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Jeyarajan G, Ayaz A, Herold F, Zou L, Heath M. A single bout of aerobic exercise does not alter inhibitory control preparatory set cerebral hemodynamics: Evidence from the antisaccade task. Brain Cogn 2024; 179:106182. [PMID: 38824809 DOI: 10.1016/j.bandc.2024.106182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2024] [Revised: 05/21/2024] [Accepted: 05/21/2024] [Indexed: 06/04/2024]
Abstract
A single bout of exercise improves executive function (EF) and is a benefit - in part -attributed to an exercise-mediated increase in cerebral blood flow enhancing neural efficiency. Limited work has used an event-related protocol to examine postexercise changes in preparatory phase cerebral hemodynamics for an EF task. This is salient given the neural efficiency hypothesis' assertion that improved EF is related to decreased brain activity. Here, event-related transcranial Doppler ultrasound was used to measure pro- (saccade to target) and antisaccades (saccade mirror-symmetrical target) preparatory phase middle cerebral artery velocity (MCAv) prior to and immediately after 15-min of aerobic exercise. Antisaccades produced longer reaction times (RT) and an increased preparatory phase MCAv than prosaccades - a result attributed to greater EF neural activity for antisaccades. Antisaccades selectively produced a postexercise RT reduction (ps < 0.01); however, antisaccade preparatory phase MCAv did not vary from pre- to postexercise (p=0.53) and did not correlate with the antisaccade RT benefit (p = 0.31). Accordingly, results provide no evidence that improved neural efficiency indexed via functional hyperemia is linked to a postexercise EF behavioural benefit. Instead, results support an evolving view that an EF benefit represents the additive interplay between interdependent exercise-mediated neurophysiological changes.
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Affiliation(s)
- Gianna Jeyarajan
- School of Kinesiology, University of Western Ontario, London, ON, Canada
| | - Azar Ayaz
- School of Kinesiology, University of Western Ontario, London, ON, Canada
| | - Fabian Herold
- Faculty of Health Sciences Brandenburg, University of Potsdam, Potsdam, Germany
| | - Liye Zou
- Body-Brain-Mind Laboratory, School of Psychology, Shenzhen University, Shenzhen, China
| | - Matthew Heath
- School of Kinesiology, University of Western Ontario, London, ON, Canada; Graduate Program in Neuroscience, Schulich School of Medicine & Dentistry, University of Western Ontario, London, ON, Canada; Canadian Centre for Activity and Aging, University of Western Ontario, London, ON, Canada.
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Abdullah M, Lin SH, Huang LC, Chiu NT, Yang YK. Fat loss and muscle gain: The possible role of striatal dopaminergic tone in determining the efficacy of physical exercise. J Formos Med Assoc 2024:S0929-6646(24)00300-0. [PMID: 38965009 DOI: 10.1016/j.jfma.2024.06.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2024] [Revised: 06/24/2024] [Accepted: 06/27/2024] [Indexed: 07/06/2024] Open
Abstract
The effectiveness of exercise for obesity is contentious due to individual response variability. Owing to the roles of dopamine in motor functions, metabolism, and appetite, this study aimed to identify striatal dopamine as a predictor of variability in exercise response, specifically in terms of fat loss and muscle gain. Healthy non-exercising males completed an 8-week program, exercising 1 h, 4 days a week. Striatal dopaminergic tone was assessed by measuring dopamine transporter availability using technetium-99 m labelled tropane derivative, [99mTc]TRODAT-1 (TRODAT), single-photon emission computed tomography, and body composition (fat and muscles mass) was analysed using bioelectrical impedance. Lower baseline dopamine levels were associated with greater fat mass loss (r = 0.58, p = 0.006), percentage fat mass loss (r = 0.53, p = 0.013), and increase in muscle mass (β = -0.53, p = 0.035, after taking age and smoking status as covariates). These findings enhance our understanding of obesity neurobiology and exercise response variability, necessitating further research for targeted interventions based on dopaminergic profiles.
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Affiliation(s)
- Muhammad Abdullah
- Taiwan International Graduate Program in Interdisciplinary Neuroscience, National Cheng Kung University and Academia Sinica, Taipei, Taiwan
| | - Shih-Hsien Lin
- Clinical Medicine Research Center, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Institute of Behavioral Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Li-Chung Huang
- Institute of Clinical Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Nan-Tsing Chiu
- Department of Nuclear Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Yen Kuang Yang
- Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Institute of Behavioral Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Psychiatry, Tainan Hospital, Ministry of Health and Welfare, Tainan, Taiwan.
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Chen JW, Du WQ, Zhu K. Optimal exercise intensity for improving executive function in patients with attention deficit hyperactivity disorder: systematic review and network meta-analysis. Eur Child Adolesc Psychiatry 2024:10.1007/s00787-024-02507-6. [PMID: 38922348 DOI: 10.1007/s00787-024-02507-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2024] [Accepted: 06/17/2024] [Indexed: 06/27/2024]
Abstract
This study aimed to compare and rank the effectiveness of optimal exercise intensity in improving executive function in patients with ADHD (Attention deficit hyperactivity disorder, ADHD) through a comprehensive comparison of direct and indirect evidence. A systematic search was performed in five electronic databases to explore the optimal exercise intensity for improving executive function in patients with ADHD by directly and indirectly comparing a variety of exercise intervention intensities. In addition, the isolated effects of exercise on improving executive function in patients with ADHD were explored through classical meta-analysis of paired direct comparisons. Twenty-nine studies were retrieved and included in this study. Classical paired meta-analysis showed that for the patients with ADHD in the age group of 7-17 years, statistical difference was observed for all the parameters of exercise interventions (intensity, frequency, period, and training method), the three dimensions of executive function, the use of medication or not, the high and low quality of the methodological approach. Network meta-analysis showed that high-intensity exercise training was optimal for improving working memory (97.4%) and inhibitory function (85.7%) in patients with ADHD. Meanwhile, moderate-intensity exercise training was optimal for improving cognitive flexibility (77.3%) in patients with ADHD. Moderate to high intensity exercise training shows potential for improving executive function in these patients. Therefore, we recommend applying high-intensity exercise intervention to improve executive function in patients with ADHD to achieve substantial improvement.
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Affiliation(s)
- Ji-Wei Chen
- Shanghai University of Sport, Shanghai, China
| | - Wen-Qian Du
- Shanghai University of Sport, Shanghai, China
| | - Kun Zhu
- Shanghai University of Sport, Shanghai, China.
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Abdullah M, Lin SH, Huang LC, Chen PS, Tseng HH, Yang YK. Fat loss and muscle gain: The possible role of cortical glutamate in determining the efficacy of physical exercise. Obes Res Clin Pract 2024; 18:163-170. [PMID: 38704348 DOI: 10.1016/j.orcp.2024.04.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Revised: 03/21/2024] [Accepted: 04/23/2024] [Indexed: 05/06/2024]
Abstract
BACKGROUND Physical exercise is widely acknowledged for its health benefits, but its effectiveness in treating obesity remains contentious due to variability in response. Owing to the roles of glutamate in appetite regulation, food addiction, and impulsivity, this observational cohort-study evaluated medial prefrontal cortex (mPFC) glutamate as a predictor of variability in exercise response, specifically in terms of fat loss and muscle gain. METHODS Healthy non-exercising adult men (n = 21) underwent an 8-week supervised exercise program. Baseline glutamate levels in the mPFC were measured through magnetic resonance spectroscopy. For exercise-dependent changes in body composition (fat and muscle mass), basal metabolic rate (BMR), and blood metabolic biomarkers related to lipid and glucose metabolism, measurements were obtained through bioelectrical impedance and blood sample analyses, respectively. RESULTS The exercise program resulted in significant improvements in body composition, including reductions in percentage body fat mass, body fat mass, and waist-to-hip ratio and an increase in mean muscle mass. Furthermore, BMR and metabolic indicators linked to glucose and lipids exhibited significant changes. Notably, lower baseline glutamate levels were associated with greater loss in percentage body fat mass (r = 0.482, p = 0.027), body fat mass (r = 0.441, p = 0.045), and increase in muscle mass (r = -0.409, p = 0.066, marginal) following the exercise program. CONCLUSION These preliminary findings contribute to our understanding of the neurobiology of obesity and emphasize the significance of glutamate in regulating body composition. The results also highlight cortical glutamate as a potential predictor of exercise-induced fat loss and muscle gain.
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Affiliation(s)
- Muhammad Abdullah
- Taiwan International Graduate Program in Interdisciplinary Neuroscience, National Cheng Kung University and Academia Sinica, Taipei, Taiwan
| | - Shih-Hsien Lin
- Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Institute of Behavioral Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Clinical Medicine Research Center, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Li-Chung Huang
- Institute of Clinical Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Po See Chen
- Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Institute of Behavioral Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Huai-Hsuan Tseng
- Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Institute of Behavioral Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Yen Kuang Yang
- Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Institute of Behavioral Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Psychiatry, Tainan Hospital, Ministry of Health and Welfare, Tainan, Taiwan.
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Wang YH, Gau SF, Yang LK, Chang JC, Cheong PL, Kuo HI. Acute aerobic exercise at different intensities modulates inhibitory control and cortical excitability in adults with attention-deficit hyperactivity disorder (ADHD). Asian J Psychiatr 2024; 95:103993. [PMID: 38485649 DOI: 10.1016/j.ajp.2024.103993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Revised: 11/30/2023] [Accepted: 03/02/2024] [Indexed: 03/21/2024]
Abstract
BACKGROUND This study aimed to investigate the effects of different aerobic exercise intensities on inhibitory control and cortical excitability in adults with attention-deficit/hyperactivity disorder (ADHD). METHODS The study was conducted in a within-subject design. Twenty-four adults with ADHD completed a stop signal task and received cortical excitability assessment by transcranial magnetic stimulation (TMS) before and after a single session of low-, moderate-, high-intensity aerobic exercise or a control intervention. RESULTS Acute moderate-, and high-intensity aerobic exercise improved inhibitory control in adults with ADHD. Moreover, the improving effect was similar between moderate-, and high-intensity aerobic exercise conditions. As shown by the brain physiology results, short interval intracortical inhibition was significantly increased following both, moderate- and high-intensity aerobic exercise intervention conditions. Additionally, the alteration of short interval intracortical inhibition and inhibitory control improvement were positively correlated. CONCLUSIONS The moderate-, and high-intensity aerobic exercise-dependent alterations of cortical excitability in adults with ADHD might partially explain the inhibitory control-improving effects of aerobic exercise in this population.
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Affiliation(s)
- Yu-Han Wang
- School and Graduate Institute of Physical Therapy, National Taiwan University, No. 17, Xu-Zhou Road, Taipei 10055, Taiwan
| | - Shur-Fen Gau
- Department of Psychiatry, National Taiwan University Hospital, No 7, Zhongshan S Road, Taipei 10055, Taiwan
| | - Li-Kuang Yang
- Department of Psychiatry, National Taiwan University Hospital, No 7, Zhongshan S Road, Taipei 10055, Taiwan
| | - Jung-Chi Chang
- Department of Psychiatry, National Taiwan University Hospital, No 7, Zhongshan S Road, Taipei 10055, Taiwan
| | - Pou-Leng Cheong
- Department of Pediatrics, National Taiwan University Hospital Hsin-Chu Hospital, No. 25, Lane 442, Section 1, Hsinchu, Taiwan; Department of Biological Science and Technology, National Yang Ming Chiao Tung University, 75 Po-Ai Street, Hsinchu 300, Taiwan
| | - Hsiao-I Kuo
- School and Graduate Institute of Physical Therapy, National Taiwan University, No. 17, Xu-Zhou Road, Taipei 10055, Taiwan.
