic exercise on the kinetics of serum BDNF levels in obese adolescent females.

Direct and Inherited Epigenetic Changes in the Nervous System Caused by Intensive Locomotion: Possible Adaptive Significance

Abstract

This review is devoted to the analysis of works that investigated the long-term effects of species-specific forms of intensive locomotion on the cognitive functions of animals and humans, which can be transmitted to the next generation. To date, the anxiolytic and cognitive-enhancing long-term effects of intensive locomotion have been demonstrated in humans, rodents, fish, insects, mollusks, and nematodes. In rodents, changes in the central nervous system caused by intense locomotion can be transmitted through the maternal and paternal line to the descendants of the first generation. These include reduced anxiety, improved spatial learning and memory, increased levels of brain neurotrophic factor and vascular endothelial growth factor in the hippocampus and frontal cortex. The shift of the balance of histone acetylation in the hippocampus of rodents towards hyperacetylation, and the balance of DNA methylation towards demethylation manifests itself both as a direct and as a first-generation inherited effect of motor activity. The question about the mechanisms that link locomotion with an increase in the plasticity of a genome in the brain of descendants remains poorly understood, and invertebrate model organisms can be an ideal object for its study. Currently, there is a lack of a theoretical model explaining why motor activity leads to long-term improvement of some cognitive functions that can be transmitted to the next generation and why such an influence could have appeared in evolution. The answer to these questions is not only of fundamental interest, but it is necessary for predicting therapeutic and possible side effects of motor activity in humans. In this regard, the article pays special attention to the review of ideas on the evolutionary aspects of the problem. We propose our own hypothesis, according to which the activating effect of intensive locomotion on the function of the nervous system could have been formed in evolution as a preadaptation to a possible entry into a new environment.

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.

Effects of a Personalised Physical Exercise Program on University Workers Overall Well-Being: "UAL-Activa" Program

Background and objectives: Regular individualised physical exercise (PE) is a habit that not only has consequences for overall health (physical, emotional, social and mental) but can also have positive effects on organisations and institutions, as it helps workers to improve their personal balance and recover from the effort of their working day, showing higher levels of energy, commitment and productivity. The aim of this study was to understand the relationship between the practice of PE and well-being in personal life and at work, as well as job satisfaction, overall health and the assessment of the personal training service provided by final-year students studying for a degree in Physical Activity and Sport Sciences. Methods: This study used a qualitative research methodology. There were 25 employees of the University of Almeria (UAL) (M = 52.16 ± 9.55 years), divided into two focus groups and participating in the physical exercise program "UAL Activa". Results: The following three main themes, based on the results, emerged: (a) social well-being during PE practice, (b) assessment of the personal training service and (c) physical exercise as an emotional benefit at work. Conclusion. The workers' interventions have shown that participating in a personalised PE program led by a personal trainer can improve overall health and mood, with a very positive influence on the working environment.

A healthy mind in a healthy body: Effects of arteriosclerosis and other risk factors on cognitive aging and dementia

In this review we start from the assumption that, to fully understand cognitive aging, it is important to embrace a holistic view, integrating changes in bodily, brain, and cognitive functions. This broad view can help explain individual differences in aging trajectories and could ultimately enable prevention and remediation strategies. As the title of this review suggests, we claim that there are not only indirect but also direct effects of various organ systems on the brain, creating cascades of phenomena that strongly contribute to age-related cognitive decline. Here we focus primarily on the cerebrovascular system, because of its direct effects on brain health and close connections with the development and progression of Alzheimer's Disease and other types of dementia. We start by reviewing the main cognitive changes that are often observed in normally aging older adults, as well as the brain systems that support them. Second, we provide a brief overview of the cerebrovascular system and its known effects on brain anatomy and function, with a focus on aging. Third, we review genetic and lifestyle risk factors that may affect the cerebrovascular system and ultimately contribute to cognitive decline. Lastly, we discuss this evidence, review limitations, and point out avenues for additional research and clinical intervention.

