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Physical exercise keeps the brain connected: biking increases white matter integrity in patients with schizophrenia and healthy controls.
Open accessAbstract
It has been shown that learning a new skill leads to structural changes in the brain. However, it is unclear whether it is the acquisition or continuous practicing of the skill that causes this effect and whether brain connectivity of patients with schizophrenia can benefit from such practice. We examined the effect of 6 months exercise on a stationary bicycle on the brain in patients with schizophrenia and healthy controls. Biking is an endemic skill in the Netherlands and thus offers an ideal situation to disentangle the effects of learning vs practice. The 33 participating patients with schizophrenia and 48 healthy individuals were assigned to either one of two conditions, ie, physical exercise or life-as-usual, balanced for diagnosis. Diffusion tensor imaging brain scans were made prior to and after intervention. We demonstrate that irrespective of diagnosis regular physical exercise of an overlearned skill, such as bicycling, significantly increases the integrity, especially of motor functioning related, white matter fiber tracts whereas life-as-usual leads to a decrease in fiber integrity. Our findings imply that exercise of an overlearned physical skill improves brain connectivity in patients and healthy individuals. This has important implications for understanding the effect of fitness programs on the brain in both healthy subjects and patients with schizophrenia. Moreover, the outcome may even apply to the nonphysical realm.
Overview
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Written from the paper’s full text.
TL;DR
In a 6-month intervention, regular stationary biking increased white matter integrity (fractional anisotropy) in motor-related tracts in both patients with schizophrenia and healthy controls, whereas life-as-usual decreased FA in the same clusters. Patients and controls benefited similarly, and fitness gains correlated with FA increases.
Key findings
- Exercise versus life-as-usual produced significant FA increases in the exercise group in the left corticospinal tract, left superior longitudinal fascicle, left inferior longitudinal fascicle, left inferior fronto-occipital fascicle, left anterior thalamic radiation, and body/splenium of the corpus callosum (p FWEcorr < 0.05); the life-as-usual group showed FA decreases in these same clusters.
- No significant differences in plasticity between patients and controls were found; both groups benefited equally from exercise.
- JHU-atlas ROI analysis showed time-by-randomization FA increases in the left CST (F = 4.15, P = .045), left SLF (F = 5.092, P = .027), and forceps major (F = 5.687, P = .02), but after correction for 14 ROIs (threshold .0035) these did not reach corrected significance.
- Correlations: change in Wpeak correlated with dFA skeleton (r = .246, P = .028) and dFA picked (r = .374, P = .001); dVO2peak correlated with dFA skeleton (r = 0.270, P = .016); in patients, decrease in positive symptoms correlated with FA improvement (r = -0.455, P = .008).
Methods
- TOPFIT cohort: 33 patients with schizophrenia and 48 healthy controls, aged 18–48 years, physically inactive, randomized 1:1 (stratified by gender, recruitment site, BMI) to 6 months of physical exercise or life-as-usual/occupational therapy; exercise was 1 h twice weekly (40 min aerobic, 20 min anaerobic), with biking about 50% of the duration.
- DTI brain scans at 3 Tesla before and after intervention; whole-brain tract-based spatial statistics (TBSS) and JHU-ICBM atlas ROI analysis of fractional anisotropy.
- Longitudinal analyses used GLM with time, randomization, group, and compliance as covariate; TBSS used 5000 permutations with threshold-free cluster enhancement; correlations examined FA changes with cardiorespiratory fitness, BMI, IQ, PANSS, and chlorpromazine equivalents.
Limitations
- Stated in the paper: patient exercise adherence is problematic due to poor motivation, medication side effects, social barriers, and symptoms; no significant baseline FA differences were found between patients and controls, so findings may not extend to patients with more severe white matter abnormalities; antipsychotic medication influence was considered but no significant correlation with FA was found; ongoing exercise may be necessary to maintain FA effects, raising motivation concerns; mechanisms remain unclear.
- Evident from the text: the ROI findings did not survive correction for multiple comparisons across 14 ROIs; compliance differed significantly between exercise and nonexercise groups and between patients and controls, although compliance was included as a covariate.
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Claims the paper makes
25 Not checked yet · 23 Own result · 14 Own interpretation · 10 Own method · 1 Check pending
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“whereas life-as-usual leads to a decrease in fiber integrity.”
- Also stated in: § Following the Intervention · plain
“Decreases in FA in these same clusters were found in the life-as-usual group.”
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Also stated in: § Following the Intervention · plain
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“FA increases between baseline and follow-up in exercise group comparing to decreases of FA in nonexercise group.”
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Local statistical maxima of FA values increases in exercise group comparing to nonexercise group (clusters with P FWEcorr < .05) MNI coordinates showing the location of the maximum intensity voxel of each cluster.”
plaindirect- Asserted: passes — The authors put it forward as true.
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In the paper
“Interestingly, the continuous exercise predominantly affects white matter in the left hemisphere specifically in right-handed individuals (for details see supplementary data).”
plaindirect- Asserted: passes — The authors put it forward as true.
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- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
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A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“even though our study has not shown direct evidence of improvement in cognitive functions based on specific psychological tests.”
plain- Asserted: passes — The authors put it forward as true.