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García-Hermoso A, Ezzatvar Y, Izquierdo M, López-Gil JF. Can an active lifestyle reduce the risk of obesity in adulthood among adolescents with Attention-Deficit/Hyperactivity Disorder symptoms? An ambispective cohort study. Psychiatry Res 2024; 334:115770. [PMID: 38350293 DOI: 10.1016/j.psychres.2024.115770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2023] [Revised: 01/31/2024] [Accepted: 02/01/2024] [Indexed: 02/15/2024]
Abstract
Various studies have associated Attention-Deficit/Hyperactivity Disorder (ADHD) with obesity, but the role of physical activity in this connection is uncertain. This study examined whether adopting an active lifestyle can mitigate the link between adolescent ADHD and the risk of adult obesity. Longitudinal data from the Add Health Study (Waves I, III, and V) were used. Participants self-reported ADHD symptoms (hyperactivity/impulsivity, inattention, combined) during Wave III and self-assessed their recent moderate-to-vigorous physical activity. An "active lifestyle" required meeting activity criteria in both adolescence (Wave I) and adulthood (Wave III-V). Of 2609 participants, 1.42 % exhibited combined ADHD symptoms. A non-linear relationship was observed between inattentive/hyperactive scores and body mass index (BMI) and waist circumference (WC). Individuals with ≥ 6 hyperactivity/impulsivity symptoms had higher BMI (1.29 kg/m²) and WC (1.27 cm) at adulthood. Logistic regressions indicate that, compared to individuals without ADHD maintaining an active lifestyle, both inactive participants with and without ADHD show an elevated risk of obesity (odds ratio [OR]=1.56 to 2.63) and abdominal obesity in adulthood (OR = 1.51 to 2.50). Mediation analysis models further confirm these findings, suggesting that physical activity may explain this association. Though exact mechanisms warrant further exploration, adopting an active lifestyle offers promise for reducing obesity risk among individuals with ADHD symptoms.
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Affiliation(s)
- Antonio García-Hermoso
- Navarrabiomed, Hospital Universitario de Navarra (HUN), IdiSNA, Universidad Pública de Navarra (UPNA), Pamplona, Spain.
| | - Yasmin Ezzatvar
- Department of Nursing, Universitat de València, Valencia, Spain
| | - Mikel Izquierdo
- Navarrabiomed, Hospital Universitario de Navarra (HUN), IdiSNA, Universidad Pública de Navarra (UPNA), Pamplona, Spain
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Samson JA, Newkirk TR, Teicher MH. Practitioner Review: Neurobiological consequences of childhood maltreatment - clinical and therapeutic implications for practitioners. J Child Psychol Psychiatry 2024; 65:369-380. [PMID: 37609790 DOI: 10.1111/jcpp.13883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/10/2023] [Indexed: 08/24/2023]
Abstract
BACKGROUND Childhood maltreatment is one of the most important preventable risk factors for a wide variety of psychiatric disorders. Further, when psychiatric disorders emerge in maltreated individuals they typically do so at younger ages, with greater severity, more psychiatric comorbid conditions, and poorer response to established treatments, resulting in a more pernicious course with an increased risk for suicide. Practitioners treating children, adolescents, and young adults with psychiatric disorders will likely encounter the highest prevalence of clients with early-onset maltreatment-associated psychiatric disorders. These may be some of their most challenging cases. METHOD In this report, we explore key validated alterations in brain structure, function, and connectivity associated with exposure to childhood maltreatment as potential mechanisms behind their patients' clinical presentations. RESULTS We then summarize key behavioral presentations likely associated with neurobiological alterations and propose a toolkit of established trauma and skills-based strategies that may help diminish symptoms and foster recovery. We also discuss how some of these alterations may serve as latent vulnerability factors for the possible development of future psychopathology. CONCLUSIONS Research on the neurobiological consequences of childhood adversity provides a vastly enriched biopsychosocial understanding of the developmental origins of health and pathology that will hopefully lead to fundamental advances in clinical psychology and psychiatry.
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Affiliation(s)
- Jacqueline A Samson
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
- Developmental Biopsychiatry Research Program, McLean Hospital, Belmont, MA, USA
| | - Thatcher R Newkirk
- Department of Psychiatry, Geisel School of Medicine, Dartmouth Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA
| | - Martin H Teicher
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
- Developmental Biopsychiatry Research Program, McLean Hospital, Belmont, MA, USA
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Mehren A, Philipsen A. [Is Physical Activity a Treatment Option for ADHD?]. ZEITSCHRIFT FUR KINDER- UND JUGENDPSYCHIATRIE UND PSYCHOTHERAPIE 2024; 52:124-133. [PMID: 38335974 DOI: 10.1024/1422-4917/a000963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/12/2024]
Abstract
Is Physical Activity a Treatment Option for ADHD? Abstract: Physical activity as an option for the prevention and treatment of psychiatric disorders is increasingly becoming the focus of research. In particular, because of improvements in cognitive functioning, attentional performance, impulsivity, and hyperactivity, physical exercise could be a promising treatment option for attention deficit hyperactivity disorder (ADHD). In this narrative review, we present and evaluate the current state of research on exercise effects in children and adolescents as well as in adults with ADHD. While studies of the short-term effects of a single bout of physical activity indicate robust effects on attention and inhibitory control, results on the impact on further symptoms of ADHD as well as in adults are mixed. Randomized controlled trials of longer-term physical activity are scarce and show high heterogeneity. Nevertheless, they are encouraging for further research in this area.
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Affiliation(s)
- Aylin Mehren
- Klinik und Poliklinik für Psychiatrie und Psychotherapie, Universitätsklinikum Bonn, Deutschland
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen Medical Centre, The Netherlands
| | - Alexandra Philipsen
- Klinik und Poliklinik für Psychiatrie und Psychotherapie, Universitätsklinikum Bonn, Deutschland
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Sharma AA, Mackensie Terry D, Popp JL, Szaflarski JP, Martin RC, Nenert R, Kaur M, Brokamp GA, Bolding M, Allendorfer JB. Neuromorphometric associations with mood, cognition, and self-reported exercise levels in epilepsy and healthy individuals. Epilepsy Behav Rep 2023; 25:100643. [PMID: 38264358 PMCID: PMC10803905 DOI: 10.1016/j.ebr.2023.100643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Revised: 12/22/2023] [Accepted: 12/27/2023] [Indexed: 01/25/2024] Open
Abstract
Regular physical activity may promote beneficial neuroplasticity, e.g., increased hippocampus volume. However, it is unclear whether self-reported physical exercise in leisure (PEL) levels are associated with the brain structure features demonstrated by exercise interventions. This pilot study investigated the relationship between PEL, mood, cognition, and neuromorphometry in patients with idiopathic generalized epilepsy (IGEs) compared to healthy controls (HCs). Seventeen IGEs and 19 age- and sex-matched HCs underwent magnetic resonance imaging (MRI) at 3T. The Baecke Questionnaire of Habitual Physical Activity, Profile of Mood States, and Montreal Cognitive Assessment (MoCA) assessed PEL, mood, and cognition, respectively. Structural MRI data were analyzed by voxel- and surface-based morphometry. IGEs had significantly lower PEL (p < 0.001), poorer mood (p = 0.029), and lower MoCA scores (p = 0.027) than HCs. These group differences were associated with reduced volume, decreased gyrification, and altered surface topology (IGEs < HCs) in frontal, temporal and cerebellar regions involved in executive function, memory retrieval, and emotional regulation, respectively. These preliminary results support the notion that increased PEL may promote neuroplasticity in IGEs, thus emphasizing the role of physical activity in promoting brain health in people with epilepsy.
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Affiliation(s)
- Ayushe A. Sharma
- University of Alabama at Birmingham (UAB), Department of Neurology, Birmingham, AL, USA
| | - D. Mackensie Terry
- University of Alabama at Birmingham (UAB), Department of Neurology, Birmingham, AL, USA
| | - Johanna L. Popp
- University of Alabama at Birmingham (UAB), Department of Neurology, Birmingham, AL, USA
| | - Jerzy P. Szaflarski
- University of Alabama at Birmingham (UAB), Department of Neurology, Birmingham, AL, USA
- University of Alabama at Birmingham (UAB), Department of Neurobiology, Birmingham, AL, USA
- University of Alabama at Birmingham (UAB), Department of Neurosurgery, Birmingham, AL, USA
- University of Alabama at Birmingham (UAB), UAB Epilepsy Center, Birmingham, AL, USA
| | - Roy C. Martin
- University of Alabama at Birmingham (UAB), Department of Neurology, Birmingham, AL, USA
- University of Alabama at Birmingham (UAB), UAB Epilepsy Center, Birmingham, AL, USA
| | - Rodolphe Nenert
- University of Alabama at Birmingham (UAB), Department of Neurology, Birmingham, AL, USA
| | - Manmeet Kaur
- University of Alabama at Birmingham (UAB), Department of Neurology, Birmingham, AL, USA
- University of Alabama at Birmingham (UAB), UAB Epilepsy Center, Birmingham, AL, USA
| | - Gabrielle A. Brokamp
- University of Alabama at Birmingham (UAB), Department of Neurology, Birmingham, AL, USA
| | - Mark Bolding
- University of Alabama at Birmingham (UAB), Department of Radiology, Birmingham, AL, USA
| | - Jane B. Allendorfer
- University of Alabama at Birmingham (UAB), Department of Neurology, Birmingham, AL, USA
- University of Alabama at Birmingham (UAB), Department of Neurobiology, Birmingham, AL, USA
- University of Alabama at Birmingham (UAB), UAB Epilepsy Center, Birmingham, AL, USA
- University of Alabama at Birmingham (UAB), UAB Center for Exercise Medicine, Birmingham, AL, USA
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Praus P, Moldavski A, Alm B, Hennig O, Rösler M, Retz W. [Epidemiology, diagnostics and treatment of attention deficit-hyperactivity disorder (ADHD) in advanced age]. DER NERVENARZT 2023; 94:1043-1049. [PMID: 37747504 PMCID: PMC10620251 DOI: 10.1007/s00115-023-01548-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 08/01/2023] [Indexed: 09/26/2023]
Abstract
Current studies demonstrate a comparably high prevalence of attention deficit-hyperactivity disorder (ADHD) in advanced age. Older people affected by ADHD suffer from a severe burden of psychiatric and somatic comorbidities as well as substantial impairment of social functioning and subjective well-being. The diagnostic differentiation from neurodegenerative diseases is particularly difficult in this age group. This narrative review summarizes the current knowledge about the epidemiology of ADHD in advanced age and possible relationships between ADHD and the risk for neurodegeneration. Furthermore, recommendations for diagnostics and treatment options of ADHD in advanced age are presented.
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Affiliation(s)
- Peter Praus
- Zentralinstitut für Seelische Gesundheit, Klinik für Psychiatrie und Psychotherapie, J5, 68159, Mannheim, Deutschland.
