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Shao X, He L, Liu Y. The effects of exercise interventions on brain-derived neurotrophic factor levels in children and adolescents: a meta-analysis. Neural Regen Res 2025; 20:1513-1520. [PMID: 39075917 DOI: 10.4103/nrr.nrr-d-23-01296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 01/27/2024] [Indexed: 07/31/2024] Open
Abstract
Brain-derived neurotrophic factor is a crucial neurotrophic factor that plays a significant role in brain health. Although the vast majority of meta-analyses have confirmed that exercise interventions can increase brain-derived neurotrophic factor levels in children and adolescents, the effects of specific types of exercise on brain-derived neurotrophic factor levels are still controversial. To address this issue, we used meta-analytic methods to quantitatively evaluate, analyze, and integrate relevant studies. Our goals were to formulate general conclusions regarding the use of exercise interventions, explore the physiological mechanisms by which exercise improves brain health and cognitive ability in children and adolescents, and provide a reliable foundation for follow-up research. We used the PubMed, Web of Science, Science Direct, Springer, Wiley Online Library, Weipu, Wanfang, and China National Knowledge Infrastructure databases to search for randomized controlled trials examining the influences of exercise interventions on brain-derived neurotrophic factor levels in children and adolescents. The extracted data were analyzed using ReviewManager 5.3. According to the inclusion criteria, we assessed randomized controlled trials in which the samples were mainly children and adolescents, and the outcome indicators were measured before and after the intervention. We excluded animal experiments, studies that lacked a control group, and those that did not report quantitative results. The mean difference (MD; before versus after intervention) was used to evaluate the effect of exercise on brain-derived neurotrophic factor levels in children and adolescents. Overall, 531 participants (60 children and 471 adolescents, 10.9-16.1 years) were included from 13 randomized controlled trials. Heterogeneity was evaluated using the Q statistic and I2 test provided by ReviewManager software. The meta-analysis showed that there was no heterogeneity among the studies (P = 0.67, I2 = 0.00%). The combined effect of the interventions was significant (MD = 2.88, 95% CI: 1.53-4.22, P < 0.0001), indicating that the brain-derived neurotrophic factor levels of the children and adolescents in the exercise group were significantly higher than those in the control group. In conclusion, different types of exercise interventions significantly increased brain-derived neurotrophic factor levels in children and adolescents. However, because of the small sample size of this meta-analysis, more high-quality research is needed to verify our conclusions. This meta-analysis was registered at PROSPERO (registration ID: CRD42023439408).
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Affiliation(s)
- Xueyun Shao
- Physical Education School, Shenzhen University, Shenzhen, Guangdong Province, China
- Shenzhen Institute of Neuroscience, Shenzhen, Guangdong Province, China
| | - Longfei He
- Shenzhen Institute of Neuroscience, Shenzhen, Guangdong Province, China
| | - Yangyang Liu
- Shenzhen Institute of Neuroscience, Shenzhen, Guangdong Province, China
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2
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Behrad S, Dezfuli SAT, Yazdani R, Hayati S, Shanjani SM. The effect of physical exercise on circulating neurotrophic factors in healthy aged subjects: A meta-analysis and meta-regression. Exp Gerontol 2024; 196:112579. [PMID: 39260585 DOI: 10.1016/j.exger.2024.112579] [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: 07/30/2024] [Revised: 08/29/2024] [Accepted: 09/07/2024] [Indexed: 09/13/2024]
Abstract
Vascular endothelial growth factor (VEGF), brain-derived neurotrophic factor (BDNF), and insulin-like growth factor-1 (IGF-1) may help the brain resist both functional and structural neurodegeneration, which is critical for maintaining cognitive and neurological health in older adults. This meta-analysis and meta-regression seek to elucidate the impact of physical activity on these biomarker levels in healthy seniors, as well as to examine the influence of several moderator factors, including age, sex, period length, and time, for the first time. The standardized mean effect metric was used to assess the influence of weights, which reflected each group's relative importance in comparison to baseline data. The study looked at potential moderating factors including age, gender, and physical activity levels. The analysis of 11 studies indicated no significant effect of physical activity on VEGF levels [0.328, CI 95 % (-0.871 to 1.52); I2 = 0.00; p = 0.592; Q = 4.14]. Physical activity had a substantial impact on brain-derived neurotrophic factor (0.827, 95 % confidence interval: 0.487 to 1.16; I2 = 0.00; p = 0.00; Q = 78.46), with females showing particularly notable effects (Tau2 = 0.327, Tau = 0.571, I2 = 80.90 %, Q = 68.05, df = 15, p = 0.00). Physical activity also had a substantial effect on insulin-like growth factor 1 (0.276, 95 % confidence interval: 0.065 to 0.487; I2 = 0.00; p = 0.10; Q = 8.35), indicating that it positively influences IGF-1 levels. Overall, while physical exercise has a significant effect on BDNF and IGF-1, more research is needed to fully understand its impact on vascular endothelial growth factor and to investigate how individual characteristics may influence exercise outcomes.
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Affiliation(s)
- Samira Behrad
- Department of Oral and Maxillofacial Pathology, Dental School, Semnan University of Medical Sciences, Semnan, Iran
| | | | - Reza Yazdani
- Department of Emergency Medicine, Faculty of Medicine, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Saeed Hayati
- Department of Emergency Medicine, Faculty of Medicine, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Sanaz Mirzayan Shanjani
- Department of Sport Physiology, Islamshahr Branch, Islamic Azad University, Islamshahr, Iran.