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- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
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In the paper
“The GLM-repeated measurement design shows significant changes over time between two randomization groups (exercise vs nonexercise), irrespective of diagnosis (schizophrenia, healthy) ( P uncorr < .05).”
plaindirect- Asserted: passes — The authors put it forward as true.
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In the paper
“Clusters with significant increases in FA between the first and second measurement were found in the exercise group in the left corticospinal tract (LCST), the left superior longitudinal fascicle (LSLF), the left inferior longitudinal fascicle (LILF), the left inferior fronto-occipital fascicle (LIFOF), left anterior thalamic radiation (ATR) and in the body and splenium of the”
plaindirect- Asserted: passes — The authors put it forward as true.
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A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Increases in fractional anisotropy (FA) occur along the left corticospinal tract (CST), the left superior longitudinal fascicle (SLF), and the forceps major (FM) following the 6-months interval in the exercise as compared to nonexercise group.”
plaindirect- Asserted: passes — The authors put it forward as true.
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A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Another potential limitation is that no significant baseline differences between patients and controls in FA were found.”
plain- Asserted: passes — The authors put it forward as true.
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A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Significant correlations between longitudinal differences in Wpeak (dWpeak) and both FA skeleton (dFA skeleton ) ( r = .246, P = .028, two-tailed) and FA picked (dFA picked ) ( r = .374, P = .001) were found irrespective of disease.”
plaincorrelational- Asserted: passes — The authors put it forward as true.
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- It may state two separate claims as one. 22
- Probably not a substantial claim. 31
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“We demonstrate that irrespective of diagnosis regular physical exercise of an overlearned skill, such as bicycling, significantly increases the integrity, especially of motor functioning related, white matter fiber tracts whereas life-as-usual leads to a decrease in fiber integrity.”
- Also stated in: § Following the Intervention · plain
“Clusters with significant increases in FA between the first and second measurement were found in the exercise group in the left corticospinal tract (LCST), the left superior longitudinal fascicle (LSLF), the left inferior longitudinal fascicle (LILF), the left inferior fronto-occipital fascicle (LIFOF), left anterior thalamic radiation (ATR) and in the body and splenium of the”
boosteddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Also stated in: § Following the Intervention · plain
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“There were no significant associations of FA or change in FA with BMI, HR rest , HR max , IQ in both groups and with overall PANSS, PANSS neg , PANSS dis , PANSS exc , PANSS emo , or ChE dose in the patients.”
plain- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Despite the differences measured between patients and controls in clinical characteristics, no significant difference in FA was detected using cluster-based and JHU-ICBM-atlasbased approaches, although mean FA value calculated for whole skeleton was lower in patients (mean = 0.420, SD = 0.017) than in controls (mean = 0.422, SD = 0.013).”
plain- Asserted: passes — The authors put it forward as true.
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- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Significant differences in the exercise and nonexercise group from the first to second measurement (time by randomization) were found in the cardiorespiratory fitness parameters (W peak , VO 2peak ), and in PANSS scores decreases in overall PANSS score, positive symptoms, excitement score, and disorganization score in exercise group of patients, contrary to increases in”
boosteddirect- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Repeating the analysis with the JHU-atlas-based ROI analysis, significant increases in FA were found over time in the exercise group as compared to the nonexercise group (time by randomization) in the LCST ( F = 4.15, P = .045), the LSLF ( F = 5.092, P = .027) and FM ( F = 5.687, P = 0.02) in both patients and controls (figure 2; table 3), but after the correction for”
plain- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“specifically, alleviation of positive symptoms and increasing white matter integrity seemed to go hand-in-hand.”
hedgedcorrelational- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“For the maximal oxygen uptake measurement (ie, VO 2peak ), a significant correlation was demonstrated only for the difference in overall FA values (dFA skeleton ) ( r = 0.270, P = .016), and not for the FA difference in clusters showing longitudinal FA increase (dFA picked ).”
boostedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
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It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Increases in the volume of the cortex 14-16,18 and hippocampus 17,19 were found after periods of exercise in healthy individuals.”
What the sources say
plaindirect- Asserted: passes — The authors put it forward as true.
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- Load-bearing: fails — The paper’s conclusions may not depend on it.
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Probably not a substantial claim. The paper’s conclusions may not depend on it.
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In the paper
“However, others did not find significant effect, eg, on cortical architecture. 20-22”
What the sources say
plain- Asserted: passes — The authors put it forward as true.
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Probably not a substantial claim. The paper’s conclusions may not depend on it.
None of the sources cited for this claim have been checked yet.
In the paper
“In healthy students, it has been shown that when a new skill is learned, such as juggling, gray matter volume increases 14 and white matter integrity improves. 23”
plaindirect- Asserted: passes — The authors put it forward as true.
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Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Moreover, some of the schizophreniarelated changes in gray 8,9 and white matter 10 are progressive in nature.”
What the sources say
hedged- Asserted: passes — The authors put it forward as true.
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- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“After having acquired proficiency in juggling, the changes in the brain reverted to normal after the students had stopped practicing for 3 months, suggesting it may be practice rather than acquisition that affects the brain.”
What the sources say
- Not checked yetcites [23] source
hedgedconditional- Asserted: passes — The authors put it forward as true.