- Pfalzklinikum für Neurologie und Psychiatrie, Klinik für Forensische Psychiatrie, Weinstraße 100, 76889, Klingenmünster, Deutschland.
| | - Alexander Moldavski
- Zentralinstitut für Seelische Gesundheit, Klinik für Psychiatrie und Psychotherapie, J5, 68159, Mannheim, Deutschland
| | - Barbara Alm
- Zentralinstitut für Seelische Gesundheit, Klinik für Psychiatrie und Psychotherapie, J5, 68159, Mannheim, Deutschland
| | - Oliver Hennig
- Zentralinstitut für Seelische Gesundheit, Klinik für Psychiatrie und Psychotherapie, J5, 68159, Mannheim, Deutschland
| | - Michael Rösler
- Institut für Gerichtliche Psychologie und Psychiatrie der Universität des Saarlandes, Universitätsklinikum des Saarlandes, 66421, Homburg/Saar, Deutschland
| | - Wolfgang Retz
- Institut für Gerichtliche Psychologie und Psychiatrie der Universität des Saarlandes, Universitätsklinikum des Saarlandes, 66421, Homburg/Saar, Deutschland
- Klinik für Psychiatrie und Psychotherapie, Universitätsmedizin Mainz, Untere Zahlbacher Straße 8, 55131, Mainz, Deutschland
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Lindvall MA, Holmqvist KL, Svedell LA, Philipson A, Cao Y, Msghina M. START - physical exercise and person-centred cognitive skills training as treatment for adult ADHD: protocol for a randomized controlled trial. BMC Psychiatry 2023; 23:697. [PMID: 37749523 PMCID: PMC10521407 DOI: 10.1186/s12888-023-05181-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Accepted: 09/11/2023] [Indexed: 09/27/2023] Open
Abstract
BACKGROUND Core symptoms in attention deficit hyperactivity disorder (ADHD) are inattention, impulsivity and hyperactivity. Many individuals with this disorder also have a sedentary lifestyle, co-morbid mental illness such as depressive and anxiety disorders, and reduced quality of life. People with ADHD often have impaired executive function, which among other things may include difficulty in time management and structuring of everyday life. Pharmacological treatment is often the first-line option, but non-pharmacological treatment is also available and is used in clinical settings. In children and adolescents with ADHD, physical exercise is used as a non-pharmacological treatment. However, the evidence for the effectiveness of exercise in adults is sparse. OBJECTIVE To implement the START intervention (START = Stöd i Aktivitet, Rörelse och Träning [Support in activity, movement and exercise]) consisting of a 12-week, structured mixed exercise programme with or without a cognitive intervention, in adults with ADHD, and study whether it has an effect on core symptoms of ADHD as well as physical, cognitive, mental and everyday functioning compared with usual treatment. A secondary aim is to investigate the participants' experiences of the intervention and its possible benefits, and to evaluate the cost-effectiveness of START compared with usual treatment. METHODS This is a randomized controlled trial planned to be conducted in 120 adults with ADHD, aged 18-65. The intervention will be given as an add-on to standard care. Participants will be randomized to three groups. Group 1 will be given a physiotherapist-led mixed exercise programme for 12 weeks. Group 2 will receive the same intervention as group 1 with the addition of occupational therapist-led cognitive skills training. Group 3 will be the control group who will receive standard care only. The primary outcome will be reduction of ADHD symptoms measured using the World Health Organization (WHO) Adult ADHD Self-Report Scale (ASRS-v1.1), Clinical Global Impression-Severity scale (CGI-S) and CGI-Improvement scale (CGI-I). The effect will be measured within 1 week after the end of the intervention and 6 and 12 months later. DISCUSSION Data collection began in March 2021. The final 12-month follow-up is anticipated to be completed by autumn 2024. TRIAL REGISTRATION ClinicalTrials.gov (Identifier: NCT05049239). Registered on 20 September 2021 (last verified: May 2021).
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Affiliation(s)
- Mialinn Arvidsson Lindvall
- University Health Care Research Centre, Faculty of Medicine and Health, Örebro University, Örebro, 70182, SE, Sweden.
| | - Kajsa Lidström Holmqvist
- University Health Care Research Centre, Faculty of Medicine and Health, Örebro University, Örebro, 70182, SE, Sweden
- Department of Neurology and Rehabilitation Medicine, Faculty of Medicine and Health, Örebro University, Örebro, 70182, SE, Sweden
| | - Lena Axelsson Svedell
- Department of Psychiatry, Faculty of Medicine and Health, Örebro University, Örebro, 70182, SE, Sweden
| | - Anna Philipson
- University Health Care Research Centre, Faculty of Medicine and Health, Örebro University, Örebro, 70182, SE, Sweden
| | - Yang Cao
- Clinical Epidemiology and Biostatistics, School of Medical Sciences, Faculty of Medicine and Health, Örebro University, Örebro, 70182, SE, Sweden
- Unit of Integrative Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Mussie Msghina
- Department of Psychiatry, Faculty of Medicine and Health, Örebro University, Örebro, 70182, SE, Sweden
- Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden
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12
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Luo X, Huang X, Lin S. Yoga and music intervention reduces inattention, hyperactivity/impulsivity, and oppositional defiant disorder in children's consumer with comorbid ADHD and ODD. Front Psychol 2023; 14:1150018. [PMID: 37809284 PMCID: PMC10552923 DOI: 10.3389/fpsyg.2023.1150018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Accepted: 08/29/2023] [Indexed: 10/10/2023] Open
Abstract
Introduction To analyze the impact of yoga and music intervention on child consumers, we selected 60 eligible child consumers from yoga and music companies. Methods This preliminary study used a randomized controlled design to investigate whether a 16-week combined yoga and music intervention improves attention, hyperactivity/impulsivity, and oppositional defiant disorder (ODD) in 60 children with attention-deficit/hyperactivity disorder (ADHD) comorbid with ODD aged 4-6 years. It also preliminarily identified which intervention is best for these children among three types: combined yoga and music, yoga-only, and musiconly interventions. We used both the parent- and teacher-rated MTA SNAP-IV ADHD Rating Scale for data collection. Results We found that the combined yoga and music intervention had a positive effect on inattention, hyperactivity/impulsivity, and ODD in children with comorbid ADHD and ODD. The combined yoga and music intervention was the most effective in reducing inattention (in repeated measures ANOVA effect size, 0.9; followed by the yoga- and the music-only interventions, respectively), hyperactivity/impulsivity (effect size, 0.92), and ODD behaviors (effect size, 0.93) in children with comorbid ADHD and ODD. Thus, the combined yoga and music intervention was the most effective and had a more comprehensive effect on children with combined ADHD and ODD compared with the two other interventions (i.e., yoga- and music-only interventions). Discussion Our findings provide preliminary evidence for the use of combined yoga and music interventions on a daily basis as a safe and effective adjunctive treatment for children with comorbid ADHD and ODD. The children in the article refer to child consumers of yoga and music companies.
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Affiliation(s)
- Xue Luo
- School of Business Administration, Southwestern University of Finance and Economics, Chengdu, China
- School of Physical Education, Chengdu Normal University, Chengdu, China
| | - Xu Huang
- School of Business Administration, Southwestern University of Finance and Economics, Chengdu, China
| | - Shuang Lin
- School of Economics and Management, Shanghai University of Sport, Shanghai, China
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13
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Ruf A, Neubauer AB, Koch ED, Ebner-Priemer U, Reif A, Matura S. Microtemporal Dynamics of Dietary Intake, Physical Activity, and Impulsivity in Adult Attention-Deficit/Hyperactivity Disorder: Ecological Momentary Assessment Study Within Nutritional Psychiatry. JMIR Ment Health 2023; 10:e46550. [PMID: 37590053 PMCID: PMC10472180 DOI: 10.2196/46550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Revised: 05/24/2023] [Accepted: 06/17/2023] [Indexed: 08/18/2023] Open
Abstract
BACKGROUND Increasing attention is being paid to lifestyle factors, such as nutrition and physical activity (PA), as potential complementary treatment options in attention-deficit/hyperactivity disorder (ADHD). Previous research indicates that sugar and saturated fat intake may be linked to increased impulsivity, a core symptom of ADHD, whereas protein intake and PA may be related to reduced impulsivity. However, most studies rely on cross-sectional data that lack microtemporal resolution and ecological validity, wherefore questions of microtemporal dynamics (eg, is the consumption of foods high in sugar associated with increased impulsivity within minutes or hours?) remain largely unanswered. Ecological momentary assessment (EMA) has the potential to bridge this gap. OBJECTIVE This study is the first to apply EMA to assess microtemporal associations among macronutrient intake, PA, and state impulsivity in the daily life of adults with and without ADHD. METHODS Over a 3-day period, participants reported state impulsivity 8 times per day (signal-contingent), recorded food and drink intake (event-contingent), and wore an accelerometer. Multilevel 2-part models were used to study the association among macronutrient intake, PA, and the probability to be impulsive as well as the intensity of impulsivity (ADHD: n=36; control: n=137). RESULTS No association between macronutrient intake and state impulsivity was found. PA was not related to the intensity of impulsivity but to a higher probability to be impulsive (ADHD: β=-.09, 95% CI -0.14 to -0.04; control: β=-.03, 95% CI -0.05 to -0.01). No evidence was found that the combined intake of saturated fat and sugar amplified the increase in state impulsivity and that PA alleviated the positive association between sugar or fat intake and state impulsivity. CONCLUSIONS Important methodological considerations are discussed that can contribute to the optimization of future EMA protocols. EMA research in the emerging field of nutritional psychiatry is still in its infancy; however, EMA is a highly promising and innovative approach as it offers insights into the microtemporal dynamics of psychiatric symptomology, dietary intake, and PA in daily life.
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Affiliation(s)
- Alea Ruf
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital, Goethe University, Frankfurt, Germany
| | - Andreas B Neubauer
- DIPF | Leibniz Institute for Research and Information in Education, Frankfurt, Germany
- Center for Research on Individual Development and Adaptive Education of Children at Risk (IDeA), Frankfurt, Germany
| | - Elena D Koch
- Mental mHealth Lab, Institute of Sports and Sports Science, Karlsruhe Institute of Technology (KIT), Karlsruhe, Germany
| | - Ulrich Ebner-Priemer
- Mental mHealth Lab, Institute of Sports and Sports Science, Karlsruhe Institute of Technology (KIT), Karlsruhe, Germany
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Andreas Reif
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital, Goethe University, Frankfurt, Germany
| | - Silke Matura
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital, Goethe University, Frankfurt, Germany
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14
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Skalidou S, Anestis A, Bakolas N, Tsoulfa G, Papadimitriou K. Swimming Activity Alleviates the Symptoms of Attention: Deficit Hyperactivity Disorder (ADHD) a Case Report. Healthcare (Basel) 2023; 11:1999. [PMID: 37510440 PMCID: PMC10379488 DOI: 10.3390/healthcare11141999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Revised: 07/05/2023] [Accepted: 07/10/2023] [Indexed: 07/30/2023] Open
Abstract
Attention deficit hyperactivity disorder (ADHD) is a neurobehavioral disorder characterized by inattention, hyperactivity, and impulsivity. Sport and physical activity have been shown to play a major role in the development of cognition, memory, selective attention, and motor reaction time, especially among adolescents with ADHD. In this context, the objective of this study was to investigate the effects of a swimming exercise program on the symptoms of ADHD in an adult with a diagnosis since childhood. The training intervention was performed for eight weeks, and the results demonstrated that the swimming-learning program significantly alleviated the symptoms of inattention and hyperactivity, as measured by the psychometric indices used in the study. Further studies are needed to establish and understand the association between physical activities and improved mental performance in adults with ADHD.
