title: Effects of acute aerobic exercise on neural correlates of attention and inhibition in adolescents with bipolar disorder.
abstract: Executive dysfunction is common during and between mood episodes in bipolar disorder (BD), causing social and functional impairment. This study investigated the effect of acute exercise on adolescents with BD and healthy control subjects (HC) to test for positive or negative consequences on neural response during an executive task. Fifty adolescents (mean age 16.54±1.47 years, 56% female, 30 with BD) completed an attention and response inhibition task before and after 20 min of recumbent cycling at ~70% of age-predicted maximum heart rate. 3 T functional magnetic resonance imaging data were analyzed in a whole brain voxel-wise analysis and as regions of interest (ROI), examining Go and NoGo response events. In the whole brain analysis of Go trials, exercise had larger effect in BD vs HC throughout ventral prefrontal cortex, amygdala and hippocampus; the profile of these effects was of greater disengagement after exercise. Pre-exercise ROI analysis confirmed this 'deficit in deactivation' for BDs in rostral ACC and found an activation deficit on NoGo errors in accumbens. Pre-exercise accumbens NoGo error activity correlated with depression symptoms and Go activity with mania symptoms; no correlations were present after exercise. Performance was matched to controls and results survived a series of covariate analyses. This study provides evidence that acute aerobic exercise transiently changes neural response during an executive task among adolescents with BD, and that pre-exercise relationships between symptoms and neural response are absent after exercise. Acute aerobic exercise constitutes a biological probe that may provide insights regarding pathophysiology and treatment of BD.
authors.affiliation: Centre for Youth Bipolar Disorder, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.|Brain Sciences, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.|Heart and Stroke Foundation Canadian Partnership for Stroke Recovery, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.
authors.forename: A W S
authors.initials: AW
authors.lastname: Metcalfe
authors.affiliation: Brain Sciences, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.|Heart and Stroke Foundation Canadian Partnership for Stroke Recovery, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.|Department of Medical Biophysics, University of Toronto, Toronto, ON, Canada.|Department of Physical Sciences, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.
authors.forename: B J
authors.initials: BJ
authors.lastname: MacIntosh
authors.affiliation: Centre for Youth Bipolar Disorder, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.
authors.forename: A
authors.initials: A
authors.lastname: Scavone
authors.affiliation: Centre for Youth Bipolar Disorder, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.|Department of Pharmacology, University of Toronto, Toronto, ON, Canada.
authors.forename: X
authors.initials: X
authors.lastname: Ou
authors.affiliation: Hospital for Sick Children, Toronto, ON, Canada.|Department of Psychiatry, University of Toronto, Toronto, ON, Canada.
authors.forename: D
authors.initials: D
authors.lastname: Korczak
authors.affiliation: Centre for Youth Bipolar Disorder, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.|Heart and Stroke Foundation Canadian Partnership for Stroke Recovery, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.|Department of Pharmacology, University of Toronto, Toronto, ON, Canada.|Department of Psychiatry, University of Toronto, Toronto, ON, Canada.
authors.forename: B I
authors.initials: BI
authors.lastname: Goldstein
mesh_terms: D000293:Adolescent; D000679:Amygdala / Q000000981:diagnostic imaging / Q000503:physiopathology; D001288:Attention; D001714:Bipolar Disorder / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000523:psychology*; D001921:Brain / Q000000981:diagnostic imaging / Q000503:physiopathology*; D020520:Brain Infarction / Q000000981:diagnostic imaging / Q000503:physiopathology; D016022:Case-Control Studies; D015444:Exercise / Q000502:physiology / Q000523:psychology*; D005260:Female; D059907:Functional Neuroimaging; D006624:Hippocampus / Q000000981:diagnostic imaging / Q000503:physiopathology; D006801:Humans; D007266:Inhibition, Psychological; D008279:Magnetic Resonance Imaging; D008297:Male; D009714:Nucleus Accumbens / Q000000981:diagnostic imaging / Q000503:physiopathology; D017397:Prefrontal Cortex / Q000000981:diagnostic imaging / Q000503:physiopathology; D055815:Young Adult