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Randomized Controlled Trial Multicenter Study Journal Article Ppublish 1 citation

PubMed: 37597507 DOI: 10.1093/schbul/sbad113

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

Schizophr Bull 50(1):145-156

Authors: Lukas Roell, Daniel Keeser, Boris Papazov, Moritz Lembeck, Irina Papazova, David Greska, Susanne Muenz, Thomas Schneider-Axmann, Eliska B Sykorova, Christina E Thieme, Bob O Vogel, Sebastian Mohnke, Charlotte Huppertz, Astrid Roeh, Katriona Keller-Varady, Berend Malchow, Sophia Stoecklein, Birgit Ertl-Wagner, Karsten Henkel, Bernd Wolfarth, Wladimir Tantchik, Henrik Walter, Dusan Hirjak, Andrea Schmitt, Alkomiet Hasan, Andreas Meyer-Lindenberg, Peter Falkai, Isabel Maurus

Affiliations

  • 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.
  • Department of Psychiatry, Psychotherapy and Psychosomatics of the University Augsburg, Medical Faculty, University of Augsburg, Bezirkskrankenhaus Augsburg, Augsburg, Germany.
  • Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Germany.
  • Department of Psychiatry and Psychotherapy, University Hospital Charité Berlin, Berlin, Germany.
  • Department of Psychiatry, Psychotherapy and Psychosomatics, RWTH Aachen University, Aachen, Germany.
  • Hannover Medical School, Department of Rehabilitation and Sports Medicine, Hannover, Germany.
  • Department of Psychiatry and Psychotherapy, University Hospital Göttingen, Göttingen, Germany.
  • Division of Neuroradiology, Department of Diagnostic Imaging, The Hospital for Sick Children, Toronto, Canada.
  • Department of Medical Imaging, University of Toronto, Toronto, Canada.
  • Department of Sports Medicine, University Hospital Charité Berlin, Berlin, Germany.
  • Laboratory of Neuroscience (LIM27), Institute of Psychiatry, University of Sao Paulo, São Paulo, Brazil.
  • Max Planck Institute of Psychiatry, Munich, Germany.

Abstract

BACKGROUND AND HYPOTHESIS

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

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

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

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

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).

MeSH

Schizophrenia, Brain, Exercise, Default Mode Network

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