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Affiliation(s)
- Smaragda Skalidou
- Laboratory of Hygiene, Social-Preventive Medicine and Medical Statistics, Faculty of Medicine, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
| | - Andreas Anestis
- Laboratory of Hygiene, Social-Preventive Medicine and Medical Statistics, Faculty of Medicine, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
- Division of Technology and Sciences, The American College of Thessaloniki, 55535 Thessaloniki, Greece
| | | | - Georgia Tsoulfa
- Division of Technology and Sciences, The American College of Thessaloniki, 55535 Thessaloniki, Greece
| | - Konstantinos Papadimitriou
- Faculty of Health and Rehabilitation Sciences, University of East London, Metropolitan College of Thessaloniki, 54624 Thessaloniki, Greece
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15
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Li S, Meng Q, Yao W, Guo S, Liu H, Wang R, Meng J, Xu M. Aerobic Exercise Changes Low-Frequency Functional and Effective Connectivity in Cognitive Load Task. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2023; 2023:1-4. [PMID: 38082696 DOI: 10.1109/embc40787.2023.10340660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2023]
Abstract
As is well known, cognitive performances are highly influenced by cognitive load, so it is meaningful to find some ways to effectively reduce the cognitive load. In particular, aerobic exercise is a promising way. However, the neural evidence is still lacking in understanding how aerobic exercise minimizes cognitive load. To solve the problem, this study adopted the N-back task in both the before (BE) and after (AE) aerobic exercise periods, behavioral and EEG data were recorded from 21 participants. Functional connectivity was constructed by the weighted phase lag index (WPLI), and effective connectivity was constructed by the partially directed coherent (PDC). Consequently, by comparing the connection strength and pattern of BE and AE, it is found that in low-frequency (0~8 Hz), aerobic exercise could enhance the connection strength of WPLI networks under high cognitive load, and increase the importance of the forehead region in the communication of PDC networks under low cognitive load. These results could advance our understanding of the underlying mechanisms of how aerobic exercise modulates cognitive load.
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16
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Festa F, Medori S, Macrì M. Move Your Body, Boost Your Brain: The Positive Impact of Physical Activity on Cognition across All Age Groups. Biomedicines 2023; 11:1765. [PMID: 37371860 DOI: 10.3390/biomedicines11061765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2023] [Revised: 06/11/2023] [Accepted: 06/16/2023] [Indexed: 06/29/2023] Open
Abstract
While the physical improvements from exercise have been well documented over the years, the impact of physical activity on mental health has recently become an object of interest. Physical exercise improves cognition, particularly attention, memory, and executive functions. However, the mechanisms underlying these effects have yet to be fully understood. Consequently, we conducted a narrative literature review concerning the association between acute and chronic physical activity and cognition to provide an overview of exercise-induced benefits during the lifetime of a person. Most previous papers mainly reported exercise-related greater expression of neurotransmitter and neurotrophic factors. Recently, structural and functional magnetic resonance imaging techniques allowed for the detection of increased grey matter volumes for specific brain regions and substantial modifications in the default mode, frontoparietal, and dorsal attention networks following exercise. Here, we highlighted that physical activity induced significant changes in functional brain activation and cognitive performance in every age group and could counteract psychological disorders and neural decline. No particular age group gained better benefits from exercise, and a specific exercise type could generate better cognitive improvements for a selected target subject. Further research should develop appropriate intervention programs concerning age and comorbidity to achieve the most significant cognitive outcomes.
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Affiliation(s)
- Felice Festa
- Department of Innovative Technologies in Medicine & Dentistry, University "G. D'Annunzio" of Chieti-Pescara, 66100 Chieti, Italy
| | - Silvia Medori
- Department of Innovative Technologies in Medicine & Dentistry, University "G. D'Annunzio" of Chieti-Pescara, 66100 Chieti, Italy
| | - Monica Macrì
- Department of Innovative Technologies in Medicine & Dentistry, University "G. D'Annunzio" of Chieti-Pescara, 66100 Chieti, Italy
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17
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Ogrodnik M, Karsan S, Malamis B, Kwan M, Fenesi B, Heisz JJ. Exploring Barriers and Facilitators to Physical Activity in Adults with ADHD: A Qualitative Investigation. JOURNAL OF DEVELOPMENTAL AND PHYSICAL DISABILITIES 2023:1-21. [PMID: 37361454 PMCID: PMC10156575 DOI: 10.1007/s10882-023-09908-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 03/27/2023] [Indexed: 06/28/2023]
Abstract
Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterized by executive dysfunction. Physical activity (PA) may improve executive dysfunction; however, specific barriers and facilitators to PA participation for adults with ADHD have not been formally documented, which was the aim of the present study. Thirty adults with ADHD completed virtual semi-structured interviews, which were analyzed thematically and guided by the Theoretical Domains Framework. Expressions of both barriers and facilitators to PA were identified. Themes such as executive dysfunction (described as forgetfulness, difficulty with sustained focus, and time management), poor self-esteem, and lack of motivation were seen as barriers to PA. Key facilitators were tied to the benefits of being physically active including improvements in executive functioning, mood, and mental health during and after activity, as well as the enjoyment of being active with others. To better support adults with ADHD in initiating physical activity, it is crucial to develop unique resources that are tailored to their specific needs. These resources should be designed to minimize barriers and maximize facilitators, while also supporting the awareness and acceptance of neurodiverse experiences.
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Affiliation(s)
- Michelle Ogrodnik
- McMaster University, 1280 Main Street West, Hamilton, ON L8S 4L8 Canada
- Waterloo University, 200 University Ave W, Waterloo, ON N2L 3G1 Canada
| | - Sameena Karsan
- McMaster University, 1280 Main Street West, Hamilton, ON L8S 4L8 Canada
| | - Brandon Malamis
- McMaster University, 1280 Main Street West, Hamilton, ON L8S 4L8 Canada
| | - Matthew Kwan
- Brock University, 1812 Sir Isaac Brock Way, St. Catherines, ON L2S 3A1 Canada
| | - Barbara Fenesi
- Western University, 1151 Richmond St, London, ON N6A 3K7 Canada
| | - Jennifer J. Heisz
- McMaster University, 1280 Main Street West, Hamilton, ON L8S 4L8 Canada
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18
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Ogrodnik M, Karsan S, Cirone V, Heisz JJ. Exploring the Relationship between Cardiorespiratory Fitness and Executive Functioning in Adults with ADHD. Brain Sci 2023; 13:673. [PMID: 37190638 PMCID: PMC10136722 DOI: 10.3390/brainsci13040673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 04/04/2023] [Accepted: 04/13/2023] [Indexed: 05/17/2023] Open
Abstract
OBJECTIVE Associations between measures of executive functioning (EF) and cardiorespiratory fitness (CRF) were examined for adults with and without ADHD. METHOD Measures of executive functioning including the Stroop task, Wisconsin Card Sorting task, and Operation Span Task were completed virtually (n = 36 ADHD; n = 36 Control). Participants completed the Six-Minute Walk Test to estimate CRF. RESULTS Mean performance measures of executive function did not differ by group. However, higher estimated CRF was associated with better Stroop task performance, and the association was strongest for individuals with ADHD. CONCLUSION In adults with ADHD, higher estimated CRF was associated with better inhibitory control, but not with other measures of executive functioning.
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Affiliation(s)
- Michelle Ogrodnik
- Department of Kinesiology, Faculty of Science, McMaster University, Hamilton, ON L8S 4L8, Canada
- Department of Kinesiology and Health Sciences, Faculty of Health, University of Waterloo, Waterloo, ON N2L 3G1, Canada
| | - Sameena Karsan
- Department of Kinesiology, Faculty of Science, McMaster University, Hamilton, ON L8S 4L8, Canada
| | - Victoria Cirone
- Department of Physical Therapy, Djavad Mowafaghian Centre for Brain Health, Vancouver Coastal Health Research Institute, The Centre for Aging SMART, The University of British Columbia, Vancouver, BC V1Y 1T3, Canada
| | - Jennifer J. Heisz
- Department of Kinesiology, Faculty of Science, McMaster University, Hamilton, ON L8S 4L8, Canada
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19
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Azami S, Alimadadi Z, Ahmadi A, Hemmati F, Mirmohammad M, Mashayekhi R. The efficacy of cognitive-motor rehabilitation on cognitive functions and behavioral symptoms of attention deficit/hyperactivity disorder (ADHD) children: Specification of near-transfer and far-transfer effects in comparison to medication. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2023; 12:64. [PMID: 37113411 PMCID: PMC10127477 DOI: 10.4103/jehp.jehp_189_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/06/2022] [Accepted: 06/12/2022] [Indexed: 06/19/2023]
Abstract
BACKGROUND AND AIM This study aimed to investigate and compare the efficacy of cognitive-motor rehabilitation (CMR) with methylphenidate on cognitive functions and behavioral symptoms of children with attention deficit/hyperactivity disorder (ADHD) and specified the near-transfer and far-transfer effects. MATERIALS AND METHODS The research was semiexperimental with posttest and follow-up assessments, in a single-blind design. Forty-eight boys with ADHD, aged 9-12, were selected conveniently regarding the inclusion/exclusion criteria, matched base on severity and Intelligence quotient (IQ) and were randomly assigned to CMR (n = 16), methylphenidate medication (MED, n = 16), and placebo CMR groups (PCMR, n = 16). CMR and PCMR received 20 3-h training sessions, and the MED group received 20 or 30 mg/day methylphenidate. Tower of London (TOL), Swanson, Nolan, and Pelham, Version IV Scale (SNAP-IV), Wechsler's digit span and mathematic subscales, dictation test, and restricted academic situation scale (RASS) were completed at posttest and follow-up. The data were analyzed by repeated measures multivariate analysis of variance. RESULTS CMR outperformed PCMR on forward digit span, backward digit span, ToL score at both posttest, and follow-up (P < 0.05). CMR scored lower than MED on ADHD-PI and ADHD-C at both posttest and follow-up (P < 0.05). Moreover, CMR outperformed MED on dictation at both assessment phases (P < 0.01) and RASS at the follow-up phase (P < 0.05). CMR outperformed PCMR on mathematics at post-test (P = 0.038) and also, in dictation and RASS, at both post-test (P < 0.001) and follow-up (P < 0.05). CONCLUSION CMR Improves near-transfer cognitive functions and behavior symptoms of ADHD as much as MED, but only CMR has more generalizable and endurable improvement on complex Efs and academic performance (far-transfer effects).
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Affiliation(s)
- Saeed Azami
- Department of Clinical and General Psychology, Semnan University, Semnan, Iran
| | - Zeynab Alimadadi
- Department of Nutrition, School of Public Health, Iran University of Medical Science, Tehran, Iran
- Psychiatrist, Tehran University of Medical Science, Tehran, Iran
| | - Ameneh Ahmadi
- Psychiatry and Psychology Research Center, Tehran University of Medical Science, Tehran, Iran
- Department of Psychology, University of Science and Culture, Tehran, Iran
| | - Fatemeh Hemmati
- General Psychology (MSc), Department of Psychology, Tarbiat Modares University, Tehran, Iran
| | - Mahdieh Mirmohammad
- General Psychology (MSc), Department of Psychology, Tarbiat Modares University, Tehran, Iran
| | - Reza Mashayekhi
- Department of Psychology, Kharazmi University of Tehran, Iran
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20
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Dinu LM, Singh SN, Baker NS, Georgescu AL, Singer BF, Overton PG, Dommett EJ. The Effects of Different Exercise Approaches on Attention Deficit Hyperactivity Disorder in Adults: A Randomised Controlled Trial. Behav Sci (Basel) 2023; 13:bs13020129. [PMID: 36829357 PMCID: PMC9952527 DOI: 10.3390/bs13020129] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 01/28/2023] [Accepted: 01/30/2023] [Indexed: 02/05/2023] Open
Abstract
Attention deficit hyperactivity disorder (ADHD) results in significant functional impairment. Current treatments, particularly for adults, are limited. Previous research indicates that exercise may offer an alternative approach to managing ADHD, but research into different types of exercise and adult populations is limited. The aim of this study was to examine the effects of acute exercise (aerobic cycling vs mind-body yoga exercises) on symptoms of ADHD in adults. Adults with ADHD (N = 82) and controls (N = 77) were randomly allocated to 10 min of aerobic (cycling) or mind-body (Hatha yoga) exercise. Immediately before and after exercise, participants completed the Test of Variables of Attention task, Delay Discounting Task, and Iowa Gambling Task to measure attention and impulsivity. Actigraphy measured movement frequency and intensity. Both groups showed improved temporal impulsivity post-exercise, with cycling beneficial to all, whilst yoga only benefited those with ADHD. There were no effects of exercise on attention, cognitive or motor impulsivity, or movement in those with ADHD. Exercise reduced attention and increased movement in controls. Exercise can improve temporal impulsivity in adult ADHD but did not improve other symptoms and worsened some aspects of performance in controls. Exercise interventions should be further investigated.
