Hippocampal plasticity in response to exercise in schizophrenia.
BACKGROUND
Hippocampal volume is lower than expected in patients with schizophrenia; however, whether this represents a fixed deficit is uncertain. Exercise is a stimulus to hippocampal plasticity.


OBJECTIVE
To determine whether hippocampal volume would increase with exercise in humans and whether this effect would be related to improved aerobic fitness.


METHODS
Randomized controlled study.


METHODS
Patients attending a day hospital program or an outpatient clinic.


METHODS
Male patients with chronic schizophrenia and matched healthy subjects.


METHODS
Aerobic exercise training (cycling) and playing table football (control group) for a period of 3 months.


METHODS
Magnetic resonance imaging of the hippocampus. Secondary outcome measures were magnetic resonance spectroscopy, neuropsychological (Rey Auditory Verbal Learning Test, Corsi block-tapping test), and clinical (Positive and Negative Syndrome Scale) features.


RESULTS
Following exercise training, relative hippocampal volume increased significantly in patients (12%) and healthy subjects (16%), with no change in the nonexercise group of patients (-1%). Changes in hippocampal volume in the exercise group were correlated with improvements in aerobic fitness measured by change in maximum oxygen consumption (r = 0.71; P = .003). In the schizophrenia exercise group (but not the controls), change in hippocampal volume was associated with a 35% increase in the N-acetylaspartate to creatine ratio in the hippocampus. Finally, improvement in test scores for short-term memory in the combined exercise and nonexercise schizophrenia group was correlated with change in hippocampal volume (r = 0.51; P < .05).


CONCLUSIONS
These results indicate that in both healthy subjects and patients with schizophrenia hippocampal volume is plastic in response to aerobic exercise.
Pajonk
Frank-Gerald
FG
Department of Psychiatry, The Saarland University Hospital, Homburg, Germany. pajonk@klinik-dr-fontheim.de
Wobrock
Thomas
T
Gruber
Oliver
O
Scherk
Harald
H
Berner
Dorothea
D
Kaizl
Inge
I
Kierer
Astrid
A
Müller
Stephanie
S
Oest
Martin
M
Meyer
Tim
T
Backens
Martin
M
Schneider-Axmann
Thomas
T
Thornton
Allen E
AE
Honer
William G
WG
Falkai
Peter
P
D000328:Adult; D001224:Aspartic Acid / Q000031:analogs & derivatives / Q000378:metabolism; D002908:Chronic Disease; D003072:Cognition Disorders / Q000175:diagnosis / Q000453:epidemiology; D015444:Exercise; D006624:Hippocampus / Q000033:anatomy & histology* / Q000378:metabolism / Q000503:physiopathology*; D006801:Humans; D008279:Magnetic Resonance Imaging; D009682:Magnetic Resonance Spectroscopy; D008297:Male; D009473:Neuronal Plasticity / Q000502:physiology*; D009483:Neuropsychological Tests; D012559:Schizophrenia / Q000453:epidemiology / Q000378:metabolism / Q000503:physiopathology*
D001224:Aspartic Acid; C000179:N-acetylaspartate