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Ceylan Hİ, Silva AF, Ramirez-Campillo R, Murawska-Ciałowicz E. Exploring the Effect of Acute and Regular Physical Exercise on Circulating Brain-Derived Neurotrophic Factor Levels in Individuals with Obesity: A Comprehensive Systematic Review and Meta-Analysis. BIOLOGY 2024; 13:323. [PMID: 38785805 PMCID: PMC11117522 DOI: 10.3390/biology13050323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/11/2024] [Revised: 04/18/2024] [Accepted: 04/29/2024] [Indexed: 05/25/2024]
Abstract
Obesity is a major global health concern linked to cognitive impairment and neurological disorders. Circulating brain-derived neurotrophic factor (BDNF), a protein crucial for neuronal growth and survival, plays a vital role in brain function and plasticity. Notably, obese individuals tend to exhibit lower BDNF levels, potentially contributing to cognitive decline. Physical exercise offers health benefits, including improved circulating BDNF levels and cognitive function, but the specific impacts of acute versus regular exercise on circulating BDNF levels in obesity are unclear. Understanding this can guide interventions to enhance brain health and counter potential cognitive decline in obese individuals. Therefore, this study aimed to explore the impact of acute and regular physical exercise on circulating BDNF in individuals with obesity. The target population comprised individuals classified as overweight or obese, encompassing both acute and chronic protocols involving all training methods. A comprehensive search was conducted across computerized databases, including PubMed, Academic Search Complete, and Web of Science, in August 2022, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Initially, 98 studies were identified, from which 16 studies, comprising 23 trials, met the selection criteria. Substantial heterogeneity was observed for both acute (I2 = 80.4%) and long-term effects (I2 = 88.7%), but low risk of bias for the included studies. A single session of exercise increased circulating BDNF levels among obese patients compared to the control group (ES = 1.25, 95% CI = 0.19 to 2.30, p = 0.021). However, with extended periods of physical exercise, there was no significant increase in circulating BDNF levels when compared to the control group (ES = 0.49, 95% CI = -0.08 to 1.06, p = 0.089). These findings highlight the need to consider exercise duration and type when studying neurobiological responses in obesity and exercise research. The study's results have implications for exercise prescription in obesity management and highlight the need for tailored interventions to optimize neurotrophic responses. Future research should focus on elucidating the adaptive mechanisms and exploring novel strategies to enhance BDNF modulation through exercise in this population. However, further research is needed considering limitations such as the potential age-related confounding effects due to diverse participant ages, lack of sex-specific analyses, and insufficient exploration of how specific exercise parameters (e.g., duration, intensity, type) impact circulating BDNF.
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Affiliation(s)
- Halil İbrahim Ceylan
- Physical Education and Sports Teaching Department, Kazim Karabekir Faculty of Education, Ataturk University, 25240 Erzurum, Turkey
| | - Ana Filipa Silva
- Escola Superior Desporto e Lazer, Instituto Politécnico de Viana do Castelo, Rua Escola Industrial e Comercial de Nun’Álvares, 4900-347 Viana do Castelo, Portugal
- Research Center in Sports Performance, Recreation, Innovation and Technology (SPRINT), 4960-320 Melgaço, Portugal
| | - Rodrigo Ramirez-Campillo
- Exercise and Rehabilitation Sciences Institute, School of Physical Therapy, Faculty of Rehabilitation Sciences, Universidad Andres Bello, Santiago de Chile 7591538, Chile;
| | - Eugenia Murawska-Ciałowicz
- Department of Physiology and Biochemistry, Faculty of Physical Education and Sport, Wrocław University of Health and Sport Sciences, 51-612 Wrocław, Poland;
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de Oliveira Segundo VH, de Azevedo KPM, de Medeiros GCBS, Mata ÁNDS, Piuvezam G. Association between sedentary behavior and Brain-Derived Neurotrophic Factor (BDNF) in children and adolescents: A protocol for systematic review and meta-analysis. PLoS One 2024; 19:e0299024. [PMID: 38442097 PMCID: PMC10914284 DOI: 10.1371/journal.pone.0299024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 02/04/2024] [Indexed: 03/07/2024] Open
Abstract
BACKGROUND There is evidence in the literature suggesting that high time spent in sedentary behavior (SB) can reduce the Brain-Derived Neurotrophic Factor (BDNF) levels, an important neurotrophin that plays a role in modulating cognition, learning and memory. Children and adolescents usually spend many hours a day on SB, either sitting for a long time and/or using screen equipment. OBJECTIVE The aim of this study is to describe a systematic review and meta-analysis protocol on the associations between SB and BDNF levels in children and adolescents. METHODS This protocol is guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols and was published in the International Prospective Register of Systematic Reviews database (PROSPERO: CRD42023392246). The databases that will be searched are EMBASE, Scopus, ScienceDirect, Web of Science, SPORTDiscus, CINAHL, and PubMed. Cross-sectional and cohort studies conducted with children and adolescents (5 to 19 yr) that analyzed the association between SB and BDNF will be included in the systematic review. The characteristics of the studies, methodological aspects, and main results will be described. Then, the risk of bias (assessed by STROBE and Newcastle-Ottawa scales) and the level of evidence (assessed by the GRADE tool) from included studies will be evaluated. Sub-group analysis will also be performed. Two experienced reviewers will perform the studies selection, data extraction, and methodological quality assessment. CONCLUSION This systematic review and meta-analysis will analyze the association between SB and BDNF in children and adolescents. The results will provide subsidies to better understand this relationship and will strengthen evidence-based practice for both health professionals and future researches.