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Affiliation(s)
- Larisa M. Dinu
- Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London SE5 8AF, UK
| | - Samriddhi N. Singh
- Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London SE5 8AF, UK
| | - Neo S. Baker
- Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London SE5 8AF, UK
| | - Alexandra L. Georgescu
- Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London SE5 8AF, UK
| | - Bryan F. Singer
- School of Psychology, Sussex Addiction Research & Intervention Centre, Sussex Neuroscience, University of Sussex, Brighton BN1 9RH, UK
| | - Paul G. Overton
- Department of Psychology, The University of Sheffield, Cathedral Court, Sheffield S1 2LT, UK
| | - Eleanor J. Dommett
- Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London SE5 8AF, UK
- Correspondence:
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21
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Verrall CE, Tran DL, Yang JYM, Lubans DR, Winlaw DS, Ayer J, Celermajer D, Cordina R. Exercise as therapy for neurodevelopmental and cognitive dysfunction in people with a Fontan circulation: A narrative review. Front Pediatr 2023; 11:1111785. [PMID: 36861078 PMCID: PMC9969110 DOI: 10.3389/fped.2023.1111785] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 01/25/2023] [Indexed: 02/15/2023] Open
Abstract
People with a Fontan circulation are at risk of neurodevelopmental delay and disability, and cognitive dysfunction, that has significant implications for academic and occupational attainment, psychosocial functioning, and overall quality of life. Interventions for improving these outcomes are lacking. This review article discusses current intervention practices and explores the evidence supporting exercise as a potential intervention for improving cognitive functioning in people living with a Fontan circulation. Proposed pathophysiological mechanisms underpinning these associations are discussed in the context of Fontan physiology and avenues for future research are recommended.
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Affiliation(s)
- Charlotte Elizabeth Verrall
- Heart Centre for Children, The Children's Hospital at Westmead, Sydney, NSW, Australia.,Children's Hospital at Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia.,Department of Cardiology, Royal Prince Alfred Hospital, Sydney, NSW, Australia
| | - Derek Lee Tran
- Department of Cardiology, Royal Prince Alfred Hospital, Sydney, NSW, Australia.,Central Clinical School, The University of Sydney School of Medicine, Sydney, NSW, Australia.,Charles Perkins Centre, Heart Research Institute, Sydney, NSW, Australia
| | - Joseph Yuan-Mou Yang
- Developmental Imaging, Murdoch Children's Research Institute, Melbourne, VIC, Australia.,Neuroscience Research, Murdoch Children's Research Institute, Melbourne, VIC, Australia.,Department of Paediatrics, University of Melbourne, Melbourne, VIC, Australia.,Department of Neurosurgery, Neuroscience Advanced Clinical Imaging Service (NACIS), Royal Children's Hospital, Melbourne, VIC, Australia
| | - David Revalds Lubans
- Centre for Active Living and Learning, College of Human and Social Futures, University of Newcastle, Callaghan, NSW, Australia.,Hunter Medical Research Institute, New Lambton Heights, NSW, Australia.,Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - David Scott Winlaw
- Cardiothoracic Surgery, the Heart Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States
| | - Julian Ayer
- Heart Centre for Children, The Children's Hospital at Westmead, Sydney, NSW, Australia.,Children's Hospital at Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
| | - David Celermajer
- Department of Cardiology, Royal Prince Alfred Hospital, Sydney, NSW, Australia.,Central Clinical School, The University of Sydney School of Medicine, Sydney, NSW, Australia.,Charles Perkins Centre, Heart Research Institute, Sydney, NSW, Australia
| | - Rachael Cordina
- Department of Cardiology, Royal Prince Alfred Hospital, Sydney, NSW, Australia.,Central Clinical School, The University of Sydney School of Medicine, Sydney, NSW, Australia.,Charles Perkins Centre, Heart Research Institute, Sydney, NSW, Australia.,Heart Research Group, Murdoch Children's Research Institute, Melbourne, VIC, Australia
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22
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Peiris DLIHK, Duan Y, Vandelanotte C, Liang W, Yang M, Baker JS. Effects of In-Classroom Physical Activity Breaks on Children's Academic Performance, Cognition, Health Behaviours and Health Outcomes: A Systematic Review and Meta-Analysis of Randomised Controlled Trials. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19159479. [PMID: 35954831 PMCID: PMC9368257 DOI: 10.3390/ijerph19159479] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/28/2022] [Revised: 07/30/2022] [Accepted: 07/30/2022] [Indexed: 02/01/2023]
Abstract
In-Classroom physical activity breaks (IcPAB) are a promising way to promote children’s health behaviors, while contributing to the development of their academic and cognitive ability and health outcomes. Yet the effect of the activity breaks, which are exclusive to classroom settings, are still mixed and unclear. Hence, this review was conducted to identify the characteristics and the effects of IcPAB among primary school children. The review protocol was registered on PROSPERO (CRD42021234192). Following the Cochrane guidelines, PubMed, PsycINFO (ProQuest), MEDLINE (EBSCOhost), Embase/Ovid, SportDISCUS (EBSCOhost), Web of Science, Scopus and Academic Search Premier (EBSCOhost) databases were searched to collect data on randomised control trials without a time restriction. The final database search was conducted on the 8 November 2021. Random effects models were used to calculate the effect sizes. The systematic review identified ten eligible studies, nine of which were also included in the meta-analysis. Few studies used the theoretical frameworks and process evaluations. IcPAB showed mixed effectiveness on academic outcomes: i.e., IcPAB had effects on spelling performance (p < 0.05) and foreign language learning (p < 0.01) but not on mathematics and reading performance. Health behaviors such as moderate-to-vigorous physical activity levels were improved (p < 0.01), but IcPAB did not have an impact on cognition outcomes and health outcomes. Given these mixed results, further research is needed underpinned by strong methodological quality, theoretical underpinnings and reliable process evaluation methods.
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Affiliation(s)
- D. L. I. H. K. Peiris
- Department of Sport, Physical Education and Health, Faculty of Social Sciences, Hong Kong Baptist University, Hong Kong, China; (D.L.I.H.K.P.); (W.L.); (M.Y.); (J.S.B.)
| | - Yanping Duan
- Department of Sport, Physical Education and Health, Faculty of Social Sciences, Hong Kong Baptist University, Hong Kong, China; (D.L.I.H.K.P.); (W.L.); (M.Y.); (J.S.B.)
- Centre for Health and Exercise Science Research, Hong Kong Baptist University, Hong Kong, China
- Correspondence: (Y.D.); (C.V.)
| | - Corneel Vandelanotte
- Physical Activity Research Group, School of Health, Medical and Applied Sciences, Central Queensland University, Rockhampton 4701, Australia
- Correspondence: (Y.D.); (C.V.)
| | - Wei Liang
- Department of Sport, Physical Education and Health, Faculty of Social Sciences, Hong Kong Baptist University, Hong Kong, China; (D.L.I.H.K.P.); (W.L.); (M.Y.); (J.S.B.)
- Centre for Health and Exercise Science Research, Hong Kong Baptist University, Hong Kong, China
| | - Min Yang
- Department of Sport, Physical Education and Health, Faculty of Social Sciences, Hong Kong Baptist University, Hong Kong, China; (D.L.I.H.K.P.); (W.L.); (M.Y.); (J.S.B.)
| | - Julien Steven Baker
- Department of Sport, Physical Education and Health, Faculty of Social Sciences, Hong Kong Baptist University, Hong Kong, China; (D.L.I.H.K.P.); (W.L.); (M.Y.); (J.S.B.)
- Centre for Health and Exercise Science Research, Hong Kong Baptist University, Hong Kong, China
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Wu J, Xiao W, Yip J, Peng L, Zheng K, Takyi Bentil O, Ren Z. Effects of Exercise on Neural Changes in Inhibitory Control: An ALE Meta-Analysis of fMRI Studies. Front Hum Neurosci 2022; 16:891095. [PMID: 35814955 PMCID: PMC9265250 DOI: 10.3389/fnhum.2022.891095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Accepted: 06/08/2022] [Indexed: 11/13/2022] Open
Abstract
It is widely known that exercise improves inhibitory control; however, the mechanisms behind the cognitive improvement remain unclear. This study analyzes the extant literature on the neuronal effects of exercise on inhibitory control functions. We searched four online databases (Pubmed, Scopus, PsycINFO, and Web of Science) for relevant peer-reviewed studies to identify eligible studies published before September 1, 2021. Among the 4,090 candidate studies identified, 14 meet the inclusion criteria, and the results of 397 participants in these 14 studies are subsequently analyzed. We quantify the neural effects on the entire brain by using GingerALE software and identify 10 clusters of exercise-induced neuronal with either increases/decreases in the superior temporal gyrus (BA 22), precuneus (BA 7), superior frontal gyrus (BA 10), cuneus (BA 19), precuneus (BA 19), caudate, posterior cingulate (BA 19), middle temporal gyrus (B 37), parahippocampal gyrus (BA 30), precentral gyrus (BA 6). Meta-analytic coactivation map (MACM) showed that multiple functional networks overlap with brain regions with activation likelihood estimation (ALE) results. We propose the effect of exercise on neural activity is related to inhibitory control in the extended frontoparietal, default mode network (DMN), visual network, and other pathways. These results provide preliminary evidence of the neural effects of exercise on inhibitory control.
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Affiliation(s)
- Jinlong Wu
- School of Physical Education, Shenzhen University, Shenzhen, China
- Institute of Textiles and Clothing, The Hong Kong Polytechnic University, Hong Kong, China
| | - Wen Xiao
- School of Physical Education, Shenzhen University, Shenzhen, China
| | - Joanne Yip
- Institute of Textiles and Clothing, The Hong Kong Polytechnic University, Hong Kong, China
| | - Li Peng
- College of Physical Education, Southwest University, Chongqing, China
| | - Kangyong Zheng
- Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, China
| | - Obed Takyi Bentil
- Civil and Environmental Engineering Department, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China
| | - Zhanbing Ren
- School of Physical Education, Shenzhen University, Shenzhen, China
- *Correspondence: Zhanbing Ren
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Effects of Physical Activity Level on Attentional Networks in Young Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19095374. [PMID: 35564768 PMCID: PMC9105944 DOI: 10.3390/ijerph19095374] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 04/26/2022] [Accepted: 04/27/2022] [Indexed: 02/05/2023]
Abstract
Although physical activity is associated with better attentional functioning in elderly populations or in specific clinical populations, the association between physical activity level and attention has been less studied in young adult populations. Thus, the purpose of this study was to investigate whether the positive effects of physical activity on attentional networks extend to young adults. In total, 57 college students were recruited and assigned to one of three groups of physical activity levels (high, moderate, and low) based on their self-reported exercise. Each participant completed the Attention Network Test to evaluate the efficiency of three components of attention: alerting, orienting, and executive control. Compared with the low physical activity group, both the high and moderate physical activity groups exhibited better executive control. In addition, the efficiency of the executive control network was positively correlated with physical activity. By contrast, no statistically significant differences were detected among these three groups for the functioning of the alerting or orienting networks. These findings suggested that physical activity had a positive effect on attention in young adults, with the benefit primarily observed for the executive control component rather than for the alerting and orienting components of attention.