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Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
In the paper
“On the other hand, after training a complicated balancing act, white matter changes remained present. 23”
What the sources say
- Not checked yetcites [23] source
plaindirect- Asserted: passes — The authors put it forward as true.
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Probably not a substantial claim. The paper’s conclusions may not depend on it.
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In the paper
“The (progressive) brain tissue loss has been associated with genetic factors and with disease-related factors 11,12 as well as effects of antipsychotic medication intake. 13”
What the sources say
plaincorrelational- Asserted: passes — The authors put it forward as true.
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Probably not a substantial claim. The paper’s conclusions may not depend on it.
None of the sources cited for this claim have been checked yet.
In the paper
“Physical exercise has been reported to affect gray matter structure. 14-19”
What the sources say
hedgeddirect- Asserted: passes — The authors put it forward as true.
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Probably not a substantial claim. The paper’s conclusions may not depend on it.
None of the sources cited for this claim have been checked yet.
In the 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”
What the sources say
plaindirect- Asserted: passes — The authors put it forward as true.
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Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Significant differences in compliance between exercise and nonexercise group and patients vs controls were found.”
plaincorrelational- Asserted: passes — The authors put it forward as true.
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Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“No significant differences were found between patients and controls in mean age, gender, handedness, and parental level of education.”
plain- Asserted: passes — The authors put it forward as true.
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Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
In the paper
“The CST represents the major fiber bundle for motor functioning, transferring information from multiple cortical areas to the brain stem and spinal cord. 51”
What the sources say
- Not checked yetcites [51] source
plain- Asserted: passes — The authors put it forward as true.
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Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“No significant baseline difference between the exercise group and nonexercise group was found in heart rate in rest (HR rest ), peak work rate at the moment of exhaustion (W peak in Watt), highest oxygen uptake during the last 30 s of the test (VO 2 in ml/kg/min), and IQ (table 1).”
plain- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“higher FA has been associated with better functional connectivity between anatomically distant gray matter regions using resting-state fMRI (functional MRI) 35,47,48”
What the sources say
plaincorrelational- Asserted: passes — The authors put it forward as true.
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Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“The SLF is a major association fiber bundle involved in higher aspects of motor behavior such as coding of body parts in the surrounding space and monitoring (competing) motor actions. 54”
What the sources say
- Not checked yetcites [54] source
plain- Asserted: passes — The authors put it forward as true.
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Probably not a substantial claim. The paper’s conclusions may not depend on it.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“A research assistant and a sport physician assessed the demographic and clinical baseline and follow-up measurements while being blind to the randomization.”
plain- Asserted: passes — The authors put it forward as true.
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Probably not a substantial claim.
None of the sources cited for this claim have been checked yet.
In the paper
“Moreover, a higher FA has been related to interhemispheric transition time measured with event-related potentials (ERP) 45 and quantitative electroencephalography (EEG). 46”
What the sources say
plaincorrelational- Asserted: passes — The authors put it forward as true.
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Probably not a substantial claim. The paper’s conclusions may not depend on it.
None of the sources cited for this claim have been checked yet.
In the paper
“Interestingly, several cross-sectional studies, mainly conducted in musicians, suggest that it is (early) practice that determines changes in the brain 24 : proficiency-expressed as practice time-is generally correlated with the degree of brain change, not with the skill of playing the instrument per se. 25”
What the sources say
hedgeddirect- Asserted: passes — The authors put it forward as true.
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Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“These results were corrected for Family-wise error (FWEcorr) (for additional information see supplementary data).”
plain- Asserted: passes — The authors put it forward as true.
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Probably not a substantial claim.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“these findings may also extend to the nonphysical realm.”
hedgedconditional- Asserted: passes — The authors put it forward as true.
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Probably not a substantial claim. It may be too vague to check against evidence. The paper’s conclusions may not depend on it.
None of the sources cited for this claim have been checked yet.
In the paper
“better functional connectivity has been associated with higher cognitive functioning, 49,50”
plaincorrelational- Asserted: passes — The authors put it forward as true.
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Probably not a substantial claim. The paper’s conclusions may not depend on it.
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In the paper
“Randomization was performed as a computer-generated procedure, incorporating a concealed allocation (ratio 1:1), with stratification for gender, recruitment site and Body Mass Index.”
plain- Asserted: passes — The authors put it forward as true.
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Probably not a substantial claim. It may state two separate claims as one.
In the paper
“Indeed, 85% of the Dutch owns a bicycle and each year travels 900 km on it. 26”
What the sources say
- Not checked yetcites [26] source
plain- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Both rodent and human studies suggest that maturation of the CST is driven by neural activity in cortical motor areas and limb experience, thus reflecting the need to adapt to changing motor demands. 52,53”
hedgeddirect- Asserted: passes — The authors put it forward as true.
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Probably not a substantial claim. The paper’s conclusions may not depend on it.
None of the sources cited for this claim have been checked yet.
In the paper
“All aforementioned tracts are involved in attention, visual processing, verbal processing and language functions, and face recognition 61 as well as executive functioning and memory encoding, 62”
plaincorrelational- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Compliance was registered as a percentage of sessions attended and was over 50% in the subjects included in the study (for details see supplementary data).”
plain- Asserted: passes — The authors put it forward as true.