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Affiliation(s)
- Victor Hugo de Oliveira Segundo
- Department of Public Health, Postgraduate Program in Public Health, Federal University of Rio Grande do Norte, Natal/RN, Brazil
- Systematic Review and Meta-analysis Laboratory (Lab-Sys/CNPq), Federal University of Rio Grande do Norte, Natal/RN, Brazil
| | - Kesley Pablo Morais de Azevedo
- Department of Public Health, Postgraduate Program in Public Health, Federal University of Rio Grande do Norte, Natal/RN, Brazil
- Systematic Review and Meta-analysis Laboratory (Lab-Sys/CNPq), Federal University of Rio Grande do Norte, Natal/RN, Brazil
| | - Gidyenne Christine Bandeira Silva de Medeiros
- Department of Public Health, Postgraduate Program in Public Health, Federal University of Rio Grande do Norte, Natal/RN, Brazil
- Systematic Review and Meta-analysis Laboratory (Lab-Sys/CNPq), Federal University of Rio Grande do Norte, Natal/RN, Brazil
| | - Ádala Nayana de Sousa Mata
- Department of Public Health, Postgraduate Program in Public Health, Federal University of Rio Grande do Norte, Natal/RN, Brazil
- Systematic Review and Meta-analysis Laboratory (Lab-Sys/CNPq), Federal University of Rio Grande do Norte, Natal/RN, Brazil
| | - Grasiela Piuvezam
- Department of Public Health, Postgraduate Program in Public Health, Federal University of Rio Grande do Norte, Natal/RN, Brazil
- Systematic Review and Meta-analysis Laboratory (Lab-Sys/CNPq), Federal University of Rio Grande do Norte, Natal/RN, Brazil
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Nelson ML, Pfeifer JA, Hickey JP, Collins AE, Kalisch BE. Exploring Rosiglitazone's Potential to Treat Alzheimer's Disease through the Modulation of Brain-Derived Neurotrophic Factor. BIOLOGY 2023; 12:1042. [PMID: 37508471 PMCID: PMC10376118 DOI: 10.3390/biology12071042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Revised: 06/24/2023] [Accepted: 07/21/2023] [Indexed: 07/30/2023]
Abstract
Alzheimer's disease (AD) is a progressive neurodegenerative disorder that debilitates over 55 million individuals worldwide. Currently, treatments manage and alleviate its symptoms; however, there is still a need to find a therapy that prevents or halts disease progression. Since AD has been labeled as "type 3 diabetes" due to its similarity in pathological hallmarks, molecular pathways, and comorbidity with type 2 diabetes mellitus (T2DM), there is growing interest in using anti-diabetic drugs for its treatment. Rosiglitazone (RSG) is a peroxisome proliferator-activated receptor-gamma agonist that reduces hyperglycemia and hyperinsulinemia and improves insulin signaling. In cellular and rodent models of T2DM-associated cognitive decline and AD, RSG has been reported to improve cognitive impairment and reverse AD-like pathology; however, results from human clinical trials remain consistently unsuccessful. RSG has also been reported to modulate the expression of brain-derived neurotrophic factor (BDNF), a protein that regulates neuroplasticity and energy homeostasis and is implicated in both AD and T2DM. The present review investigates RSG's limitations and potential therapeutic benefits in pre-clinical models of AD through its modulation of BDNF expression.
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Affiliation(s)
- Mackayla L Nelson
- Department of Biomedical Sciences and Collaborative Specialization in Neuroscience Program, University of Guelph, Guelph, ON N1G 2W1, Canada
| | - Julia A Pfeifer
- Department of Biomedical Sciences and Collaborative Specialization in Neuroscience Program, University of Guelph, Guelph, ON N1G 2W1, Canada
| | - Jordan P Hickey
- Department of Biomedical Sciences and Collaborative Specialization in Neuroscience Program, University of Guelph, Guelph, ON N1G 2W1, Canada
| | - Andrila E Collins
- Department of Biomedical Sciences and Collaborative Specialization in Neuroscience Program, University of Guelph, Guelph, ON N1G 2W1, Canada
| | - Bettina E Kalisch
- Department of Biomedical Sciences and Collaborative Specialization in Neuroscience Program, University of Guelph, Guelph, ON N1G 2W1, Canada
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Russell D, Arnold LE. Complementary and Integrative Treatments for Attention-Deficit/Hyperactivity Disorder in Youth. Child Adolesc Psychiatr Clin N Am 2023; 32:173-192. [PMID: 37147036 DOI: 10.1016/j.chc.2022.08.005] [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] [Indexed: 05/07/2023]
Abstract
First-line psychopharmacologic and psychosocial treatments for attention-deficit/hyperactivity disorder in children are effective but limited by tolerability and accessibility problems. Many complementary and integrative strategies have been investigated as alternative or adjunctive treatments for the disorder, and the literature has progressed to meta-analyses for several. Although heterogeneity of study methods and risk of bias pervades the literature, we conclude that Omega-3 supplementation, dietary restriction of artificial food colorings, and physical activity can be considered evidence-based. Additionally, meditation, yoga, and sleep hygiene are safe, partially effective, cost effective and sensible adjunctive treatment strategies.
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Affiliation(s)
- Douglas Russell
- Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, c/o Seattle Children's Hospital, OA.5.154 PO Box 5371, Seattle, WA 98145-5005, USA.