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Jiang K, Xu Y, Li Y, Li L, Yang M, Xue P. How aerobic exercise improves executive function in ADHD children: a resting-state fMRI study. Int J Dev Neurosci 2022; 82:295-302. [PMID: 35274372 DOI: 10.1002/jdn.10177] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 02/11/2022] [Accepted: 02/28/2022] [Indexed: 11/08/2022] Open
Abstract
The aim of the study is to explore the functional magnetic resonance imaging (fMRI) characteristics of the improvement in executive function by aerobic exercise in children with attention deficit hyperactivity disorder (ADHD). Seventeen children with ADHD were selected for 8 weeks of rope skipping aerobic training, and fMRI findings and executive function were examined before and after training. Regional homogeneity (ReHo) and degree centrality (DC) indexes were used in fMRI analysis, while the flanker task was used to test executive function. A paired t-test was used to compare the fMRI indexes and response time of executive function before and after training. After aerobic exercise, the brain regions in which the ReHo value of ADHD children significantly increased included the left middle frontal gyrus and the right superior frontal gyrus; the brain region in which the DC value increased was the right posterior cingulate cortex. The flanker task response time decreased significantly (P<0.05, after correction) after aerobic exercise. The study findings support the hypothesis that aerobic exercise can improve the executive function of ADHD children, and the brain mechanism involved is mainly related to the enhancement of spontaneous pre-frontal lobe activity.
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Affiliation(s)
- Kaihua Jiang
- Department of Pediatrics, Changzhou Children's Hospital of Nantong University, Changzhou, China
| | - Yue Xu
- Department of Pediatrics, Changzhou Children's Hospital of Nantong University, Changzhou, China
| | - Yamin Li
- Department of Pediatrics, Changzhou Children's Hospital of Nantong University, Changzhou, China
| | - Lin Li
- Department of Pediatrics, Changzhou Children's Hospital of Nantong University, Changzhou, China
| | - Mingmei Yang
- Department of Pediatrics, Changzhou Children's Hospital of Nantong University, Changzhou, China
| | - Peng Xue
- Department of Pediatrics, Changzhou Children's Hospital of Nantong University, Changzhou, China
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Su WC, Amonkar N, Cleffi C, Srinivasan S, Bhat A. Neural Effects of Physical Activity and Movement Interventions in Individuals With Developmental Disabilities-A Systematic Review. Front Psychiatry 2022; 13:794652. [PMID: 35242063 PMCID: PMC8886122 DOI: 10.3389/fpsyt.2022.794652] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Accepted: 01/03/2022] [Indexed: 01/21/2023] Open
Abstract
Individuals with developmental disabilities present with perceptuo-motor, social communication, and cognitive impairments that often relate to underlying atypical brain structure and functioning. Physical activity/movement interventions improve behavioral performance of individuals with and without developmental disabilities. Majority of the evidence on potential neural mechanisms explaining the impact of physical activity/movement interventions is based on studies in individuals with typical development; there is a dearth of systematic reviews synthesizing the neural effects of physical activity/movement interventions in individuals with developmental disabilities. In this systematic review, we have gathered evidence on the neural effects of physical activity/movement interventions from 32 papers reporting substantial neural effects and behavioral improvements in individuals with developmental disabilities. Chronic intervention effects (multiple sessions) were greater than acute intervention effects (single session). Specifically, using electroencephalogram, functional magnetic resonance imaging, diffusion tensor imaging, and functional near-infrared spectroscopy, studies found physical activity/movement intervention-related changes in neural activity, indicating normalization of cortical arousal in individuals with attention-deficit /hyperactivity disorder (ADHD), increased social brain connectivity in individuals with autism spectrum disorder (ASD), and more efficient executive functioning processes in individuals with a wide range of other developmental disabilities. Despite promising results, more research is clearly needed in this area with larger sample sizes, using standardized neuroimaging tools/variables, and across multiple diagnoses to further explore the neural mechanisms underlying physical activity/movement interventions and to replicate findings from the present review.
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Affiliation(s)
- Wan-Chun Su
- Department of Physical Therapy, University of Delaware, Newark, DE, United States
- Biomechanics and Movement Science Program, University of Delaware, Newark, DE, United States
| | - Nidhi Amonkar
- Physical Therapy Program, Department of Kinesiology, University of Connecticut, Storrs, CT, United States
| | - Corina Cleffi
- Department of Physical Therapy, University of Delaware, Newark, DE, United States
- Biomechanics and Movement Science Program, University of Delaware, Newark, DE, United States
| | - Sudha Srinivasan
- Physical Therapy Program, Department of Kinesiology, University of Connecticut, Storrs, CT, United States
- Institute for Health, Intervention, and Policy (InCHIP), University of Connecticut, Storrs, CT, United States
- The Connecticut Institute for the Brain and Cognitive Sciences (IBACS), University of Connecticut, Storrs, CT, United States
| | - Anjana Bhat
- Department of Physical Therapy, University of Delaware, Newark, DE, United States
- Biomechanics and Movement Science Program, University of Delaware, Newark, DE, United States
- Department of Psychological and Brain Sciences, University of Delaware, Newark, DE, United States
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Champ RE, Adamou M, Tolchard B. The impact of psychological theory on the treatment of Attention Deficit Hyperactivity Disorder (ADHD) in adults: A scoping review. PLoS One 2021; 16:e0261247. [PMID: 34932573 PMCID: PMC8691636 DOI: 10.1371/journal.pone.0261247] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Accepted: 11/25/2021] [Indexed: 12/12/2022] Open
Abstract
Psychological theory and interpretation of research are key elements influencing clinical treatment development and design in Attention Deficit Hyperactivity Disorder (ADHD). Research-based treatment recommendations primarily support Cognitive Behavioural Therapy (CBT), an extension of the cognitive behavioural theory, which promotes a deficit-focused characterisation of ADHD and prioritises symptom reduction and cognitive control of self-regulation as treatment outcomes. A wide variety of approaches have developed to improve ADHD outcomes in adults, and this review aimed to map the theoretical foundations of treatment design to understand their impact. A scoping review and analysis were performed on 221 documents to compare the theoretical influences in research, treatment approach, and theoretical citations. Results showed that despite variation in the application, current treatments characterise ADHD from a single paradigm of cognitive behavioural theory. A single theoretical perspective is limiting research for effective treatments for ADHD to address ongoing issues such as accommodating context variability and heterogeneity. Research into alternative theoretical characterisations of ADHD is recommended to provide treatment design opportunities to better understand and address symptoms.
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Affiliation(s)
- Rebecca E. Champ
- Department of Nursing and Midwifery, School of Human and Health Sciences, University of Huddersfield, Huddersfield, United Kingdom
| | - Marios Adamou
- Department of Nursing and Midwifery, School of Human and Health Sciences, University of Huddersfield, Huddersfield, United Kingdom
| | - Barry Tolchard
- School of Health and Life Sciences, Teeside University, Middlesbrough, United Kingdom
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Khodaverdi Z, Moreau D, Garber CE. Is there an effective dose of aerobic exercise associated with better executive function in youth with attention deficit hyperactivity disorder? Child Neuropsychol 2021; 28:569-596. [PMID: 34711134 DOI: 10.1080/09297049.2021.1992378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Attention-deficit/hyperactivity disorder (ADHD) is the most prevalent neurodevelopmental disorder in children, and it's linked to a higher risk of academic failure, interpersonal issues, mental illness, and criminality. Despite several of the comparative and detailed reviews on the effects of ADHD interventions on core symptoms, there is no data summarizing the effects of aerobic exercise (AE) on executive functions (EFs). Therefore, this study aimed to systematically review and determine the relationship between AE (acute and chronic) dosage and EFs (attention, inhibition, set-shifting, and working memory) in youth with ADHD. The consideration of how AE dosage impacts aspects of EFs has not been investigated in detail previously. The study adhered to PRISMA guideline. Sixdatabases were searched without any date restrictions, up to February 2021, for articles relating to AE interventions to influence EFs in youth with ADHD≤18 years old. Quality assessment of the reviewed papers was addressed. Thirteen studies met the inclusion criteria. Improvements in all aspects of EFs were reported after children with ADHD engaged in acute AE lasting 20-30 minutes with at least moderate intensity (65% ≤ 80% HRmax).Furthermore, chronic exercise that lasts at least 45 minutes and in the range of moderate tohigh intensity (i.e., 60% ≤ 75% HRmax), 3 days/week for 6-12, elicits additional benefits in inhibition and set-shifting.Different dosage of AE might differently influence aspects of EFs; however, this finding rests on preliminary evidence at this stage and thus should be treated with caution.It is necessary to establish suitable interventions with regard to the dosage of AE types to improve EFs in young people with ADHD.
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Affiliation(s)
- Zeinab Khodaverdi
- Department of Biobehavioral Sciences, Teachers College, Columbia University, New York, NY, USA
| | - David Moreau
- School of Psychology and Centre for Brain Research, University of Auckland, Auckland, New Zealand
| | - Carol Ewing Garber
- Department of Biobehavioral Sciences, Teachers College, Columbia University, New York, NY, USA
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Li X, Wang Z, Wang Y, Li X, Li D. Effect of exercise on inhibitory control in adolescents is dose-dependent. SPORTS MEDICINE AND HEALTH SCIENCE 2021; 4:54-60. [PMID: 35782777 PMCID: PMC9219311 DOI: 10.1016/j.smhs.2021.10.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 09/30/2021] [Accepted: 10/14/2021] [Indexed: 01/04/2023] Open
Abstract
Adolescence is an important stage for brain maturation. To investigate the effect of different exercise doses on inhibitory control in adolescents aged 12 to 14-year old, an after-school exercise program was offered 5 days per week for 12 weeks during a school semester. Thirsty-four adolescents (17 boys) from the first six classes were randomly divided into low-dose exercise group (LE group, one 30-min aerobic exercise bout per day, n = 16) and high-dose exercise group (HE group, two 30-min aerobic exercise bouts per day, n = 18), while 23 adolescents (10 boys) in the control group (CON, zero 30-min exercise bout, n = 23) were from the last two classes. All the participants in different classes received the same physical education with the same contents, duration, and intensity at class. All the participants completed flanker tests and cardiorespiratory tests before and after exercise intervention. The HE group showed more significant improvements on inhibitory control and V˙O2peak than CON (p < 0.05). Changes in physical activity (PA) were significantly correlated with changes in interference scores (Spearman rho = -0.30, p < 0.05), V˙O2peak (Spearman rho = 0.31, p < 0.05), and BF percentage (Spearman rho = -0.32, p < 0.05). This study demonstrated that effect of exercise on inhibitory control in adolescents is dose-dependent, which highlights the need to focus on the exercise dose in daily life for improving cognition among adolescents.
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30
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EKERER C, INCE G, ÖVER MF. Sekiz haftalık yapılandırılmış Brain Gym aktivite programının üniversite öğrencilerinin seçici dikkat, inhibitör kontrol ve bilişsel esneklik üzerine etkisi. CUKUROVA MEDICAL JOURNAL 2021. [DOI: 10.17826/cumj.871110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Onandia-Hinchado I, Pardo-Palenzuela N, Diaz-Orueta U. Cognitive characterization of adult attention deficit hyperactivity disorder by domains: a systematic review. J Neural Transm (Vienna) 2021; 128:893-937. [PMID: 33620582 DOI: 10.1007/s00702-021-02302-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Accepted: 01/06/2021] [Indexed: 02/06/2023]
Abstract
Attention deficit hyperactivity disorder (ADHD) is reportedly the most frequent neurodevelopmental disorder diagnosed during childhood, and it is recognized as a common condition in adulthood. We review the evidence to help identify cognitive domains associated to deficits in adult ADHD. A systematic review with narrative synthesis was performed, assessing studies on adult ADHD, neuropsychology and research on involved cognitive domains in adults 18+ years old with an established diagnosis of ADHD, in seven electronic databases (PubMed, PsychInfo, WebOfScience, Embase, Scopus, OvidSPMedline, and Teseo), and Worldcat and OpenGrey grey literature databases. 93 studies were included for this review, encompassing findings from a total 5574 adults diagnosed only with ADHD, medication-naïve or non-medicated at the moment of the assessment and 4880 healthy controls. Adults diagnosed with ADHD may show, when compared to healthy controls, a cognitive profile characterized by deficits across all attention modalities, processing speed, executive function (mainly working memory and inhibition with emphasis on reward delay and interference control), verbal memory, reading skills, social cognition and arithmetic abilities. A cognitive characterization of adult ADHD by domains is established beyond the sole consideration of attention and executive function problems. Along with these, verbal memory, language (mainly reading), social cognition and arithmetic abilities may also contribute to a more comprehensive characterization of the cognitive profile in adult ADHD.
