title: Exercise training for neural recovery in a restricted sample of pediatric brain tumor survivors: a controlled clinical trial with crossover of training versus no training.
abstract: Exercise promotes repair processes in the mouse brain and improves cognition in both mice and humans. It is not known whether these benefits translate to human brain injury, particularly the significant injury observed in children treated for brain tumors.
  
  
  
  We conducted a clinical trial with crossover of exercise training versus no training in a restricted sample of children treated with radiation for brain tumors. The primary outcome was change in brain structure using MRI measures of white matter (ie, fractional anisotropy [FA]) and hippocampal volume [mm3]). The secondary outcome was change in reaction time (RT)/accuracy across tests of attention, processing speed, and short-term memory. Linear mixed modeling was used to test the effects of time, training, training setting, and carryover.
  
  
  
  Twenty-eight participants completed training in either a group (n=16) or a combined group/home (n=12) setting. Training resulted in increased white matter FA (Δ=0.05, P<.001). A carryover effect was observed for participants ~12 weeks after training (Δ=0.05, P<.001). Training effects were observed for hippocampal volume (Δ=130.98mm3; P=.001) and mean RT (Δ=-457.04ms, P=0.36) but only in the group setting. Related carryover effects for hippocampal volume (Δ=222.81mm3, P=.001), and RT (Δ=-814.90ms, P=.005) were also observed. Decreased RT was predicted by increased FA (R=-0.62, P=.01). There were no changes in accuracy.
  
  
  
  Exercise training is an effective means for promoting white matter and hippocampal recovery and improving reaction time in children treated with cranial radiation for brain tumors.
authors.affiliation: Neurosciences and Mental Health, Hospital for Sick Children, Toronto, Ontario, Canada.|Department of Psychology, Hospital for Sick Children, Toronto, Ontario, Canada.
authors.forename: Lily
authors.initials: L
authors.lastname: Riggs
authors.affiliation: Division of Haematology/Oncology, Hospital for Sick Children, Toronto, Ontario, Canada.|Department of Rehabilitation Services, Hospital for Sick Children, Toronto, Ontario,Canada.
authors.forename: Janine
authors.initials: J
authors.lastname: Piscione
authors.affiliation: Diagnostic Imaging, Hospital for Sick Children, Toronto, Ontario, Canada.
authors.forename: Suzanne
authors.initials: S
authors.lastname: Laughlin
authors.affiliation: Department of Applied Psychology and Human Development, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Todd
authors.initials: T
authors.lastname: Cunningham
authors.affiliation: Department of Paediatrics, McMaster University, Hamilton, Ontario, Canada.
authors.forename: Brian W
authors.initials: BW
authors.lastname: Timmons
authors.affiliation: Faculty of Physical Education and Recreation, University of Alberta, Edmonton, Alberta, Canada.
authors.forename: Kerry S
authors.initials: KS
authors.lastname: Courneya
authors.affiliation: Division of Haematology/Oncology, Hospital for Sick Children, Toronto, Ontario, Canada.|Department of Paediatrics, University of Toronto, Toronto, Ontario,Canada.
authors.forename: Ute
authors.initials: U
authors.lastname: Bartels
authors.affiliation: Neurosciences and Mental Health, Hospital for Sick Children, Toronto, Ontario, Canada.
authors.forename: Jovanka
authors.initials: J
authors.lastname: Skocic
authors.affiliation: Neurosciences and Mental Health, Hospital for Sick Children, Toronto, Ontario, Canada.
authors.forename: Cynthia
authors.initials: C
authors.lastname: de Medeiros
authors.affiliation: Neurosciences and Mental Health, Hospital for Sick Children, Toronto, Ontario, Canada.
authors.forename: Fang
authors.initials: F
authors.lastname: Liu
authors.affiliation: Department of Paediatrics, McMaster University, Hamilton, Ontario, Canada.
authors.forename: Nicholas
authors.initials: N
authors.lastname: Persadie
authors.affiliation: Department of Paediatrics, McMaster University, Hamilton, Ontario, Canada.
authors.forename: Katrin
authors.initials: K
authors.lastname: Scheinemann
authors.affiliation: Neurosciences and Mental Health, Hospital for Sick Children, Toronto, Ontario, Canada.
authors.forename: Nadia
authors.initials: N
authors.lastname: Scantlebury
authors.affiliation: Neurosciences and Mental Health, Hospital for Sick Children, Toronto, Ontario, Canada.
authors.forename: Kamila U
authors.initials: KU
authors.lastname: Szulc
authors.affiliation: Division of Haematology/Oncology, Hospital for Sick Children, Toronto, Ontario, Canada.|Department of Paediatrics, University of Toronto, Toronto, Ontario,Canada.
authors.forename: Eric
authors.initials: E
authors.lastname: Bouffet
authors.affiliation: Neurosciences and Mental Health, Hospital for Sick Children, Toronto, Ontario, Canada.|Department of Psychology, Hospital for Sick Children, Toronto, Ontario, Canada.|Department of Psychology, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Donald J
authors.initials: DJ
authors.lastname: Mabbott
mesh_terms: D000293:Adolescent; D001932:Brain Neoplasms / Q000534:rehabilitation* / Q000628:therapy; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D018849:Controlled Clinical Trials as Topic; D018592:Cross-Over Studies; D005081:Exercise Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D009048:Motor Skills / Q000502:physiology; D009367:Neoplasm Staging; D009483:Neuropsychological Tests; D011379:Prognosis; D011788:Quality of Life; D020127:Recovery of Function; D015996:Survival Rate; D017741:Survivors
keywords: brain recovery; cranial radiation; exercise; neuroplasticity; pediatric brain tumor