| | - L Eugene Arnold
- Department of Psychiatry and Behavioral Health, The Ohio State University College of Medicine, 395E McCampbell Hall, 1581 Dodd Drive, Columbus, OH 43210, USA
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Rodríguez-Gutiérrez E, Torres-Costoso A, Pascual-Morena C, Pozuelo-Carrascosa DP, Garrido-Miguel M, Martínez-Vizcaíno V. Effects of Resistance Exercise on Neuroprotective Factors in Middle and Late Life: A Systematic Review and Meta-Analysis. Aging Dis 2023:AD.2022.1207. [PMID: 37163437 PMCID: PMC10389831 DOI: 10.14336/ad.2022.1207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Accepted: 12/07/2022] [Indexed: 05/12/2023] Open
Abstract
Neuroprotective factors are involved in brain functioning. Although physical exercise has been shown to have a positive influence on these factors, the effect of resistance exercise on them is not well known. This systematic review and meta-analysis aimed to 1) estimate the efficacy of resistance exercise on major neuroprotective factors, such as insulin-like growth factor-1 (IGF-1), brain-derived neurotrophic factor (BDNF), and vascular endothelial growth factor (VEGF), in middle and late life and 2) determine whether the effect is dose dependent. A systematic search was conducted in CINAHL, Cochrane CENTRAL, MEDLINE, Scopus, PEDro, SPORTDiscus, and Web of Science up to November 2022. Random effects models were used to estimate standardized mean differences (SMDs) and their respective 95% confidence intervals (CI) for the effect of resistance exercise on peripheral IGF-1, BDNF or VEGF levels in older adults. Thirty randomized clinical trials with 1247 subjects (53.25% women, 45-92 years) were included in the systematic review, and 27 were selected for the meta-analysis. A significant effect of resistance exercise on IGF-1 levels was observed (SMD: 0.48; 95% CI: 0.27, 0.69), being more effective when performing 3 sessions/week (SMD: 0.55; 95% CI: 0.31, 0.79) but not on BDNF (SMD: 0.33; 95% CI: -0.29, 0.94). The effect on VEGF could not be determined due to the scarcity of studies. Our data support the resistance training recommendation in middle and late life, at a frequency of at least 3 sessions/week, to mitigate the neurological and cognitive consequences associated with aging, mainly through IGF-1.
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Affiliation(s)
| | - Ana Torres-Costoso
- Health and Social Research Center, Universidad de Castilla-La Mancha, 16071 Cuenca, Spain
- Facultad de Fisioterapia y Enfermería, Universidad de Castilla-La Mancha, 45071, Toledo, Spain
| | - Carlos Pascual-Morena
- Health and Social Research Center, Universidad de Castilla-La Mancha, 16071 Cuenca, Spain
| | - Diana P Pozuelo-Carrascosa
- Health and Social Research Center, Universidad de Castilla-La Mancha, 16071 Cuenca, Spain
- Grupo de Investigación Multidisciplinar en Cuidados (IMCU), Campus de Fábrica de Armas, Universidad de Castilla-La Mancha, Toledo, 45071, Spain
| | - Miriam Garrido-Miguel
- Health and Social Research Center, Universidad de Castilla-La Mancha, 16071 Cuenca, Spain
- Facultad de Enfermería, Universidad de Castilla-La Mancha, 02006, Albacete, Spain
| | - Vicente Martínez-Vizcaíno
- Health and Social Research Center, Universidad de Castilla-La Mancha, 16071 Cuenca, Spain
- Facultad de Ciencias de la Salud, Universidad Autónoma de Chile, 3460000 Talca, Chile
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8
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Olivas-Martinez A, Suarez B, Salamanca-Fernandez E, Reina-Perez I, Rodriguez-Carrillo A, Mustieles V, Olea N, Freire C, Fernández MF. Development and validation of brain-derived neurotrophic factor measurement in human urine samples as a non-invasive effect biomarker. Front Mol Neurosci 2023; 15:1075613. [PMID: 36710936 PMCID: PMC9878568 DOI: 10.3389/fnmol.2022.1075613] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Accepted: 12/14/2022] [Indexed: 01/13/2023] Open
Abstract
Background Brain-derived neurotrophic factor (BDNF), a neurotrophic growth factor mainly expressed in the brain, has been proposed as a potential effect biomarker; that is, as a measurable biomarker whose values could be associated with several diseases, including neurological impairments. The European Human Biomonitoring Initiative (HBM4EU) has also recognized effect biomarkers as a useful tool for establishing link between exposure to environmental pollutants and human health. Despite the well-establish protocol for measuring serum BDNF, there is a need to validate its assessment in urine, a non-invasive sample that can be easily repeated over time. The aim of this study was to develop, standardize and validate a methodology to quantify BDNF protein levels in urine samples before its implementation in biomonitoring studies. Methods Different experimental conditions and non-competitive commercial enzyme-linked immunosorbent assay (ELISA) kits were tested to determine the optimal analytical procedure, trying to minimize the shortcomings of ELISA kits. The fine-tune protocol was validated in a pilot study using both upon awakening (n = 150) and prior to sleeping (n = 106) urine samples from the same Spanish adolescent males in a well-characterized study population (the Spanish INMA-Granada cohort). Results The best results were obtained in 0.6 ml of urine after the acidification and extraction (pre-concentration) of samples. The highest reproducibility was obtained with the ELISA kit from Raybiotech. Urinary BDNF concentrations of adolescent males were within the previously reported range (morning = 0.047-6.801 ng/ml and night = 0.047-7.404 ng/ml). Urinary BDNF levels in the awakening and pre-sleep samples did not follow a normal distribution and were not correlated. Conclusion The developed methodology offers good sensitivity and reproducibility. Having reliable markers in urine may facilitate both diagnosis and monitoring possible diseases (and treatment). Further studies are needed to implement urinary BDNF in biomonitoring studies to further elucidate its usefulness and biological significance for neurological impairments.
