Effects of Exercise on Structural and Functional Brain Patterns in Schizophrenia—Data From a Multicenter Randomized-Controlled Study
Schizophrenia Bulletin, vol. 50, pp. 145–156
Abstract
BACKGROUND AND HYPOTHESIS: Aerobic exercise interventions in people with schizophrenia have been demonstrated to improve clinical outcomes, but findings regarding the underlying neural mechanisms are limited and mainly focus on the hippocampal formation. Therefore, we conducted a global exploratory analysis of structural and functional neural adaptations after exercise and explored their clinical implications. STUDY DESIGN: In this randomized controlled trial, structural and functional MRI data were available for 91 patients with schizophrenia who performed either aerobic exercise on a bicycle ergometer or underwent a flexibility, strengthening, and balance training as control group. We analyzed clinical and neuroimaging data before and after 6 months of regular exercise. Bayesian linear mixed models and Bayesian logistic regressions were calculated to evaluate effects of exercise on multiple neural outcomes and their potential clinical relevance. STUDY RESULTS: Our results indicated that aerobic exercise in people with schizophrenia led to structural and functional adaptations mainly within the default-mode network, the cortico-striato-pallido-thalamo-cortical loop, and the cerebello-thalamo-cortical pathway. We further observed that volume increases in the right posterior cingulate gyrus as a central node of the default-mode network were linked to improvements in disorder severity. CONCLUSIONS: These exploratory findings suggest a positive impact of aerobic exercise on 3 cerebral networks that are involved in the pathophysiology of schizophrenia. CLINICAL TRIALS REGISTRATION: The underlying study of this manuscript was registered in the International Clinical Trials Database, ClinicalTrials.gov (NCT number: NCT03466112, https://clinicaltrials.gov/ct2/show/NCT03466112?term=NCT03466112&draw=2&rank=1) and in the German Clinical Trials Register (DRKS-ID: DRKS00009804).
Authors 25
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LMU Klinikum · Ludwig-Maximilians-Universität München
Affiliation as printed
Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich , Munich , Germany
Department of Radiology, University Hospital, LMU Munich , Munich , Germany
Neuroimaging Core Unit Munich (NICUM), University Hospital, LMU Munich , Munich , Germany
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LMU Klinikum · Ludwig-Maximilians-Universität München
Affiliation as printed
Department of Radiology, University Hospital, LMU Munich , Munich , Germany
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LMU Klinikum · Ludwig-Maximilians-Universität München
Affiliation as printed
Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich , Munich , Germany
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University of Augsburg · Bezirkskrankenhaus Augsburg
Affiliation as printed
Department of Psychiatry, Psychotherapy and Psychosomatics of the University Augsburg, Medical Faculty, University of Augsburg, Bezirkskrankenhaus Augsburg , Augsburg , Germany
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LMU Klinikum · Ludwig-Maximilians-Universität München
Affiliation as printed
Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich , Munich , Germany
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LMU Klinikum · Ludwig-Maximilians-Universität München
Affiliation as printed
Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich , Munich , Germany
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Heidelberg University · Central Institute of Mental Health
Affiliation as printed
Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University , Germany
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Heidelberg University · Central Institute of Mental Health
Affiliation as printed
Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University , Germany
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Charité - Universitätsmedizin Berlin
Affiliation as printed
Department of Psychiatry and Psychotherapy, University Hospital Charité Berlin , Berlin , Germany
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Charité - Universitätsmedizin Berlin
Affiliation as printed
Department of Psychiatry and Psychotherapy, University Hospital Charité Berlin , Berlin , Germany
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Affiliation as printed
Department of Psychiatry, Psychotherapy and Psychosomatics, RWTH Aachen University , Aachen , Germany
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University of Augsburg · Bezirkskrankenhaus Augsburg
Affiliation as printed
Department of Psychiatry, Psychotherapy and Psychosomatics of the University Augsburg, Medical Faculty, University of Augsburg, Bezirkskrankenhaus Augsburg , Augsburg , Germany
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Medizinische Hochschule Hannover
Affiliation as printed
Hannover Medical School, Department of Rehabilitation and Sports Medicine , Hannover , Germany
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Universitätsmedizin Göttingen · University of Göttingen
Affiliation as printed
Department of Psychiatry and Psychotherapy, University Hospital Göttingen , Göttingen , Germany
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LMU Klinikum · Ludwig-Maximilians-Universität München
Affiliation as printed
Department of Radiology, University Hospital, LMU Munich , Munich , Germany
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University of Toronto · Hospital for Sick Children · LMU Klinikum · Ludwig-Maximilians-Universität München
Affiliation as printed
Department of Medical Imaging, University of Toronto , Toronto , Canada
Department of Radiology, University Hospital, LMU Munich , Munich , Germany
Division of Neuroradiology, Department of Diagnostic Imaging, The Hospital for Sick Children , Toronto , Canada
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Charité - Universitätsmedizin Berlin
Affiliation as printed
Department of Sports Medicine, University Hospital Charité Berlin , Berlin , Germany
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Charité - Universitätsmedizin Berlin
Affiliation as printed
Department of Psychiatry and Psychotherapy, University Hospital Charité Berlin , Berlin , Germany
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Charité - Universitätsmedizin Berlin
Affiliation as printed
Department of Psychiatry and Psychotherapy, University Hospital Charité Berlin , Berlin , Germany
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Heidelberg University · Central Institute of Mental Health
Affiliation as printed
Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University , Germany
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Universidade de São Paulo · LMU Klinikum · Ludwig-Maximilians-Universität München
Affiliation as printed
Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich , Munich , Germany
Laboratory of Neuroscience (LIM27), Institute of Psychiatry, University of Sao Paulo , São Paulo , Brazil
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University of Augsburg · Bezirkskrankenhaus Augsburg
Affiliation as printed
Department of Psychiatry, Psychotherapy and Psychosomatics of the University Augsburg, Medical Faculty, University of Augsburg, Bezirkskrankenhaus Augsburg , Augsburg , Germany
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Heidelberg University · Central Institute of Mental Health
Affiliation as printed
Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University , Germany
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LMU Klinikum · Max Planck Institute of Psychiatry · Ludwig-Maximilians-Universität München
Affiliation as printed
Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich , Munich , Germany
Max Planck Institute of Psychiatry , Munich , Germany
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LMU Klinikum · Ludwig-Maximilians-Universität München
Affiliation as printed
Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich , Munich , Germany
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