title: Exercise Augmentation of Exposure Therapy for PTSD: Rationale and Pilot Efficacy Data.
abstract: Brain-derived neurotrophic factor (BDNF) is associated with synaptic plasticity, which is crucial for long-term learning and memory. Some studies suggest that people suffering from anxiety disorders show reduced BDNF relative to healthy controls. Lower BDNF is associated with impaired learning, cognitive deficits, and poor exposure-based treatment outcomes. A series of studies with rats showed that exercise elevates BDNF and enhances fear extinction. However, this strategy has not been tested in humans. In this pilot study, we randomized participants (N = 9, 8 females, M(Age) = 34) with posttraumatic stress disorder (PTSD) to (a) prolonged exposure alone (PE) or (b) prolonged exposure+exercise (PE+E). Participants randomized to the PE+E condition completed a 30-minute bout of moderate-intensity treadmill exercise (70% of age-predicted HR(max)) prior to each PE session. Consistent with prediction, the PE+E group showed a greater improvement in PTSD symptoms (d = 2.65) and elevated BDNF (d = 1.08) relative to the PE only condition. This pilot study provides initial support for further investigation into exercise augmented exposure therapy.
authors.affiliation: a Department of Psychology, Institute for Mental Health Research , The University of Texas at Austin , Austin , TX , USA.
authors.forename: Mark B
authors.initials: MB
authors.lastname: Powers
authors.forename: Johnna L
authors.initials: JL
authors.lastname: Medina
authors.forename: Stephanie
authors.initials: S
authors.lastname: Burns
authors.forename: Brooke Y
authors.initials: BY
authors.lastname: Kauffman
authors.forename: Marie
authors.initials: M
authors.lastname: Monfils
authors.forename: Gordon J G
authors.initials: GJ
authors.lastname: Asmundson
authors.forename: Allison
authors.initials: A
authors.lastname: Diamond
authors.forename: Christa
authors.initials: C
authors.lastname: McIntyre
authors.forename: Jasper A J
authors.initials: JA
authors.lastname: Smits
mesh_terms: D000328:Adult; D019208:Brain-Derived Neurotrophic Factor / Q000097:blood*; D003131:Combined Modality Therapy / Q000379:methods; D015444:Exercise / Q000523:psychology*; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D007171:Implosive Therapy / Q000379:methods*; D008297:Male; D010865:Pilot Projects; D013313:Stress Disorders, Post-Traumatic / Q000097:blood / Q000628:therapy*; D055815:Young Adult
chemical_list: D019208:Brain-Derived Neurotrophic Factor; C579455:BDNF protein, human
keywords: BDNF; CBT; anxiety disorders; augmentation; exercise; exposure therapy; pilot data