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Affiliation(s)
- Alicia Olivas-Martinez
- Centre for Biomedical Research (CIBM), University of Granada, Granada, Spain,Instituto de Investigación Biosanitaria de Granada, Granada, Spain
| | - Beatriz Suarez
- Centre for Biomedical Research (CIBM), University of Granada, Granada, Spain
| | - Elena Salamanca-Fernandez
- Centre for Biomedical Research (CIBM), University of Granada, Granada, Spain,Department of Radiology and Physical Medicine, School of Medicine, University of Granada, Granada, Spain
| | - Iris Reina-Perez
- Centre for Biomedical Research (CIBM), University of Granada, Granada, Spain,Department of Radiology and Physical Medicine, School of Medicine, University of Granada, Granada, Spain
| | - Andrea Rodriguez-Carrillo
- Centre for Biomedical Research (CIBM), University of Granada, Granada, Spain,Department of Radiology and Physical Medicine, School of Medicine, University of Granada, Granada, Spain
| | - Vicente Mustieles
- Centre for Biomedical Research (CIBM), University of Granada, Granada, Spain,Instituto de Investigación Biosanitaria de Granada, Granada, Spain,Department of Radiology and Physical Medicine, School of Medicine, University of Granada, Granada, Spain,Consortium for Biomedical Research in Epidemiology and Public Health, Madrid, Spain
| | - Nicolás Olea
- Centre for Biomedical Research (CIBM), University of Granada, Granada, Spain,Instituto de Investigación Biosanitaria de Granada, Granada, Spain,Department of Radiology and Physical Medicine, School of Medicine, University of Granada, Granada, Spain,Consortium for Biomedical Research in Epidemiology and Public Health, Madrid, Spain
| | - Carmen Freire
- Centre for Biomedical Research (CIBM), University of Granada, Granada, Spain,Instituto de Investigación Biosanitaria de Granada, Granada, Spain,Consortium for Biomedical Research in Epidemiology and Public Health, Madrid, Spain
| | - Mariana F. Fernández
- Centre for Biomedical Research (CIBM), University of Granada, Granada, Spain,Instituto de Investigación Biosanitaria de Granada, Granada, Spain,Department of Radiology and Physical Medicine, School of Medicine, University of Granada, Granada, Spain,Consortium for Biomedical Research in Epidemiology and Public Health, Madrid, Spain,*Correspondence: Mariana F. Fernández,
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Burdack J, Schöllhorn WI. Cognitive Enhancement through Differential Rope Skipping after Math Lesson. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:205. [PMID: 36612527 PMCID: PMC9819879 DOI: 10.3390/ijerph20010205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 12/19/2022] [Accepted: 12/20/2022] [Indexed: 06/17/2023]
Abstract
Numerous studies have shown cognitive enhancement through sport and physical exercise. Despite the variety of studies, the extent to which physical activity before or after a cognitive learning session leads to more effective cognitive enhancement remains largely unresolved. Moreover, little attention has been paid to the dependence of the motor learning approach then applied. In this study, we compare the influence of differential with uniformly rope skipping directly succeeding an acquisition phase in arithmetic mathematics. For three weeks 26 pupils, 14 female, 12 male, and 13.9 ± 0.7 years old, completed nine 15 min exercises in arithmetic math, each followed by 3 min rope skipping with heart rate measurement. Arithmetic performance was tested in a pre-, post- and retention test design. The results showed a statistically significant difference between the differential and the control groups within the development of arithmetic performance, especially in the retention test. There was no statistical difference in heart rate. It is suggested that the results provide evidence for sustainable improvements of cognitive learning performance by means of highly variable rope skipping.
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Yu JY, Jeong DE, Joo JY, Kim ST. Brain-derived neurotrophic factor levels and macular ganglion cell-inner plexiform layer thickness in macular telangiectasia type 2. Int Ophthalmol 2022; 43:1927-1933. [DOI: 10.1007/s10792-022-02592-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2021] [Accepted: 11/12/2022] [Indexed: 12/14/2022]
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Valkenborghs SR, Hillman CH, Al‐Iedani O, Nilsson M, Smith JJ, Leahy AA, Harries SK, Ramadan S, Lubans DR. Effect of high-intensity interval training on hippocampal metabolism in older adolescents. Psychophysiology 2022; 59:e14090. [PMID: 35599295 PMCID: PMC9787522 DOI: 10.1111/psyp.14090] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 04/26/2022] [Accepted: 04/26/2022] [Indexed: 12/30/2022]
Abstract
Although well-evidenced in older adults, the effects of exercise on the hippocampus in youth are relatively unknown. This study examined the impact of a 6-month school-based physical activity intervention on hippocampal metabolism in adolescents using magnetic resonance spectroscopy. A subset of lower fit older adolescents [N = 56, 61% female, 16.1 ± 0.4 years] was included from four secondary schools (10 classes) in New South Wales, Australia, who were participating in a larger cluster randomized controlled trial. Participants were randomized to the Burn 2 Learn (B2L) intervention (five classes, 30 participants) or a control group (five classes, 26 participants). Changes in hippocampal metabolism were assessed using linear mixed models adjusted for clustering at the class level. We observed group-by-time effects for the B2L intervention on N-acetylaspartate (NAA) (+2.66 mmol/L, 95% CI 0.20 to 5.11, d = 0.66) and glutamate+glutamine (Glx) (+3.38 mmol/L, 95% CI 0.34 to 6.42, d = 0.67) in the left hippocampus. Increases in left hippocampal NAA and Glx concentrations were associated with improvements in cardiorespiratory fitness (NAA: rs = 0.52, p = .016; Glx: rs = 0.57, p = .007), lower body muscular fitness (NAA: rs = 0.49, p = .018; Glx: rs = 0.59, p = .003), and working memory (NAA: rs = 0.42, p = .032; Glx: rs = 0.43, p = .028) in the intervention group. Our findings suggest physical activity may improve hippocampal metabolism in lower fit older adolescents with implications for working memory. Further studies involving larger samples are needed to replicate our findings.
