Effects of Exercise on Structural and Functional Brain Patterns in Schizophrenia-Data From a Multicenter Randomized-Controlled Study.

brain structure exercise functional connectivity randomized-controlled trial schizophrenia

Journal

Schizophrenia bulletin
ISSN: 1745-1701
Titre abrégé: Schizophr Bull
Pays: United States
ID NLM: 0236760

Informations de publication

Date de publication:
19 Aug 2023
Historique:
medline: 20 8 2023
pubmed: 20 8 2023
entrez: 19 8 2023
Statut: aheadofprint

Résumé

Aerobic exercise interventions in people with schizophrenia have been demonstrated to improve clinical outcomes, but findings regarding the underlying neural mechanisms are limited and mainly focus on the hippocampal formation. Therefore, we conducted a global exploratory analysis of structural and functional neural adaptations after exercise and explored their clinical implications. In this randomized controlled trial, structural and functional MRI data were available for 91 patients with schizophrenia who performed either aerobic exercise on a bicycle ergometer or underwent a flexibility, strengthening, and balance training as control group. We analyzed clinical and neuroimaging data before and after 6 months of regular exercise. Bayesian linear mixed models and Bayesian logistic regressions were calculated to evaluate effects of exercise on multiple neural outcomes and their potential clinical relevance. Our results indicated that aerobic exercise in people with schizophrenia led to structural and functional adaptations mainly within the default-mode network, the cortico-striato-pallido-thalamo-cortical loop, and the cerebello-thalamo-cortical pathway. We further observed that volume increases in the right posterior cingulate gyrus as a central node of the default-mode network were linked to improvements in disorder severity. These exploratory findings suggest a positive impact of aerobic exercise on 3 cerebral networks that are involved in the pathophysiology of schizophrenia. The underlying study of this manuscript was registered in the International Clinical Trials Database, ClinicalTrials.gov (NCT number: NCT03466112, https://clinicaltrials.gov/ct2/show/NCT03466112?term=NCT03466112&draw=2&rank=1) and in the German Clinical Trials Register (DRKS-ID: DRKS00009804).

Sections du résumé

BACKGROUND AND HYPOTHESIS OBJECTIVE
Aerobic exercise interventions in people with schizophrenia have been demonstrated to improve clinical outcomes, but findings regarding the underlying neural mechanisms are limited and mainly focus on the hippocampal formation. Therefore, we conducted a global exploratory analysis of structural and functional neural adaptations after exercise and explored their clinical implications.
STUDY DESIGN METHODS
In this randomized controlled trial, structural and functional MRI data were available for 91 patients with schizophrenia who performed either aerobic exercise on a bicycle ergometer or underwent a flexibility, strengthening, and balance training as control group. We analyzed clinical and neuroimaging data before and after 6 months of regular exercise. Bayesian linear mixed models and Bayesian logistic regressions were calculated to evaluate effects of exercise on multiple neural outcomes and their potential clinical relevance.
STUDY RESULTS RESULTS
Our results indicated that aerobic exercise in people with schizophrenia led to structural and functional adaptations mainly within the default-mode network, the cortico-striato-pallido-thalamo-cortical loop, and the cerebello-thalamo-cortical pathway. We further observed that volume increases in the right posterior cingulate gyrus as a central node of the default-mode network were linked to improvements in disorder severity.
CONCLUSIONS CONCLUSIONS
These exploratory findings suggest a positive impact of aerobic exercise on 3 cerebral networks that are involved in the pathophysiology of schizophrenia.
CLINICAL TRIALS REGISTRATION BACKGROUND
The underlying study of this manuscript was registered in the International Clinical Trials Database, ClinicalTrials.gov (NCT number: NCT03466112, https://clinicaltrials.gov/ct2/show/NCT03466112?term=NCT03466112&draw=2&rank=1) and in the German Clinical Trials Register (DRKS-ID: DRKS00009804).

