title: The Impact of Aerobic Exercise on Brain-Derived Neurotrophic Factor and Neurocognition in Individuals With Schizophrenia: A Single-Blind, Randomized Clinical Trial.
abstract: Individuals with schizophrenia display substantial neurocognitive deficits for which available treatments offer only limited benefits. Yet, findings from studies of animals, clinical and nonclinical populations have linked neurocognitive improvements to increases in aerobic fitness (AF) via aerobic exercise training (AE). Such improvements have been attributed to up-regulation of brain-derived neurotrophic factor (BDNF). However, the impact of AE on neurocognition, and the putative role of BDNF, have not been investigated in schizophrenia. Employing a proof-of-concept, single-blind, randomized clinical trial design, 33 individuals with schizophrenia were randomized to receive standard psychiatric treatment (n = 17; "treatment as usual"; TAU) or attend a 12-week AE program (n = 16) utilizing active-play video games (Xbox 360 Kinect) and traditional AE equipment. Participants completed assessments of AF (indexed by VO2 peak ml/kg/min), neurocognition (MATRICS Consensus Cognitive Battery), and serum-BDNF before and after and 12-week period. Twenty-six participants (79%) completed the study. At follow-up, the AE participants improved their AF by 18.0% vs a -0.5% decline in the TAU group (P = .002) and improved their neurocognition by 15.1% vs -2.0% decline in the TAU group (P = .031). Hierarchical multiple regression analyses indicated that enhancement in AF and increases in BDNF predicted 25.4% and 14.6% of the neurocognitive improvement variance, respectively. The results indicate AE is effective in enhancing neurocognitive functioning in people with schizophrenia and provide preliminary support for the impact of AE-related BDNF up-regulation on neurocognition in this population. Poor AF represents a modifiable risk factor for neurocognitive dysfunction in schizophrenia for which AE training offer a safe, nonstigmatizing, and side-effect-free intervention.
authors: Department of Psychiatry, Columbia University, New York, NY; New York State Psychiatric Institute, New York, NY; kimhyda@nyspi.columbia.edu.
authors: David
authors: D
authors: Kimhy
authors: Department of Psychiatry, Columbia University, New York, NY;
authors: Julia
authors: J
authors: Vakhrusheva
authors: Department of Rehabilitation Medicine, Albert Einstein College of Medicine, Bronx, NY;
authors: Matthew N
authors: MN
authors: Bartels
authors: Department of Rehabilitation & Regenerative Medicine, Columbia University, New York, NY;
authors: Hilary F
authors: HF
authors: Armstrong
authors: Department of Psychiatry, Columbia University, New York, NY; New York State Psychiatric Institute, New York, NY;
authors: Jacob S
authors: JS
authors: Ballon
authors: New York State Psychiatric Institute, New York, NY;
authors: Samira
authors: S
authors: Khan
authors: New York State Psychiatric Institute, New York, NY;
authors: Rachel W
authors: RW
authors: Chang
authors: New York State Psychiatric Institute, New York, NY;
authors: Marie C
authors: MC
authors: Hansen
authors: New York State Psychiatric Institute, New York, NY;
authors: Lindsey
authors: L
authors: Ayanruoh
authors: New York State Psychiatric Institute, New York, NY;
authors: Amanda
authors: A
authors: Lister
authors: Neuroscience Center, University of Helsinki, Helsinki, Finland.
authors: Eero
authors: E
authors: Castrén
authors: Department of Psychiatry, Columbia University, New York, NY; New York State Psychiatric Institute, New York, NY;
authors: Edward E
authors: EE
authors: Smith
authors: Department of Psychiatry, Columbia University, New York, NY; New York State Psychiatric Institute, New York, NY;
authors: Richard P
authors: RP
authors: Sloan
mesh_terms: D000328:Adult; D019208:Brain-Derived Neurotrophic Factor / Q000097:blood*; D003072:Cognition Disorders / Q000097:blood / Q000209:etiology / Q000628:therapy; D015444:Exercise / Q000502:physiology; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010809:Physical Fitness / Q000502:physiology; D012559:Schizophrenia / Q000097:blood / Q000150:complications / Q000628:therapy; D016037:Single-Blind Method; D016896:Treatment Outcome; D018910:Video Games
chemical_list: D019208:Brain-Derived Neurotrophic Factor; C579455:BDNF protein, human
keywords: aerobic fitness; brain-derived neurotrophic factor/active-play video games; cognition; neurotrophins