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Probably not a substantial claim. The paper’s conclusions may not depend on it.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“At baseline, a significant difference was found between the patients and the controls, irrespective of intervention condition, in heart rate in rest (HR rest ), maximal heart rate (HR max ), together with difference in peak work rate at the moment of exhaustion (W peak in Watt) as a measure of cardiorespiratory fitness, although no significant difference in the highest oxygen uptake during”
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Body mass index (BMI) was significantly higher in patients as compared to healthy subjects.”
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
None of the sources cited for this claim have been checked yet.
In the paper
“A positive influence of antipsychotic medication on glia cells and myelination has been demonstrated. 82,83”
boosteddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Moreover, these associations imply that changes are caused by practice of an overlearned aerobic activity rather than anaerobic newly learned exercise.”
hedgeddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: unclear — It is unclear why the paper says it holds.
It may state two separate claims as one.
- Rests on an assumption: Biking is an overlearned physical skill.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Therefore we cannot predict how our findings will extend to patients with more severe white matter abnormalities, either through more or less prominent improvements in fiber integrity.”
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Alternatively, the effect in white matter may be due to improvements in cardiorespiratory fitness, as suggested by positive associations between FA and cardiorespiratory fitness parameters over time.”
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“two randomization groups (exercise vs nonexercise)”
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“In patients implementation and sustainability of regular exercise commitment remains problematic due to poor motivation, 73 side effects of medications, 74,75 social barriers, 76 and symptoms. 73”
What the sources say
- Not checked yetcites [73] Archie, 2003, Pilot study: access to fitness facility and exercise levels in olanzapine-treated patients, Can J Psychiatry source
- Not checked yetcites [74] source
- Not checked yetcites [75] Newcomer, 2006, The metabolic effects of antipsychotic medications, Can J Psychiatry source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
In the paper
“A growing body of evidence suggests possibly direct contributions of activation of fiber bundles to changes in white matter. 84”
What the sources say
- Not checked yetcites [84] Mandl, 2013, Functional diffusion tensor imaging at 3 Tesla, Front Hum Neurosci source
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
The paper relies on this without support.
It is not known whether exercise benefits white matter connectivity in patients with schizophrenia.
“However, it is not known if exercise benefits white matter connectivity in patients with schizophrenia.”
The paper relies on this without support.
When a skill is endemic in a population, learning is not involved.
“When the skill is endemic in a population, it is evident that learning is not involved.”
The paper relies on this without support.
Biking is an overlearned physical skill.
“practicing an overlearned physical skill (ie, biking)”
The paper relies on this without support.
FA is a valid measure of white matter integrity/brain connectivity.
“improves brain connectivity”
“increasing white matter integrity”
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
In the citing paper
“White-matter alterations may also occur in non-healthy individuals as one recent RCT demonstrated a 6-month AE intervention to improve global white-matter integrity in patients with schizophrenia (Svatkova 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 Svatkova et al., 2015
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
Each contradiction between two passages listed here was confirmed by an independent check.
Rated minor: it would not touch a result — a value no result rests on, a p-value that stays on the same side of the significance level, or a conflict that is clerical, resolved elsewhere in the paper, or outside its own findings.
In the paper
§ Following the Intervention
“the left inferior longitudinal fascicle (LILF)”
§ FA with Cardiovascular Fitness, Oxygen Uptake, BMI, and IQ
“LIFOF, the left inferior fronto-occipital fascicle; LILF, the left inferior fronto-occipital fascicle”
Citations
Cites
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Tract-based spatial statistics: Voxelwise analysis of multi-subject diffusion data
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Research works printed but not linked: 1
- American Psychiatric Association, 2000, Diagnostical and Statistical Manual of Mental Disorders
Cited by
Sorted by citations
Firth, J., Stubbs, B., Rosenbaum, S., Vancampfort, D., Malchow, B., Schuch, F., Elliott, R., Nuechterlein, K. H., & Yung, A. R. (2016) · Schizophrenia Bulletin · doi:10.1093/schbul/sbw115 · Cited by 488
Dauwan, M., Begemann, M. J. H., Heringa, S. M., & Sommer, I. E. (2016) · Schizophrenia Bulletin · doi:10.1093/schbul/sbv164 · Cited by 393
Exercise effects on depression: Possible neural mechanisms
Gujral, S., Aizenstein, H., Reynolds, C. F., Butters, M. A., & Erickson, K. I. (2017) · General Hospital Psychiatry · doi:10.1016/j.genhosppsych.2017.04.012 · Cited by 334
“They found that regardless of psychiatric diagnosis, the aerobic exercise intervention increased FA in the corpus callosum, SLF, and corticospinal tract (79).”
BackgroundExercise-Induced Neuroplasticity: A Mechanistic Model and Prospects for Promoting Plasticity
El‐Sayes, J., Harasym, D., Turco, C. V., Locke, M. B., & Nelson, A. J. (2018) · The Neuroscientist · doi:10.1177/1073858418771538 · Cited by 335
van Tilborg, E., de Theije, C. G. M., van Hal, M., Wagenaar, N., de Vries, L. S., Benders, M. J. N. L., Rowitch, D. H., & Nijboer, C. H. A. (2017) · Glia · doi:10.1002/glia.23256 · Cited by 321
“Animal and human studies have shown that neural activity stimulates OPC differentiation and myelination during motor learning (Scholz et al., 2009; Svatkova et al., 2015; Zatorre et al., 2012).”