Effect of Aerobic Exercises in Improving Premenstrual Symptoms Among Healthy Women: A Systematic Review of Randomized Controlled Trials

Background

Premenstrual symptoms in women of reproductive age are associated with substantial distress and functional impairments. A healthy lifestyle is the first step to manage premenstrual symptoms. Recreational physical activities have been recommended as an alternative to medical management in easing premenstrual symptoms.

Objective

The objective of this systematic review is to analyze the effects of aerobic exercises in improving premenstrual symptoms among healthy women.

Methods

Randomized controlled trials (RCTs) published from inception to February 2022, were searched using keywords in electronic databases such as, SCOPUS, PubMed, PEDro, Cochrane and web of science. RCTs published in English, comparing the effects of aerobic exercise with other interventions or controls were included. PEDro scale and Cochrane collaboration tool for risk of bias was used to assess the methodological quality of included trials. Data from the included study and the participant’s characteristics, interventions, outcome and results were extracted.

Results

Five RCTs with 492 participants were included in this systematic review. Methodological quality assessed by PEDro (4.8/10) and Cochrane collaboration tool for risk of bias were moderate. Allocation concealment, blinding of participants and outcome assessors were the most common bias in all included studies. Walking, swimming and running were the common aerobic exercises performed in the RCTs. Aerobic exercise is effective in improving physical physiological symptoms among women with premenstrual syndrome (PMS).

Conclusion

Aerobic exercises are effective in improving premenstrual symptoms. This review provides moderate evidence for improving hematological parameters during PMS. Further RCTs with long term follow up and quality of life would consolidate our findings.

PE augmented mindfulness: A neurocognitive framework for research and future healthcare

Various well-controlled studies have suggested that practitioners in mindfulness can be prone to patient drop-out (e.g., due to chronic stress, pathology, cognitive reactivity), despite researchers having identified the underlying mechanisms that link mindfulness to mental health. In this article, a framework for physical exercise (PE) augmented mindfulness is proposed, which posits that consistently practiced PE before meditation can support (early-stage) mindfulness. Neurocognitive research shows PE (aerobic exercises or yoga) and mindfulness to impact similar pathways of stress regulation that involve cognitive control and stress regulation, thereby supporting the proposed synergistic potential of PE augmented mindfulness. Research focused on the psychophysiological impact of PE, showed its practice to promote short-term neurocognitive changes that can promote both cognitive control and the attainment of mindful awareness (MA). In order to chart dose responses required for protocol development, further research will be presented. Together these findings are discussed in light of future research on this multidisciplinary topic, protocol development, mindful walking, and further application in healthcare and beyond.

A Path Model for Subjective Well-Being during the Second Wave of the COVID-19 Pandemic: A Comparative Study among Polish and Ukrainian University Students

Background: Previous studies showed several associations between physical and mental health dimensions and well-being. This study aims to examine a complex path model explaining the life satisfaction of university students from Poland and Ukraine during the second wave of the COVID-19 pandemic. Methods: The cross-sectional web-based study was performed in November 2020 using Google Forms. The conventional sample of 3230 university students from Poland (n = 1581) and Ukraine (n = 1649), aged 18–59 (M = 21.40, SD = 3.46), with 59% women, participated in the study. We used standardized questionnaires to measure life satisfaction (SWLS), self-reported physical health (GSRH), perceived stress (PSS-10), coronavirus-related PTSD (PCL-S), anxiety (GAD-7), and depression (PHQ-9). We also developed some questions to assess the exposure to the COVID-19 pandemic, positive effects of the pandemic, religiosity, and physical activity (PA). Results: We found a high prevalence of stress, coronavirus-related PTSD, anxiety, and depression and a low level of life satisfaction and physical health. Polish students, women, and those with insufficient PA levels reported worse physical and mental health than Ukrainians, men, and those who exercised sufficiently during the pandemic. Low perceived stress can directly predict life satisfaction, anxiety, and depression. Low stress also leads to better physical health, sufficient PA levels, high religiosity, and more perceived positive effects of the pandemic. Several indirect effects between particular variables and life satisfaction were also found in the path model. Conclusions: The target group for campus prevention programs is Polish university students, women, and people with insufficient PA levels. Intervention and prevention programs should focus on coping strategies and techniques for improving mental and physical health.