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Affiliation(s)
- Sarah Ruth Valkenborghs
- School of Biomedical Sciences and PharmacyThe University of NewcastleCallaghanNew South WalesAustralia,Centre for Active Living and LearningThe University of NewcastleCallaghanNew South WalesAustralia
| | - Charles H. Hillman
- Center for Cognitive & Brain Health, Department of Psychology, Department of Physical Therapy, Movement, and Rehabilitation SciencesNortheastern UniversityBostonMassachusettsUSA
| | - Oun Al‐Iedani
- School of Health SciencesThe University of NewcastleCallaghanNew South WalesAustralia
| | - Michael Nilsson
- Centre for Rehab InnovationsThe University of NewcastleCallaghanNew South WalesAustralia,Priority Research Centre for Stroke and Brain InjuryThe University of NewcastleCallaghanNew South WalesAustralia,School of Medicine and Public HealthThe University of NewcastleCallaghanNew South WalesAustralia
| | - Jordan J. Smith
- Centre for Active Living and LearningThe University of NewcastleCallaghanNew South WalesAustralia,School of EducationThe University of NewcastleCallaghanNew South WalesAustralia
| | - Angus Aaron Leahy
- Centre for Active Living and LearningThe University of NewcastleCallaghanNew South WalesAustralia,School of EducationThe University of NewcastleCallaghanNew South WalesAustralia
| | - Simon K. Harries
- Centre for Active Living and LearningThe University of NewcastleCallaghanNew South WalesAustralia,School of EducationThe University of NewcastleCallaghanNew South WalesAustralia
| | - Saadallah Ramadan
- School of Health SciencesThe University of NewcastleCallaghanNew South WalesAustralia
| | - David Revalds Lubans
- Centre for Active Living and LearningThe University of NewcastleCallaghanNew South WalesAustralia,School of EducationThe University of NewcastleCallaghanNew South WalesAustralia
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12
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Williams RA, Dring KJ, Morris JG, Sunderland C, Nevill ME, Cooper SB. Effect of two-weeks of school-based sprint training on physical fitness, risk factors for cardiometabolic diseases and cognitive function in adolescent girls: A randomized controlled pilot trial. Front Sports Act Living 2022; 4:884051. [PMID: 35992157 PMCID: PMC9390877 DOI: 10.3389/fspor.2022.884051] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Accepted: 07/18/2022] [Indexed: 11/25/2022] Open
Abstract
Background School-based physical activity interventions are accessible to most adolescents and could enhance adolescent cardiometabolic health and cognition; yet the feasibility and success of school-based physical activity interventions is understudied. Methods Sixteen adolescent girls (age: 11.7 ± 0.3 y; height: 1.58 ± 0.07 m; body mass: 45.5 ± 9.2 kg) were randomized to either an intervention (2-weeks sprint training; n = 8) or control group (continuation of regular physical activity levels; n = 8). Following familiarization, all participants completed baseline measurements including fasted and postprandial capillary blood samples, a battery of cognitive function tests (Stroop Test, Sternberg Paradigm and Flanker Task), and an assessment of physical fitness (20 m sprint and multi-stage fitness test). The intervention group completed 2-weeks progressive sprint training (3 sessions per week: week one 6 × 10 s sprints, week two 8 × 10 s sprints). Follow-up measurements were completed 48 h after the final sprint training session. Data were analyzed via ANCOVA to examine between group differences at follow-up whilst controlling for baseline score. Results Accuracy in the intervention group during the three-item Sternberg paradigm was greater when compared with the control group (Intervention: 99.6 ± 1.1%; Control: 97.7 ± 2.2%, p = 0.046). BDNF concentration was also higher in the intervention group at follow-up than control group (Intervention: 39.12 ± 9.88 ng.ml−1; Control: 22.95 ± 9.13 ng.ml−1, p < 0.001). There were no differences at follow-up between the intervention and control group for measures of cardiometabolic health (fasted cytokine concentrations or postprandial glycaemic and insulinaemic responses) or on the Stroop Test or Flanker Task (all p > 0.05). However, the intervention group reported enjoying the sprint training and that they found the sessions valuable. Conclusion Two-weeks sprint interval training in a school-setting enhanced working memory and increased concentrations of BDNF in adolescent girls. The intervention was deemed enjoyable and worthwhile by the adolescent girls and thus the longer-term implementation of such an intervention should be examined.
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Fernández-Rodríguez R, Álvarez-Bueno C, Martínez-Ortega IA, Martínez-Vizcaíno V, Mesas AE, Notario-Pacheco B. Immediate effect of high-intensity exercise on brain-derived neurotrophic factor in healthy young adults: A systematic review and meta-analysis. JOURNAL OF SPORT AND HEALTH SCIENCE 2022; 11:367-375. [PMID: 34481089 PMCID: PMC9189701 DOI: 10.1016/j.jshs.2021.08.004] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 06/09/2021] [Accepted: 07/20/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Although brain-derived neurotrophic factor (BDNF) has been identified as a molecular biomarker of the neurophysiological effects induced by exercise, the acute effects of high-intensity exercise (HIE) on BDNF levels are inconclusive. This study aims to estimate the immediate effects of HIE on BDNF levels in healthy young adults. METHODS A systematic search was conducted in the MEDLINE, Scopus, Cochrane CENTRAL, and SPORTDiscuss databases up to December 2020. Randomized controlled trials (RCTs) and non-RCTs reporting pre-post changes in serum or plasma BDNF after an acute intervention of HIE compared to a control condition were included. Pooled effect sizes (p-ESs) and 95% confidence intervals (95%CIs) were calculated for RCTs using a random effects model with Stata/SE (Version 15.0; StataCorp., College Station, TX, USA). The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed. PROPERO registration number: CRD42020221047. RESULTS A total of 22 studies with 552 individuals (age range: 20-31 years; 59.1% male) were included. The meta-analysis included 10 RCTs that reported valid outcome data. Higher BDNF levels were observed when HIE interventions were compared with non-exercise (p-ES = 0.55, 95%CI: 0.12-0.98; I2 = 25.7%; n = 4 studies) and light-intensity exercise (p-ES = 0.78, 95%CI: 0.15-1.40; I2 = 52.4%; n = 3 studies) but not moderate-intensity exercise (p-ES = 0.93, 95%CI: -0.16 to 2.02; I2 = 88.5%; n = 4 studies) conditions. CONCLUSION In comparison to non-exercise or light-intensity exercises, an immediate increase in BDNF levels may occur when young adults perform HIE. Given the benefits obtained maximizing circulating BDNF when performing HIE and its potential effects on brain health, our findings suggest that HIE could be recommended by clinicians as a useful exercise strategy to healthy adults.