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Affiliation(s)
| | | | - Unai Diaz-Orueta
- Department of Psychology, Maynooth University, Room 3.11, John Hume Building, North Campus, Maynooth, Co. Kildare, Ireland.
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Björk A, Rönngren Y, Wall E, Vinberg S, Hellzen O, Olofsson N. A nurse-led lifestyle intervention for adult persons with attention-deficit/hyperactivity disorder (ADHD) in Sweden. Nord J Psychiatry 2020; 74:602-612. [PMID: 32493144 DOI: 10.1080/08039488.2020.1771768] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Introduction: Attention-deficit/hyperactivity disorder (ADHD) is associated with lifestyle-related diseases. Therefore, a nurse-led lifestyle intervention including interpersonal relationships, health education and cognitive support was developed to facilitate healthier lifestyle habits.Aim: The aim was to develop a lifestyle intervention and investigate its impact on mental and physical healthMethod: The 52-week intervention included 35 adults with ADHD. In a pre- and post-test design, symptoms of ADHD were measured with the Adult ADHD Self-Report Scale, quality of life was measured with the Adult ADHD Quality of Life scale and mental health was measured with the Hospital Anxiety and Depression scale. Lifestyle habits and dimensions of health were measured by the Lifestyle-Performance-Health Questionnaire and physical fitness was measured by the VO2 Max Test and calculations of waist circumference and body mass index. Result: Post-tests for a group of 25 persons showed positive changes following the intervention regarding weekly physical activity, quality of life and general and mental health. Lifestyle habit support was found to be important. The impact of the intervention should be confirmed in a long-term study with a control group.Conclusion: This intervention may be beneficial and may be implemented in a primary healthcare setting or in other open care units.
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Affiliation(s)
- Annette Björk
- Department of Health Sciences, Mid Sweden University, Sundsvall/Östersund, Sweden
| | - Ylva Rönngren
- Department of Nursing Sciences, Mid Sweden University, Sundsvall/Östersund, Sweden
| | - Erika Wall
- Department of Health Sciences, Mid Sweden University, Sundsvall/Östersund, Sweden
| | - Stig Vinberg
- Department of Health Sciences, Mid Sweden University, Sundsvall/Östersund, Sweden
| | - Ove Hellzen
- Department of Nursing Sciences, Mid Sweden University, Sundsvall/Östersund, Sweden
| | - Niclas Olofsson
- Department of Health Sciences, Mid Sweden University, Sundsvall/Östersund, Sweden
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Wang D, Zhu T, Chen J, Lu Y, Zhou C, Chang YK. Acute Aerobic Exercise Ameliorates Cravings and Inhibitory Control in Heroin Addicts: Evidence From Event-Related Potentials and Frequency Bands. Front Psychol 2020; 11:561590. [PMID: 33101132 PMCID: PMC7554636 DOI: 10.3389/fpsyg.2020.561590] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Accepted: 08/31/2020] [Indexed: 12/14/2022] Open
Abstract
Objective Aerobic exercise is considered a potential adjunctive treatment for heroin addicts, but little is known about its mechanisms. Less severe cravings and greater inhibitory control have been associated with reduced substance use. The aim of the current study was to determine the effects, as measured by behavioral and neuroelectric measurements, of acute aerobic exercise on heroin cravings and inhibitory control induced by heroin-related conditions among heroin addicts. Design The present study used a randomized controlled design. Methods Sixty male heroin addicts who met the DSM-V criteria were recruited from the Isolated Detoxification Center in China and randomly assigned to one of two groups; one group completed a 20-min bout of acute stationary cycle exercise with vigorous intensity (70-80% of maximum heart rate, exercise group), and the other group rested (control group). The self-reported heroin craving levels and inhibitory control outcomes (measured by a heroin-related Go/No-Go task) were assessed pre- and post-exercise. Results The heroin craving levels in the exercise group were significantly attenuated during, immediately following, and 40 min after vigorous exercise compared with before exercise; moreover, during exercise, a smaller craving was observed in the exercise group than in the control group. Acute exercise also facilitated inhibition performance in the No-Go task. After exercise, the participants' accuracy, the N2d amplitudes, and the theta two band spectral power during the No-Go conditions were higher in the exercise group than in the control group. Interestingly, significant correlations between the changes in these sensitive measurements and the changes in cravings were observed. Conclusions This is the first empirical study to demonstrate that aerobic exercise may be efficacious for reducing heroin cravings and promoting inhibitory control among heroin addicts.
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Affiliation(s)
- Dongshi Wang
- Faculty of Sports Science, Ningbo University, Ningbo, China
| | - Ting Zhu
- Center for Mental Health and Education, Ningbo City College of Vocational Technology, Ningbo, China
| | - Jiachen Chen
- Faculty of Sports Science, Ningbo University, Ningbo, China
| | - Yingzhi Lu
- School of Psychology, Shanghai University of Sport, Shanghai, China
| | - Chenglin Zhou
- School of Psychology, Shanghai University of Sport, Shanghai, China
| | - Yu-Kai Chang
- Department of Physical Education, National Taiwan Normal University, Taipei, Taiwan.,Institute for Research Excellence in Learning Science, National Taiwan Normal University, Taipei, Taiwan
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[ADHD in the transition to adulthood: prevalence, symptoms, risks, and care]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2020; 63:910-915. [PMID: 32588062 DOI: 10.1007/s00103-020-03175-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Attention-deficit/hyperactivity disorder (ADHD) is a common neurodevelopmental disorder. In contrast to earlier assumptions, ADHD at least partially persists into adulthood in 50-80% of the patients.This narrative review article highlights the risks, treatment options, and care requirements associated with the transition to adulthood. Available epidemiological and routine care data and guidelines are reviewed and screened for indications and recommendations to improve the health-care of adolescents with ADHD.Epidemiological and routine care data point to a care gap for adolescents with ADHD in the sensitive phase of transition from adolescence to adulthood. Specific transition concepts should be expanded and their effectiveness scientifically investigated.
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[Nonpharmacological treatment options for attention deficit hyperactivity disorder in adulthood: an update]. DER NERVENARZT 2020; 91:591-598. [PMID: 32399608 DOI: 10.1007/s00115-020-00916-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Attention deficit hyperactivity disorder (ADHD) in adulthood is a frequent disorder with a prevalence of 2.5%, which can successfully be treated by pharmacotherapy in 50-70% of cases, depending on the response criteria. Therefore, besides medication nonpharmacological interventions are an important component of the treatment. The essential nonpharmacological interventions are presented and described with respect to the evidence for treatment. According to the S3 guidelines an extensive psychoeducation (PE) functions as the basis of the treatment. If there is still a need for treatment after PE and the clarification of associated disorders, pharmacotherapy is applied. Further psychosocial interventions can then be used as accompaniment or supplement, e.g. when the effectiveness of medication treatment is insufficient. In particular, cognitive behavioral concepts and their variations (dialectic behavioral therapy, metacognitive training, reasoning and rehabilitation therapy) and coaching should be mentioned here, which show increasing evidence for treatment. Neurofeedback can be used if no other psychosocial treatment options are delayed or omitted due to the treatment. Mindfulness training and sport interventions seem to be meaningful as supplementation but similarly to the individualized cognitive training, further research studies are necessary to enable clear statements regarding treatment evidence in adulthood. Further controlled investigations regarding the effectiveness of nonpharmacological interventions on ADHD and associated symptoms and disorders are therefore desirable.
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36
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Combined and Isolated Effects of Acute Exercise and Brain Stimulation on Executive Function in Healthy Young Adults. J Clin Med 2020; 9:jcm9051410. [PMID: 32397614 PMCID: PMC7291170 DOI: 10.3390/jcm9051410] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2020] [Revised: 05/04/2020] [Accepted: 05/04/2020] [Indexed: 12/20/2022] Open
Abstract
Abstract: Acute cognitive enhancement has been sought by healthy young individuals to improve academic and professional performance. Among several methods, physical exercise interventions and transcranial direct current brain stimulation (tDCS) have shown promise in impacting executive functions. Here, we observed a set of new findings about the causal effect of acute aerobic exercise and tDCS across three facets of executive function: Inhibition (as measured by a flanker task) was selectively impacted by acute aerobic exercise but not tDCS, whereas working memory (as measured by an n-back task) was impacted by both acute aerobic exercise and tDCS, with effects emerging on distinct processing components for each manipulation. Sustained attention (as measured by the Mackworth clock task), on the other hand, was not impacted by acute aerobic exercise or tDCS. Interestingly, no effects of combining acute aerobic exercise and tDCS emerged. We argue that understanding the unique and combined contributions of these cognitive enhancement techniques can not only contribute to a deeper mechanistic explanation in healthy individuals but also inform future research with clinical and aging populations.
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Gentile A, Boca S, Şahin FN, Güler Ö, Pajaujiene S, Indriuniene V, Demetriou Y, Sturm D, Gómez-López M, Bianco A, Alesi M. The Effect of an Enriched Sport Program on Children's Executive Functions: The ESA Program. Front Psychol 2020; 11:657. [PMID: 32411039 PMCID: PMC7198739 DOI: 10.3389/fpsyg.2020.00657] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Accepted: 03/18/2020] [Indexed: 11/17/2022] Open
Abstract
PURPOSE The effects of physical exercise on executive functions (EFs) are well-documented. EFs are involved in daily activities, and their development determines the quality of people's future life, both in terms of mental health and quality of life. The purpose of the current paper is to evaluate the effects of a physical education program, elaborated within the Enriched Sports Activity Program (ESA Program), an Erasmus + Project, on EFs, namely, visuospatial working memory, inhibitory control, cognitive flexibility, and task switching. METHOD Data were collected on November 2017 (t1) and May 2018 (t2). At t1, a sample of 357 children from four European countries (Italy, Germany, Lithuania, and Turkey) performed a cognitive test battery made up of Digit Span Forward/Backward, Stroop Task, and Trail Making Test (TMT), whose order was randomized. From November until May, classrooms from the experimental group followed the ESA Program, while classrooms from the control continued with the ordinary physical education class. At t2, children from both experimental and control groups performed again the cognitive battery. RESULT The repeated measures ANOVA showed a significant effect of the ESA Program on the TMT B and on Digit Span Backward, but no significant effects were found on Digit Span Forward and Stroop Task. CONCLUSION The introduction of a sport program enriched with cognitive stimuli has beneficial effects for children working memory and cognitive flexibility.