Kandola, A., Hendrikse, J., Lucassen, P. J., & Yücel, M. (2016) · Frontiers in Human Neuroscience · doi:10.3389/fnhum.2016.00373 · Cited by 155
“Another study in patients with schizophrenia also demonstrated AE to counteract the deterioration of white-matter tract integrity that is associated with the disorder (Svatkova et al., 2015).”
Riggs, L., Piscione, J., Laughlin, S., Cunningham, T., Timmons, B. W., Courneya, K. S., Bartels, U. K., Skocic, J., de Medeiros, C. B., Liu, F., et al. (2016) · Neuro-Oncology · doi:10.1093/neuonc/now177 · Cited by 153
Shared vulnerability for connectome alterations across psychiatric and neurological brain disorders
de Lange, S. C., Scholtens, L. H., Initiative, A. D. N., van den Berg, L. H., Boks, M. P., Bozzali, M., Cahn, W., Dannlowski, U., Durston, S., Geuze, E., et al. (2019) · Nature Human Behaviour · doi:10.1038/s41562-019-0659-6 · Cited by 122
Self-citationHortobágyi, T., Větrovský, T., Balbim, G. M., Silva, N. C. B. S., Manca, A., Deriu, F., Kolmos, M., Kruuse, C. R., Liu-Ambrose, T. Y. L., Radak, Z. O., et al. (2022) · Ageing Research Reviews · doi:10.1016/j.arr.2022.101698 · Cited by 132
Firth, J., Stubbs, B., Vancampfort, D., Firth, J. A., Large, M., Rosenbaum, S., Hallgren, M., Ward, P. B., Sarris, J., & Yung, A. R. (2018) · Schizophrenia Bulletin · doi:10.1093/schbul/sby034 · Cited by 105
Sabé, M., Kaiser, S., & Sentissi, O. (2019) · General Hospital Psychiatry · doi:10.1016/j.genhosppsych.2019.11.002 · Cited by 100
Exercise as a Treatment for Schizophrenia: A Review
Girdler, S. J., Confino, J., & Woesner, M. E. (2025) · Psychopharmacology Bulletin · doi:10.64719/pb.4584 · Cited by 100
Fernández-Abascal, B., Suárez‐Pinilla, P., Cobo-Corrales, C., Crespo‐Facorro, B., & Suárez‐Pinilla, M. (2021) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2021.01.005 · Cited by 93
“Change in PANSS total score at the end of intervention Twenty-two studies (Beebe et al., 2005; Brar et al., 2005; Caponnetto et al., 2019; Cordes et al., 2014; Curcic et al., 2017; Ikai et al., 2013, 2014, 2017; Isuru et al., 2015; Kaltsatou et al., 2015; Kang et al., 2016; Kwon et al., 2006; Lin et al., 2015; McCread…”
BackgroundMethodInfluentialThe pro‐cognitive mechanisms of physical exercise in people with schizophrenia
Firth, J., Cotter, J., Carney, R., & Yung, A. R. (2017) · British Journal of Pharmacology · doi:10.1111/bph.13772 · Cited by 79
“…et al., 2015; Malchow et al., 2016), combined aerobic and resistance training (Scheewe et al., 2013; Kim et al., 2014; Cassilhas et al., 2015; Svatkova et al., 2015), low-intensity exercise with some aerobic activity (Kuo et al., 2013; Ho et al., 2016), highintensity interval training (HIIT)…”
InfluentialEndurance Exercise as an “Endogenous” Neuro-enhancement Strategy to Facilitate Motor Learning
Taubert, M., Villringer, A., & Lehmann, N. (2015) · Frontiers in Human Neuroscience · doi:10.3389/fnhum.2015.00692 · Cited by 95
Shimada, T., Ito, S., Makabe, A., Yamanushi, A., Takenaka, A., Kawano, K., & Kobayashi, M. (2022) · Psychiatry Research · doi:10.1016/j.psychres.2022.114656 · Cited by 81
Exercise Treatments for Psychosis: a Review
Mittal, V. A., Vargas, T., Osborne, K. J., Dean, D. J., Gupta, T., Ristanovic, I., Hooker, C. I., & Shankman, S. A. (2017) · Current Treatment Options in Psychiatry · doi:10.1007/s40501-017-0112-2 · Cited by 86
The effect of mind-body and aerobic exercise on negative symptoms in schizophrenia: A meta-analysis
Vogel, J. S., van der Gaag, M., Slofstra, C., Knegtering, H., Bruins, J., & Castelein, S. (2019) · Psychiatry Research · doi:10.1016/j.psychres.2019.03.012 · Cited by 73
“In recent years, new intervention studies were published on these di ff erent types of PE that have not been included in any previous reviews (Bhatia et al., 2017; Kang et al., 2016; Loh et al., 2015; Su et al., 2016; Svatkova et al., 2015).”