Identifiants

pubmed: 37597507
pii: 7246442
doi: 10.1093/schbul/sbad113
pii:
doi:

Banques de données

ClinicalTrials.gov
['NCT03466112']

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Subventions

Organisme : German Federal Ministry of Education and Research (BMBF)
ID : 01EE1407E

Informations de copyright

© The Author(s) 2023. Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center. All rights reserved. For permissions, please email: journals.permissions@oup.com.

Auteurs

Lukas Roell (L)

Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany.
Neuroimaging Core Unit Munich (NICUM), University Hospital, LMU Munich, Munich, Germany.

Daniel Keeser (D)

Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany.
Neuroimaging Core Unit Munich (NICUM), University Hospital, LMU Munich, Munich, Germany.
Department of Radiology, University Hospital, LMU Munich, Munich, Germany.

Boris Papazov (B)

Department of Radiology, University Hospital, LMU Munich, Munich, Germany.

Moritz Lembeck (M)

Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany.

Irina Papazova (I)

Department of Psychiatry, Psychotherapy and Psychosomatics of the University Augsburg, Medical Faculty, University of Augsburg, Bezirkskrankenhaus Augsburg, Augsburg, Germany.

David Greska (D)

Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany.

Susanne Muenz (S)

Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany.

Thomas Schneider-Axmann (T)

Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany.

Eliska B Sykorova (EB)

Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Germany.

Christina E Thieme (CE)

Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Germany.

Bob O Vogel (BO)

Department of Psychiatry and Psychotherapy, University Hospital Charité Berlin, Berlin, Germany.

Sebastian Mohnke (S)

Department of Psychiatry and Psychotherapy, University Hospital Charité Berlin, Berlin, Germany.

Charlotte Huppertz (C)

Department of Psychiatry, Psychotherapy and Psychosomatics, RWTH Aachen University, Aachen, Germany.

Astrid Roeh (A)

Department of Psychiatry, Psychotherapy and Psychosomatics of the University Augsburg, Medical Faculty, University of Augsburg, Bezirkskrankenhaus Augsburg, Augsburg, Germany.

Katriona Keller-Varady (K)

Hannover Medical School, Department of Rehabilitation and Sports Medicine, Hannover, Germany.

Berend Malchow (B)

Department of Psychiatry and Psychotherapy, University Hospital Göttingen, Göttingen, Germany.

Sophia Stoecklein (S)

Department of Radiology, University Hospital, LMU Munich, Munich, Germany.

Birgit Ertl-Wagner (B)

Department of Radiology, University Hospital, LMU Munich, Munich, Germany.
Division of Neuroradiology, Department of Diagnostic Imaging, The Hospital for Sick Children, Toronto, Canada.
Department of Medical Imaging, University of Toronto, Toronto, Canada.

Karsten Henkel (K)

Department of Psychiatry, Psychotherapy and Psychosomatics, RWTH Aachen University, Aachen, Germany.

Bernd Wolfarth (B)

Department of Sports Medicine, University Hospital Charité Berlin, Berlin, Germany.

Wladimir Tantchik (W)

Department of Psychiatry and Psychotherapy, University Hospital Charité Berlin, Berlin, Germany.

Henrik Walter (H)

Department of Psychiatry and Psychotherapy, University Hospital Charité Berlin, Berlin, Germany.

Dusan Hirjak (D)

Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Germany.

Andrea Schmitt (A)

Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany.
Laboratory of Neuroscience (LIM27), Institute of Psychiatry, University of Sao Paulo, São Paulo, Brazil.

Alkomiet Hasan (A)

Department of Psychiatry, Psychotherapy and Psychosomatics of the University Augsburg, Medical Faculty, University of Augsburg, Bezirkskrankenhaus Augsburg, Augsburg, Germany.

Andreas Meyer-Lindenberg (A)

Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Germany.

Peter Falkai (P)

Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany.
Max Planck Institute of Psychiatry, Munich, Germany.

Isabel Maurus (I)

Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany.

Classifications MeSH