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Affiliation(s)
| | - Celia Álvarez-Bueno
- Health and Social Research Center, Universidad de Castilla-La Mancha, Cuenca 16071, Spain; Universidad Politécnica y Artística del Paraguay, Asunción 2024, Paraguay.
| | | | - Vicente Martínez-Vizcaíno
- Health and Social Research Center, Universidad de Castilla-La Mancha, Cuenca 16071, Spain; Faculty of Medicine, Universidad Autónoma de Chile, Talca 3460000, Chile
| | - Arthur Eumann Mesas
- Health and Social Research Center, Universidad de Castilla-La Mancha, Cuenca 16071, Spain; Postgraduate Program in Public Health, Universidad Estadual de Londrina, Londrina 86051-990, Brazil
| | - Blanca Notario-Pacheco
- Health and Social Research Center, Universidad de Castilla-La Mancha, Cuenca 16071, Spain
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14
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Bonanni R, Cariati I, Tarantino U, D’Arcangelo G, Tancredi V. Physical Exercise and Health: A Focus on Its Protective Role in Neurodegenerative Diseases. J Funct Morphol Kinesiol 2022; 7:jfmk7020038. [PMID: 35645300 PMCID: PMC9149968 DOI: 10.3390/jfmk7020038] [Citation(s) in RCA: 29] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Revised: 04/26/2022] [Accepted: 04/27/2022] [Indexed: 02/07/2023] Open
Abstract
Scientific evidence has demonstrated the power of physical exercise in the prevention and treatment of numerous chronic and/or age-related diseases, such as musculoskeletal, metabolic, and cardiovascular disorders. In addition, regular exercise is known to play a key role in the context of neurodegenerative diseases, as it helps to reduce the risk of their onset and counteracts their progression. However, the underlying molecular mechanisms have not yet been fully elucidated. In this regard, neurotrophins, such as brain-derived neurotrophic factor (BDNF), nerve growth factor (NGF), glia cell line-derived neurotrophic factor (GDNF), neurotrophin-3 (NT-3), and neurotrophin-4 (NT-4), have been suggested as key mediators of brain health benefits, as they are involved in neurogenesis, neuronal survival, and synaptic plasticity. The production of these neurotrophic factors, known to be increased by physical exercise, is downregulated in neurodegenerative disorders, suggesting their fundamental importance in maintaining brain health. However, the mechanism by which physical exercise promotes the production of neurotrophins remains to be understood, posing limits on their use for the development of potential therapeutic strategies for the treatment of neurodegenerative diseases. In this literature review, we analyzed the most recent evidence regarding the relationship between physical exercise, neurotrophins, and brain health, providing an overview of their involvement in the onset and progression of neurodegeneration.
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Affiliation(s)
- Roberto Bonanni
- Department of Clinical Sciences and Translational Medicine, “Tor Vergata” University of Rome, 00133 Rome, Italy; (R.B.); (U.T.)
| | - Ida Cariati
- Department of Clinical Sciences and Translational Medicine, “Tor Vergata” University of Rome, 00133 Rome, Italy; (R.B.); (U.T.)
- Correspondence:
| | - Umberto Tarantino
- Department of Clinical Sciences and Translational Medicine, “Tor Vergata” University of Rome, 00133 Rome, Italy; (R.B.); (U.T.)
- Department of Orthopaedics and Traumatology, “Policlinico Tor Vergata” Foundation, 00133 Rome, Italy
- Centre of Space Bio-Medicine, “Tor Vergata” University of Rome, 00133 Rome, Italy; (G.D.); (V.T.)
| | - Giovanna D’Arcangelo
- Centre of Space Bio-Medicine, “Tor Vergata” University of Rome, 00133 Rome, Italy; (G.D.); (V.T.)
- Department of Systems Medicine, “Tor Vergata” University of Rome, 00133 Rome, Italy
| | - Virginia Tancredi
- Centre of Space Bio-Medicine, “Tor Vergata” University of Rome, 00133 Rome, Italy; (G.D.); (V.T.)