Aerobic exercise, cardiorespiratory fitness, and the human hippocampus
Aghjayan, S. L., Lesnovskaya, A., Esteban‐Cornejo, I., Peven, J. C., Stillman, C. M., & Erickson, K. I. (2021) · Hippocampus · doi:10.1002/hipo.23337 · Cited by 69
Neurobiological effects of aerobic exercise, with a focus on patients with schizophrenia
Maurus, I., Hasan, A., Röh, A., Takahashi, S., Rauchmann, B., Keeser, D., Malchow, B., Schmitt, A., & Falkai, P. (2019) · European Archives of Psychiatry and Clinical Neuroscience · doi:10.1007/s00406-019-01025-w · Cited by 68
Aging and Physiological Lessons from Master Athletes
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Lehmann, N., Villringer, A., & Taubert, M. (2020) · Journal of Neuroscience · doi:10.1523/jneurosci.2310-19.2020 · Cited by 64
“In line with this, previous intervention studies revealed large-scale white matter remodeling after CE training in young- to middle-aged subjects, which applies to healthy volunteers (Svatkova et al., 2015), patients with schizophrenia (Svatkova et al.”
BackgroundResultInfluentialTreatment-Resistant Schizophrenia: Genetic and Neuroimaging Correlates
Vita, A., Minelli, A., Barlati, S., Deste, G., Giacopuzzi, E., Valsecchi, P., Turrina, C., & Gennarelli, M. (2019) · Frontiers in Pharmacology · doi:10.3389/fphar.2019.00402 · Cited by 57
“, 2016, 2017) and physical aerobic exercise (Svatkova et al., 2015; Malchow et al., 2016).”
BackgroundAerobic Exercise in People with Schizophrenia: Neural and Neurocognitive Benefits
Vakhrusheva, J., Marino, B., Stroup, T. S., & Kimhy, D. (2016) · Current Behavioral Neuroscience Reports · doi:10.1007/s40473-016-0077-2 · Cited by 53
Nicolini, C., Fahnestock, M. L., Gibala, M. J., & Nelson, A. J. (2020) · Neuroscience · doi:10.1016/j.neuroscience.2020.12.013 · Cited by 59
“, 2020), while neuroimaging ones have demonstrated that exercise positively influences functional connectivity, gray matter density, and white matter microstructure in motor areas (Erickson et al., 2011; Voss et al., 2013b; Herting et al., 2014; Rajab et al., 2014; Schlaffke et al., 2014; Svatkova et al., 2015; Rowley…”
BackgroundSormunen, E., Saarinen, M. M., Salokangas, R. K. R., Telama, R., Hutri‐Kähönen, N., Tammelin, T., Viikari, J. S. A., Raitakari, O. T., & Hietala, J. A. (2017) · Schizophrenia · doi:10.1038/s41537-016-0007-z · Cited by 48
The effects of aerobic exercise on cognition in schizophrenia: A 3-month follow-up study
Su, C., Wang, P., Lin, Y.-J., Tang, T., Liu, M., & Chen, M. (2016) · Psychiatry Research · doi:10.1016/j.psychres.2016.08.011 · Cited by 46
Lifestyle-dependent microglial plasticity: training the brain guardians
Augusto‐Oliveira, M., & Verkhratsky, A. (2021) · Biology Direct · doi:10.1186/s13062-021-00297-4 · Cited by 47
The Role of Exercise-Induced Cardiovascular Adaptation in Brain Health
Tarumi, T., & Zhang, R. (2015) · Exercise and Sport Sciences Reviews · doi:10.1249/jes.0000000000000063 · Cited by 42
“(27) conducted a 6-month interventional trial of moderate-intensity cycling in the group of healthy participants as well as patients with schizophrenia.”
BackgroundXu, Y., Cai, Z., Fang, C., Zheng, J., Shan, J., & Yang, Y. (2022) · Psychiatry Research · doi:10.1016/j.psychres.2022.114560 · Cited by 42
“Finally, 22 articles (Behere et al., 2011; Campos et al., 2015; Chen et al., 2016;, Ho et al., 2016; Huang et al., 2021b; Kimhy et al., 2015; Kuo et al., 2021; Lin et al., 2015; Malchow et al., 2015; Massa et al., 2020; Namdar et al., 2020; Nuechterlein et al., 2016; Oertel-Knöchel et al., 2014; Pajonk et al., 2010; R…”
White Matter Alterations in Depressive Disorder
He, E., Liu, M., Gong, S., Fu, X., Han, Y., & Deng, F. (2022) · Frontiers in Immunology · doi:10.3389/fimmu.2022.826812 · Cited by 44
Tarumi, T., Thomas, B. P., Tseng, B. Y., Wang, C., Womack, K. B., Hynan, L. S., Lu, H., Cullum, C. M., & Zhang, R. (2019) · Journal of Alzheimer s Disease · doi:10.3233/jad-190875 · Cited by 45
“Inanotherstudythat enrolledyoungandmiddle-agedhealthyadultsand schizophrenicpatients,6monthsofcyclingexercise wasassociatedwithincreasedfractionalanisotropy of the motor-related WM fiber tracts in both participant groups when compared with the life-as-usual (control) group [34].”
