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Exercise therapy, cardiorespiratory fitness and their effect on brain volumes: a randomised controlled trial in patients with schizophrenia and healthy controls.
Open accessAbstract
The objective of this study was to examine exercise effects on global brain volume, hippocampal volume, and cortical thickness in schizophrenia patients and healthy controls. Irrespective of diagnosis and intervention, associations between brain changes and cardiorespiratory fitness improvement were examined. Sixty-three schizophrenia patients and fifty-five healthy controls participated in this randomised controlled trial. Global brain volumes, hippocampal volume, and cortical thickness were estimated from 3-Tesla MRI scans. Cardiorespiratory fitness was assessed with a cardiopulmonary ergometer test. Subjects were assigned exercise therapy or occupational therapy (patients) and exercise therapy or life-as-usual (healthy controls) for six months 2h weekly. Exercise therapy effects were analysed for subjects who were compliant at least 50% of sessions offered. Significantly smaller baseline cerebral (grey) matter, and larger third ventricle volumes, and thinner cortex in most areas of the brain were found in patients versus controls. Exercise therapy did not affect global brain and hippocampal volume or cortical thickness in patients and controls. Cardiorespiratory fitness improvement was related to increased cerebral matter volume and lateral and third ventricle volume decrease in patients and to thickening in the left hemisphere in large areas of the frontal, temporal and cingulate cortex irrespective of diagnosis. One to 2h of exercise therapy did not elicit significant brain volume changes in patients or controls. However, cardiorespiratory fitness improvement attenuated brain volume changes in schizophrenia patients and increased thickness in large areas of the left cortex in both schizophrenia patients and healthy controls.
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“While some RCTs have found that AE did not have an impact on hippocampal volume (Ruscheweyh et al., 2011; Scheewe et al., 2013; Krogh et al., 2014; Rosenbaum et al., 2015; Malchow et al., 2016), it is possible that such discrepancies are caused by a lack of consistency in AE protocols used (Prakash et al., 2015) or in the methods of calculating hippocampal volume (Niemann et al., 2014).”
From Aerobic Exercise as a Tool to Improve Hippocampal Plasticity and Function in Humans: Practical Implications for Mental Health Treatment (2016) · cites this paper as Scheewe et al., 2013
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“However, other studies have found AE interventions to of had no impact on hippocampal volume or function in patients with schizophrenia (Scheewe et al., 2013; Rosenbaum et al., 2015).”
From Aerobic Exercise as a Tool to Improve Hippocampal Plasticity and Function in Humans: Practical Implications for Mental Health Treatment (2016) · cites this paper as Scheewe et al., 2013
In the citing paper
“In patients with schizophrenia, a period of exercise training resulted in hippocampal volume increase in one study 19 but other studies did not reveal increases in hippocampal volume 20 or cortical density. 18”
From Physical exercise keeps the brain connected: biking increases white matter integrity in patients with schizophrenia and healthy controls. (2015) · cites this paper as [20]
In the citing paper
“However, others did not find significant effect, eg, on cortical architecture. 20-22”
From Physical exercise keeps the brain connected: biking increases white matter integrity in patients with schizophrenia and healthy controls. (2015) · cites this paper as [20]
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Exercise training increases size of hippocampus and improves memory
Erickson, K. I., Voss, M. W., Prakash, R. S., Basak, C., Szabo, A., Chaddock, L., Kim, J. S., Heo, S., Alves, H., White, S. M., et al. (2011) · Proceedings of the National Academy of Sciences · doi:10.1073/pnas.1015950108 · Cited by 4,855
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Exercise as medicine - evidence for prescribing exercise as therapy in 26 different chronic diseases
Pedersen, B. K., & Saltin, B. (2015) · Scandinavian Journal of Medicine & Science in Sports · doi:10.1111/sms.12581 · Cited by 3,514
Excess early mortality in schizophrenia.
Laursen, T. M., Nordentoft, M., & Mortensen, P. B. (2014) · Annual Review of Clinical Psychology · doi:10.1146/annurev-clinpsy-032813-153657 · Cited by 913
A systematic review and meta-analysis of exercise interventions in schizophrenia patients
Firth, J., Cotter, J., Elliott, R., French, P., & Yung, A. R. (2015) · Psychological Medicine · doi:10.1017/s0033291714003110 · Cited by 600
Effect of aerobic exercise on hippocampal volume in humans: A systematic review and meta-analysis
Firth, J., Stubbs, B., Vancampfort, D., Schuch, F., Lagopoulos, J., Rosenbaum, S., & Ward, P. B. (2018) · NeuroImage · doi:10.1016/j.neuroimage.2017.11.007 · Cited by 526
Dauwan, M., Begemann, M. J. H., Heringa, S. M., & Sommer, I. E. (2016) · Schizophrenia Bulletin · doi:10.1093/schbul/sbv164 · Cited by 393
Metadata
- Authors
- Scheewe, T. W., van Haren, N. E. M., Sarkisyan, G., Schnack, H. G., Brouwer, R. M., de Glint, M., Hulshoff Pol, H. E., Backx, F. J. G., Kahn, R. S., & Cahn, W.
- Affiliations
- University Medical Center Utrecht (NL)
- Corresponding author
- Scheewe, Thomas W.
- Venue
- European Neuropsychopharmacology
- Publisher
- Elsevier BV
- Published
- 2013-07
- Volume
- 23
- Issue
- 7
- Pages
- 675-685
- ISSN
- 0924-977X (ISSN-L)
- OpenAlex
- W2030455633
- Cited by
- 148
- References
- 65
- Citations by year
- 2026: 4 · 2025: 3 · 2024: 10 · 2023: 8 · 2022: 10 · 2021: 13 · 2020: 18 · 2019: 11 · 2018: 10 · 2017: 12 · 2016: 17 · 2015: 19 · 2014: 5 · 2013: 8
- FWCI
- 7.30
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- European Neuropsychopharmacology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- GGZ Friesland
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Physical Activity and Health
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Keywords
- exercise therapy, cardiorespiratory fitness, schizophrenia, brain volume, hippocampal volume, cortical thickness, third ventricle, occupational therapy, brain structural changes
- MeSH terms
- Adolescent, Adult, Brain, Cerebral Cortex, Exercise Test, Exercise Therapy, Female, Hippocampus, Humans, Male, Middle Aged, Occupational Therapy, Physical Fitness, Psychiatric Status Rating Scales, Schizophrenia, Antipsychotic Agents, Case-Control Studies, Neuroimaging
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