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Affiliation(s)
- Ambra Gentile
- Ph.D. Program in Health Promotion and Cognitive Sciences, University of Palermo, Palermo, Italy
- Department of Psychology, Educational Sciences and Human Movement, University of Palermo, Palermo, Italy
| | - Stefano Boca
- Department of Psychology, Educational Sciences and Human Movement, University of Palermo, Palermo, Italy
| | | | - Özkan Güler
- Faculty of Sports Science, Ankara University, Ankara, Turkey
| | - Simona Pajaujiene
- Department of Coaching Science, Lithuanian Sports University, Kaunas, Lithuania
| | - Vinga Indriuniene
- Department of Physical and Social Education, Lithuanian Sports University, Kaunas, Lithuania
| | - Yolanda Demetriou
- Department of Sport and Health Sciences, Technical University of Munich, Munich, Germany
| | - David Sturm
- Department of Sport and Health Sciences, Technical University of Munich, Munich, Germany
| | - Manuel Gómez-López
- Department of Physical Activity and Sport, Faculty of Sports Sciences, University of Murcia, Murcia, Spain
| | - Antonino Bianco
- Department of Psychology, Educational Sciences and Human Movement, University of Palermo, Palermo, Italy
| | - Marianna Alesi
- Department of Psychology, Educational Sciences and Human Movement, University of Palermo, Palermo, Italy
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The Contribution of Functional Magnetic Resonance Imaging to the Understanding of the Effects of Acute Physical Exercise on Cognition. Brain Sci 2020; 10:brainsci10030175. [PMID: 32197357 PMCID: PMC7139910 DOI: 10.3390/brainsci10030175] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Revised: 03/04/2020] [Accepted: 03/13/2020] [Indexed: 02/06/2023] Open
Abstract
The fact that a single bout of acute physical exercise has a positive impact on cognition is well-established in the literature, but the neural correlates that underlie these cognitive improvements are not well understood. Here, the use of neuroimaging techniques, such as functional magnetic resonance imaging (fMRI), offers great potential, which is just starting to be recognized. This review aims at providing an overview of those studies that used fMRI to investigate the effects of acute physical exercises on cerebral hemodynamics and cognition. To this end, a systematic literature survey was conducted by two independent reviewers across five electronic databases. The search returned 668 studies, of which 14 studies met the inclusion criteria and were analyzed in this systematic review. Although the findings of the reviewed studies suggest that acute physical exercise (e.g., cycling) leads to profound changes in functional brain activation, the small number of available studies and the great variability in the study protocols limits the conclusions that can be drawn with certainty. In order to overcome these limitations, new, more well-designed trials are needed that (i) use a more rigorous study design, (ii) apply more sophisticated filter methods in fMRI data analysis, (iii) describe the applied processing steps of fMRI data analysis in more detail, and (iv) provide a more precise exercise prescription.
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Gooderham GK, Ho S, Handy TC. Variability in Executive Control Performance Is Predicted by Physical Activity. Front Hum Neurosci 2020; 13:463. [PMID: 32038199 PMCID: PMC6985373 DOI: 10.3389/fnhum.2019.00463] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2019] [Accepted: 12/18/2019] [Indexed: 12/11/2022] Open
Abstract
Physical activity (PA) promotes neurogenesis and has neuroprotective effects on the brain, bolstering the structural and functional resources necessary for improved cognitive functioning. Intraindividual variability (IIV) in cognitive performance is linked to neuropsychological structure and functional ability. Despite evidence of the neurogenerative and neuroprotective effects of PA, limited investigation into the link between PA and IIV has been conducted. Across three studies we investigate the effect of PA on IIV in reaction time (RT) on three modified Flanker Tasks. The International PA Questionnaire was used to evaluate PA while the Attention Network Test (ANT) and two additional modified Flanker Tasks were used to assess executive control and attentional performance. RT coefficients of variation (RTCV) were calculated for each participant by dividing the standard deviation by the mean RT for each stimuli condition. Analysis revealed that basic RT was not associated with PA nor was PA predictive of IIV on the modified Flanker Tasks. However, three consistent findings emerged from analysis of the ANT. First, RTCV and moderate PA were positively related, such that more self-reported moderate PA was associated with greater IIV. Conversely, RTCV and vigorous PA were negatively related. Finally, when controlling for the effects of PA on IIV in young adults, variability decreases as age increases. In sum, PA is predictive of IIV on attentional and executive control tasks in young adults, though only at particular intensities and on certain tasks, indicating that task type and cognitive load are important determinants of the relationship between PA and cognitive performance. These findings are consistent with prior literature that suggests that the role of PA in young adults is reliant on specific interventions and measures in order to detect effects more readily found in adolescent and aging populations.
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Affiliation(s)
- G Kyle Gooderham
- Attentional Neuroscience Laboratory, Department of Psychology, University of British Columbia, Vancouver, BC, Canada
| | - Simon Ho
- Attentional Neuroscience Laboratory, Department of Psychology, University of British Columbia, Vancouver, BC, Canada
| | - Todd C Handy
- Attentional Neuroscience Laboratory, Department of Psychology, University of British Columbia, Vancouver, BC, Canada
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Mehren A, Reichert M, Coghill D, Müller HHO, Braun N, Philipsen A. Physical exercise in attention deficit hyperactivity disorder - evidence and implications for the treatment of borderline personality disorder. Borderline Personal Disord Emot Dysregul 2020; 7:1. [PMID: 31921425 PMCID: PMC6945516 DOI: 10.1186/s40479-019-0115-2] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Accepted: 10/23/2019] [Indexed: 12/13/2022] Open
Abstract
A growing body of literature indicates a potential role for physical exercise in the treatment of attention deficit hyperactivity disorder (ADHD). Suggested effects include the reduction of ADHD core symptoms as well as improvements in executive functions. In the current review, we provide a short overview on the neurophysiological mechanisms assumed to underlie the beneficial effects of exercise. Further, we review the current evidence from experimental studies regarding both acute exercise and long-term interventions in ADHD. While the positive effects observed after acute aerobic exercise are promising, very few well-designed long-term intervention studies have been conducted yet. Moreover, although exercise effects have not yet been studied in borderline personality disorder (BPD), in the end of this paper we derive hypotheses why exercise could also be beneficial for this patient population.
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Affiliation(s)
- Aylin Mehren
- 1Department of Psychology, Biological Psychology Lab, European Medical School, University of Oldenburg, Oldenburg, Germany
| | - Markus Reichert
- 2Department of Applied Psychology, Mental mHealth Lab, Institute of Sports and Sports Science, Karlsruhe Institute of Technology (KIT), Karlsruhe, Germany.,3Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - David Coghill
- 4Royal Children's Hospital, Melbourne, Victoria Australia
| | - Helge H O Müller
- 5Department of Psychiatry and Psychotherapy, University of Bonn, Bonn, Germany
| | - Niclas Braun
- 5Department of Psychiatry and Psychotherapy, University of Bonn, Bonn, Germany
| | - Alexandra Philipsen
- 5Department of Psychiatry and Psychotherapy, University of Bonn, Bonn, Germany
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Effects of Acute Aerobic Exercise on Response Inhibition in Adult Patients with ADHD. Sci Rep 2019; 9:19884. [PMID: 31882652 PMCID: PMC6934617 DOI: 10.1038/s41598-019-56332-y] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Accepted: 12/06/2019] [Indexed: 12/24/2022] Open
Abstract
Previous studies suggest beneficial effects of aerobic exercise on executive functions, which are a core deficit in ADHD. The aim of the present fMRI study was to investigate acute effects of aerobic exercise on inhibitory control and related brain activation in adult patients with ADHD. 23 patients and 23 matched healthy controls performed on a Go/No-go task in an MRI scanner, following both, an exercise condition involving 30 min of cycling at moderate intensity, and a control condition. ADHD patients compared to healthy controls showed increased brain activation during successful inhibition in the exercise compared to the control condition in parietal, temporal, and occipital regions. Exercise did not improve behavioral performance in either group, but in ADHD patients, exercise-related increases in brain activation and behavioral task performance (i.e., correct inhibition rate) negatively correlated with correct inhibition rate in the control condition. Thus, patients with worse inhibition performance showed stronger exercise-related enhancements, indicating that the lack of improvements on the behavioral level for the whole patient group could be due to ceiling effects. Our findings might be an important step in understanding the neural basis of exercise effects and could, in the long term, help in developing alternative treatment approaches for ADHD.
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Mehren A, Diaz Luque C, Brandes M, Lam AP, Thiel CM, Philipsen A, Özyurt J. Intensity-Dependent Effects of Acute Exercise on Executive Function. Neural Plast 2019; 2019:8608317. [PMID: 31281346 PMCID: PMC6589258 DOI: 10.1155/2019/8608317] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Revised: 04/05/2019] [Accepted: 05/06/2019] [Indexed: 12/17/2022] Open
Abstract
Numerous studies suggest beneficial effects of aerobic exercise at moderate intensity on cognition, while the effects of high-intensity exercise are less clear. This study investigated the acute effects of exercise at moderate and high intensities on executive functions in healthy adults, including functional MRI to examine the underlying neural mechanisms. Furthermore, the association between exercise effects and cardiorespiratory fitness was examined. 64 participants performed in two executive function tasks (flanker and Go/No-go tasks), while functional MR images were collected, following two conditions: in the exercise condition, they cycled on an ergometer at either moderate or high intensity (each n = 32); in the control condition, they watched a movie. Differences in behavioral performance and brain activation between the two conditions were compared between groups. Further, correlations between cardiorespiratory fitness and exercise effects on neural and behavioral correlates of executive performance were calculated. Moderate exercise compared to high-intensity exercise was associated with a tendency towards improved behavioral performance (sensitivity index d') in the Go/No-go task and increased brain activation during hit trials in areas related to executive function, attention, and motor processes (insula, superior frontal gyrus, precentral gyrus, and supplementary motor area). Exercise at high intensity was associated with decreased brain activation in those areas and no changes in behavioral performance. Exercise had no effect on brain activation in the flanker task, but an explorative analysis revealed that reaction times improved after high-intensity exercise. Higher cardiorespiratory fitness was correlated with increased brain activation after moderate exercise and decreased brain activation after high-intensity exercise. These data show that exercise at moderate vs. high intensity has different effects on executive task performance and related brain activation changes as measured by fMRI and that cardiorespiratory fitness might be a moderating factor of acute exercise effects. Thus, our results may contribute to further clarify the neurophysiological mechanisms underlying the beneficial effects of exercise on cognition.
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Affiliation(s)
- Aylin Mehren
- Biological Psychology Lab, Department of Psychology, School of Medicine and Health Sciences, Carl von Ossietzky Universität Oldenburg, Oldenburg, Germany
- Psychiatry and Psychotherapy, School of Medicine and Health Sciences, University Hospital Karl-Jaspers-Klinik, Carl von Ossietzky Universität Oldenburg, Oldenburg, Germany
| | - Cecilia Diaz Luque
- Biological Psychology Lab, Department of Psychology, School of Medicine and Health Sciences, Carl von Ossietzky Universität Oldenburg, Oldenburg, Germany
| | - Mirko Brandes
- Leibniz Institute for Prevention Research and Epidemiology-BIPS GmbH, Department of Prevention and Evaluation, Unit Applied Health Intervention Research, Bremen, Germany
| | - Alexandra P. Lam
- Department of Psychiatry and Psychotherapy, University of Bonn, Bonn, Germany
| | - Christiane M. Thiel
- Biological Psychology Lab, Department of Psychology, School of Medicine and Health Sciences, Carl von Ossietzky Universität Oldenburg, Oldenburg, Germany
- Research Center Neurosensory Science, Carl von Ossietzky Universität Oldenburg, Oldenburg, Germany
- Cluster of Excellence “Hearing4all”, Carl von Ossietzky Universität Oldenburg, Oldenburg, Germany
| | - Alexandra Philipsen
- Department of Psychiatry and Psychotherapy, University of Bonn, Bonn, Germany
| | - Jale Özyurt
- Biological Psychology Lab, Department of Psychology, School of Medicine and Health Sciences, Carl von Ossietzky Universität Oldenburg, Oldenburg, Germany
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