- Department of Systems Medicine, “Tor Vergata” University of Rome, 00133 Rome, Italy
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15
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Prior short-term exercise prevents behavioral and biochemical abnormalities induced by single prolonged stress in a rat model of posttraumatic stress disorder. Behav Brain Res 2022; 428:113864. [DOI: 10.1016/j.bbr.2022.113864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Revised: 03/27/2022] [Accepted: 03/27/2022] [Indexed: 11/21/2022]
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16
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Wang YH, Zhou HH, Luo Q, Cui S. The effect of physical exercise on circulating brain-derived neurotrophic factor in healthy subjects: A meta-analysis of randomized controlled trials. Brain Behav 2022; 12:e2544. [PMID: 35274832 PMCID: PMC9014996 DOI: 10.1002/brb3.2544] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 01/21/2022] [Accepted: 02/12/2022] [Indexed: 12/29/2022] Open
Abstract
OBJECTIVE To investigate how physical exercise (PE) would affect brain-derived neurotrophic factor (BDNF) in randomized controlled trials (RCTs) of healthy subjects. METHODS Seven databases (PubMed, Web of Science, Cochrane, Embase, PsycINFO, CINAHL, SPORTDiscus) were searched for RCTs assessing the effects of PE on serum and/or plasma BDNF until December 18, 2021. Meta-analysis was performed by random-effects method with standardized mean difference (SMD) and 95% confidence intervals (CIs). Subgroup analysis and meta-regression analysis were conducted to investigate the potential source of heterogeneity. Trim and fill method, and leave-one-out cross-validation were conducted. RESULTS Eventually, 21 articles, involving 809 participants, were included in the meta-analysis. Overall, both acute (5 trials, SMD: 1.20, 95% CI: 0.36 to 2.04, p = .005) and long-term (17 trials, SMD: 0.68, 95% CI: 0.27 to 1.08, p = .001) PE had significant positive effects on BDNF levels. Via subgroup analysis, studies of long-term PE with larger sample sizes, female participants, participants older than 60 years, and aerobic exercise contributed to a more pronounced improvement on BDNF levels than that found when all studies were combined. CONCLUSION Both acute and long-term PE had significant positive effects on circulating BDNF in healthy subjects. This review suggests that acute exercise and long-term aerobic exercise are powerful forms of PE to enhance neurotrophic effect, especially for female subjects or subjects over 60 years.
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Affiliation(s)
- Ya-Hai Wang
- Physical Education College, Yunnan Normal University, Kunming, China
| | - Huan-Huan Zhou
- School of Public Health, Medical College of Soochow University, Suzhou, China
| | - Qiang Luo
- Department of Orthopedics and Traumatology, Pu'er Hospital of Traditional Chinese Medicine, Pu'er, China
| | - Sidong Cui
- Physical Education College, Yunnan Normal University, Kunming, China
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17
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Lubans DR, Leahy AA, Mavilidi MF, Valkenborghs SR. Physical Activity, Fitness, and Executive Functions in Youth: Effects, Moderators, and Mechanisms. Curr Top Behav Neurosci 2021; 53:103-130. [PMID: 34697789 DOI: 10.1007/7854_2021_271] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Over the last decade, a growing body of research has examined the link between physical activity, fitness, and cognitive function in children and adolescents. Physical activity experimental research conducted with children and adolescents has identified selectively greater effects for tasks requiring higher order executive functions. As such, the primary aim of our chapter is to provide an overview of findings from systematic reviews and meta-analyses that have examined the effects of physical activity on measures of executive function in child and adolescent populations. We begin our chapter with definitions of key concepts associated with physical activity, fitness and cognitive function. We then provide a synthesis of systematic reviews and meta-analyses that have examined the acute and chronic effect of physical activity on EFs. Following this, we discuss the quantitative (e.g., time, intensity) and qualitative (e.g., type) characteristics of physical activity that may moderate effects. The next section focuses on the neurobiological, psychosocial and behavioral mechanisms responsible for the effect of physical activity on executive functions. We conclude by highlighting the limitations of the existing evidence base and providing recommendations for future research.
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Affiliation(s)
| | - Angus A Leahy
- The University of Newcastle, Callaghan, NSW, Australia
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18
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Effects of Training with Different Modes of Strength Intervention on Psychosocial Disorders in Adolescents: A Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18189477. [PMID: 34574400 PMCID: PMC8471285 DOI: 10.3390/ijerph18189477] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 08/27/2021] [Accepted: 09/01/2021] [Indexed: 12/21/2022]
Abstract
Physical exercise has a positive impact on anxiety and depression. However, the evidence that associates strength training with a decrease in adolescents' psychosocial disorders is scarce. Consequently, the objective was to analyze the effects of training with different modes of strength intervention on anxiety, stress, and depression in adolescents. The search was designed according to PRISMA®. We searched WoS, Scopus, SPORTDiscus, PubMed, and MEDLINE (2010-2020). Methodological quality and risk of bias were assessed with the Cochrane Collaboration. The analysis was carried out with a standardized mean difference (SMD) pooled using the Hedges g test (95% CI). The Main Outcome Measures were: anxiety, stress, and depression in adolescents post strength training. Nine studies were included in the systematic review and seven in the meta-analysis. These studies showed a large and significant effect of strength training on anxiety (SMD = -1.75; CI = 95%: -3.03, -0.48; p = 0.007) and depression (SMD = -1.61; CI = 95%: -2.54, -0.67, p = 0.0007). In conclusion, training with different modes of strength intervention have shown control over anxiety and depression in adolescents. However, conventional strength training seems to have better results than other modes of strength intervention.
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19
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Nicolini C, Nelson AJ. Current Methodological Pitfalls and Caveats in the Assessment of Exercise-Induced Changes in Peripheral Brain-Derived Neurotrophic Factor: How Result Reproducibility Can Be Improved. FRONTIERS IN NEUROERGONOMICS 2021; 2:678541. [PMID: 38235217 PMCID: PMC10790889 DOI: 10.3389/fnrgo.2021.678541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Accepted: 05/04/2021] [Indexed: 01/19/2024]
Abstract
Neural mechanisms, such as enhanced neuroplasticity within the motor system, underpin exercise-induced motor improvements. Being a key mediator of motor plasticity, brain-derived neurotrophic factor (BDNF) is likely to play an important role in mediating exercise positive effects on motor function. Difficulties in assessing brain BDNF levels in humans have drawn attention to quantification of blood BDNF and raise the question of whether peripheral BDNF contributes to exercise-related motor improvements. Methodological and non-methodological factors influence measurements of blood BDNF introducing a substantial variability that complicates result interpretation and leads to inconsistencies among studies. Here, we discuss methodology-related issues and approaches emerging from current findings to reduce variability and increase result reproducibility.
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Affiliation(s)
| | - Aimee J. Nelson
- Department of Kinesiology, McMaster University, Hamilton, ON, Canada
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