Association between changes in handgrip strength and depression in Korean adults: a longitudinal panel study

Depression in older adults is a global socioeconomic burden. Identifying factors, such as physical activity or exercise that can help prevent depression is important. We aimed to investigate the relationship between changes in handgrip strength and the presence of depression using longitudinal, nationwide data of older Korean adults. Data from the Korean Longitudinal Study of Aging were used in this study. A total of 6783 participants who had undergone a handgrip strength test and completed the short-form Center for Epidemiologic Studies Depression Scale (CESD-10-D) questionnaire from 2006 to 2018 were included. General estimating equations were used to assess the temporal effect of the changes in handgrip strength on depression. A decrease in handgrip strength was associated with high CESD-10-D scores (β = 0.1889 in men, β = 0.1552 in women). As a continuous variable, handgrip strength was negatively correlated with CESD-10-D scores(β = - 0.0166 in men, β = - 0.0196 in women). Changes in the handgrip strength were associated with depressive symptoms in our longitudinal study. Those who experienced a decrease in handgrip strength had severe depressive symptoms compared to those with unchanged or increased handgrip strength. These findings can be used to guide general health policies for the prevention of depression.

Aerobic exercise as a promising nonpharmacological therapy for the treatment of substance use disorders

Despite the prevalence and public health impact of substance use disorders (SUDs), effective long-term treatments remain elusive. Aerobic exercise is a promising, nonpharmacological treatment currently under investigation as a strategy for preventing drug relapse. Aerobic exercise could be incorporated into the comprehensive treatment regimens for people with substance abuse disorders. Preclinical studies of SUD with animal models have shown that aerobic exercise diminishes drug-seeking behavior, which leads to relapse, in both male and female rats. Nevertheless, little is known regarding the effects of substance abuse-induced cellular and physiological adaptations believed to be responsible for drug-seeking behavior. Accordingly, the overall goal of this review is to provide a summary and an assessment of findings to date, highlighting evidence of the molecular and neurological effects of exercise on adaptations associated with SUD.

Physical Activity, Life Satisfaction, Stress Perception and Coping Strategies of University Students in Belarus during the COVID-19 Pandemic

The COVID-19 restrictions in Belarus turned out to be less stringent than those of its neighboring countries. Objective: We aimed to evaluate physical activity, life satisfaction, perception of stress, choice of coping strategies and their correlations among Belarusian students. An anonymous Internet survey was conducted among 1769 students studying at the faculties of physical culture (415), pedagogical (737), and medical (617) universities. International Physical Activity Questionnaires (IPAQ) and Satisfaction With Life Scale (SWLS), Perceived Stress Scale-10 (PSS-10), and Coping Orientations to Problems Experienced (mini-COPE) questionnaires were used. The respondents declared sufficient and high levels of physical activity. The level of physical activity was correlated with life satisfaction (typically for student-athletes). The least satisfaction with life and highest level of perceived stress were among future doctors. The minimum indicator of stress was noted in athletes. The most common coping strategy was active coping. Strategies of problem avoidance and seeking support from outside were not used by student-athletes. These strategies were used by pedagogical and medical students. Student-athletes have the most favorable opportunities, followed by representatives of pedagogical and medical students. The proposed classification of the levels of behavior (optimal, acceptable, satisfactory and risky) makes it possible to adjust lifestyles.