The YOUth cohort study: MRI protocol and test-retest reliability in adults
Buimer, E. E. L., Pas, P., Brouwer, R. M., Froeling, M., Hoogduin, H. M., Leemans, A., Luijten, P. R., van Nierop, B. J., Raemaekers, M. A. H., Schnack, H. G., et al. (2020) · Developmental Cognitive Neuroscience · doi:10.1016/j.dcn.2020.100816 · Cited by 38
Self-citationvan der Stouwe, E. C. D., van Busschbach, J. T., de Vries, B., Cahn, W., Aleman, A., & Pijnenborg, G. H. M. (2018) · NeuroImage Clinical · doi:10.1016/j.nicl.2018.04.018 · Cited by 43
“AC CE PT ED M AN US CR IPT 21 NEURAL CORRELATES OF EXERCISE TRAINING Most studies that included individuals with a schizophrenia spectrum disorder as well as healthy individuals found effects in the same direction for both groups on the primary imaging outcome (Malchow et al., 2015; Pajonk et al., 2010; Scheewe et al.…”
Self-citationDamme, K. S. F., Gupta, T., Ristanovic, I., Kimhy, D., Bryan, A. D., & Mittal, V. A. (2022) · Schizophrenia Bulletin · doi:10.1093/schbul/sbac084 · Cited by 40
Bredin, S. S. D., Kaufman, K., Chow, M. I., Lang, D. J., Wu, N., Kim, D. D., & Warburton, D. E. R. (2022) · Frontiers in Cardiovascular Medicine · doi:10.3389/fcvm.2021.753117 · Cited by 39
What are the top 10 physical activity research questions in schizophrenia?
Vancampfort, D., Rosenbaum, S., Probst, M., Connaughton, J., du Plessis, C., Yamamoto, T., & Stubbs, B. (2016) · Disability and Rehabilitation · doi:10.3109/09638288.2015.1116622 · Cited by 35
“Previous research [37,38] suggested that aerobic fitness”
Aerobic exercise in severe mental illness: requirements from the perspective of sports medicine
Falkai, P., Schmitt, A., Rosenbeiger, C. P., Maurus, I., Hattenkofer, L., Hasan, A., Malchow, B., Heim-Ohmayer, P., Halle, M., & Heitkamp, M. (2021) · European Archives of Psychiatry and Clinical Neuroscience · doi:10.1007/s00406-021-01360-x · Cited by 40
“Additionally, a 6-month aerobic exercise program improved the integrity of motor function-related white matter fiber tracts compared with a life-as-usual condition [90].”
BackgroundCampos, C., Rocha, N., Lattari, E., Nardi, A. E., & Machado, S. E. D. C. (2017) · CNS & Neurological Disorders - Drug Targets · doi:10.2174/1871527315666161223142918 · Cited by 34
Dai, Y., Ding, H., Lu, X., Wu, X., Xu, C., Jiang, T., Liang, M., Xia, Z., Song, C., Shen, H., et al. (2022) · Schizophrenia · doi:10.1038/s41537-022-00297-x · Cited by 38
de Girolamo, G., Rocchetti, M., Benzi, I. M. A., Agosta, S., Casiraghi, L., Ferrari, C., Franceschi, N. D., Macis, A., Pogliaghi, S., & Starace, F. (2020) · BMC Psychiatry · doi:10.1186/s12888-020-02588-y · Cited by 32
Minichino, A., Ando, A. M. C., Francesconi, M., Salatino, A., Chiaie, R. D., & Cadenhead, K. S. (2017) · Progress in Neuro-Psychopharmacology and Biological Psychiatry · doi:10.1016/j.pnpbp.2017.03.020 · Cited by 32
The impact of sleep on complex gross‐motor adaptation in adolescents
Bothe, K., Hirschauer, F., Wiesinger, H., Edfelder, J. M., Gruber, G., Birklbauer, J., & Hoedlmoser, K. (2018) · Journal of Sleep Research · doi:10.1111/jsr.12797 · Cited by 30
“Moreover, a study by Svatkova et al. (2015) reported a left hemispheric increase in white matter integrity for right‐handed participants after 6 months of training on a stationary bicycle.”
BackgroundEndurance training in patients with schizophrenia and healthy controls: differences and similarities
Keller-Varady, K., Hasan, A., Schneider-Axmann, T., Hillmer-Vogel, U., Adomßent, B., Wobrock, T., Schmitt, A., Niklas, A., Falkai, P., & Malchow, B. (2015) · European Archives of Psychiatry and Clinical Neuroscience · doi:10.1007/s00406-015-0651-8 · Cited by 32
Fissler, P., Müller, H., Küster, O. C., Laptinskaya, D., Thurm, F., Wöll, A., Elbert, T. R., Kassubek, J., Arnim, C. A. F. V., & Kolassa, I. (2017) · Frontiers in Human Neuroscience · doi:10.3389/fnhum.2017.00110 · Cited by 35
Enhancing Neuroplasticity to Augment Cognitive Remediation in Schizophrenia
Jahshan, C. S., Rassovsky, Y., & Green, M. F. (2017) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2017.00191 · Cited by 29
Well-being and mobility: A new perspective
Ferdman, A. (2021) · Transportation Research Part A Policy and Practice · doi:10.1016/j.tra.2021.02.003 · Cited by 35
“Cycling is an overlearned physical skill that improves brain connectivity (Svatkova et al. 2015).”