Adolescents' Physical Activity and Psychological Adjustment Across the First Year of the COVID-19 Pandemic

The outbreak of the COVID-19 virus dramatically changed daily life and created many obstacles for adolescents to engage in physical activity (PA). This study tracked rates of self-reported PA and examined its impact on adjustment among adolescents during the first 14 months of the pandemic. Canadian adolescents (N = 1068, 14-18 y, meanage = 16.95 y) reported on their frequency of PA, context of activity, and adjustment across 4 time points (April 2020 to June 2021). In line with our hypothesis, higher average levels of vigorous PA across the pandemic predicted less anxiety and depression and higher self-esteem at our study's end. Vigorous PA also buffered the relationships COVID-19 stress had with anxiety and self-esteem. The results further support recommendations for PA throughout the pandemic and while dealing with lockdown situations.

Exercise and the Brain: Lessons From Invertebrate Studies

Benefits of physical exercise for brain functions are well documented in mammals, including humans. In this review, we will summarize recent research on the effects of species-specific intense locomotion on behavior and brain functions of different invertebrates. Special emphasis is made on understanding the biological significance of these effects as well as underlying cellular and molecular mechanisms. The results obtained in three distantly related clades of protostomes, Nematodes, Molluscs and Artropods, suggest that influence of intense locomotion on the brain could have deep roots in evolution and wide adaptive significance. In C. elegans, improved learning, nerve regeneration, resistance to neurodegenerative processes were detected after physical activity; in L. stagnalis—facilitation of decision making in the novel environment, in Drosophila—increased endurance, improved sleep and feeding behavior, in G. bimaculatus—improved orientation in conspecific phonotaxis, enhanced aggressiveness, higher mating success, resistance to some disturbing stimuli. Many of these effects have previously been described in mammals as beneficial results of running, suggesting certain similarity between distantly-related species. Our hypothesis posits that the above modulation of cognitive functions results from changes in the organism’s predictive model. Intense movement is interpreted by the organism as predictive of change, in anticipation of which adjustments need to be made. Identifying the physiological and molecular mechanisms behind these adjustments is easier in experiments in invertebrates and may lead to the discovery of novel neurobiological mechanisms for regulation and correction of cognitive and emotional status.

The effect of aerobic exercises of different intensities on anxiety, cigarette addiction, sleep quality, and quality of life in former smokers

BACKGROUND

There is a worldwide struggle to quit smoking and prevent relapsing. Aerobic exercises are frequently utilized to aid in smoking cessation and prevent relapse.

AIMS

This study aimed to investigate the effects of aerobic exercises of different intensity on the level of anxiety, smoking addiction, and quality of sleep and life in former smokers.

METHODS

The study included 60 people aged 18 to 45 who had quit smoking within the previous month. Individuals were randomly assigned to control (CON), mild-intensity aerobic activity (MIA), and moderate-intensity aerobic activity (MoIA) groups. The MIA group did submaximal aerobic exercises at 40% of maximum heart rate (MHR), while the MoIA group did them at 60% of MHR for 8 weeks/3 days. Participants' anxiety levels were assessed using the Beck Anxiety Scale (BAS), smoking addiction was assessed using the Fagerström Test for Nicotine Dependence and Substance Craving Scale (SCS), sleep quality was assessed using the Pittsburgh Sleep Quality Index, and quality of life was assessed using the SF-36 Short Form Scale (SF-36).

RESULTS

The SCS score of the MoIA group declined more than the MIA and CON groups, and the MIA group had a lower sleep disturbance score than other groups when the influence of exercise training was assessed over time (p < 0.05). Aerobic exercise had no influence on SF-36 or BAS scores (p > 0.05).

CONCLUSIONS

The benefits of mild and moderate aerobic exercise on quality of life and anxiety are similar. However, mild-intensity aerobic exercises may be suitable for sleep difficulties while moderate-intensity aerobic exercises may be preferred for reducing smoking addiction.