BackgroundFalkai, P., Rossner, M. J., Raabe, F. J., Wagner, E. M., Keeser, D., Maurus, I., Roell, L., Chang, E., Seitz‐Holland, J., Schulze, T. G., et al. (2023) · Schizophrenia Bulletin · doi:10.1093/schbul/sbad065 · Cited by 30
“94 In addition, aerobic exercise was shown to improve white matter organization in patients with SZ, 95 suggesting a possible trophic effect of aerobic exercise on myelin structure, possibly by stimulating plastic, regenerative mechanisms.”
BackgroundA systematic review of trials investigating strength training in schizophrenia spectrum disorders
Keller-Varady, K., Varady, P. A., Röh, A., Schmitt, A., Falkai, P., Hasan, A., & Malchow, B. (2017) · Schizophrenia Research · doi:10.1016/j.schres.2017.06.008 · Cited by 27
Yao, J., Song, Q., Zhang, K., Hong, Y., Li, W., Mao, D., Cong, Y., & Li, J. X. (2018) · Research in Sports Medicine · doi:10.1080/15438627.2018.1502184 · Cited by 26
“And an increase in FA usually indicates an increase in brain function and brain connectivity (Svatkova et al., 2015).”
BackgroundRißmayer, M., Kambeitz, J. P., Javelle, F., & Lichtenstein, T. (2024) · Schizophrenia Bulletin · doi:10.1093/schbul/sbae015 · Cited by 25
Chao, Y., Wu, C. W., Lin, L.-J., Lai, C., Wu, H.-Y., Hsu, A., & Chen, C.-N. (2020) · Journal of Medical and Biological Engineering · doi:10.1007/s40846-020-00522-x · Cited by 26
Steventon, J. J., Chandler, H. L., Foster, C., Dingsdale, H., Germuska, M. A., Massey, T. H., Parker, G. D., Wise, R. G., & Murphy, K. (2021) · Scientific Reports · doi:10.1038/s41598-021-01630-7 · Cited by 25
Garcés, L. G., Sánchez‐López, M. I., Cano, S. L., Meliá, Y. C., Marqués-Azcona, D., Biviá-Roig, G., Lisón, J. F., & Peyró-Gregori, L. (2021) · Scientific Reports · doi:10.1038/s41598-021-03761-3 · Cited by 26
Physical exercise keeps the brain connected by increasing white matter integrity in healthy controls
Bashir, S., Alsultan, F., Abujamea, A. H., Almousa, A., Alnafisah, M., Alzahrani, M., Abualait, T., & Yoo, W. (2021) · Medicine · doi:10.1097/md.0000000000027015 · Cited by 19
Swora, E., Boberska, M., Kuliś, E., Knoll, N., Keller, J., & Łuszczyńska, A. (2022) · Journal of Clinical Medicine · doi:10.3390/jcm11102719 · Cited by 19
“20 Svatkova (2015) [41] 81 (26%) 18–48 Schizophrenia Czech Republic Experimentallongitudinal PANSS Exercise Positive: r = 0.”
BackgroundHuang, Y., Hung, C., Hsu, S., Lin, P., Lee, Y., Chong, M., Chen, C.-C., Kuo, Y., & Wang, L. (2020) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2020.12.062 · Cited by 24
Guo, F. H., Tian, Y., Zhong, F., Wu, C., Cui, Y., & Huang, C. X. (2020) · Psychology Research and Behavior Management · doi:10.2147/prbm.s267066 · Cited by 22
Lak, M., Jafarpour, A., Shahrbaf, M. A., Lak, M., & Dolatshahi, B. (2024) · Schizophrenia Research · doi:10.1016/j.schres.2024.07.020 · Cited by 19
Verkooijen, S., Stevelink, R., Abramovic, L., Vinkers, C. H., Ophoff, R. A., Kahn, R. S., Boks, M. P., & van Haren, N. E. M. (2017) · Psychiatry Research Neuroimaging · doi:10.1016/j.pscychresns.2017.01.013 · Cited by 19
“Although the e ff ect of such therapies has not yet been studied in a bipolar sample, a fi rst study in schizophrenia patients found that an exercise intervention increased the level of white matter integrity (Svatkova et al., 2015).”
Self-citationSecondary White Matter Injury and Therapeutic Targets After Subarachnoid Hemorrhage
Ru, X., Gao, L., Zhou, J., Li, Q., Zuo, S., Chen, Y., Liu, Z., & Feng, H. (2021) · Frontiers in Neurology · doi:10.3389/fneur.2021.659740 · Cited by 18
Lehmann, N., Villringer, A., & Taubert, M. (2022) · Scientific Reports · doi:10.1038/s41598-022-05145-7 · Cited by 19
Exercise and microstructural changes in the motor cortex of older adults
Rowley, C. D., Bock, N. A., Deichmann, R., Engeroff, T., Hattingen, E., Hellweg, R., Pilatus, U., Füzéki, E., Gerten, S., Vogt, L., et al. (2019) · European Journal of Neuroscience · doi:10.1111/ejn.14585 · Cited by 17
“Furthermore, practicing an overlearned skill such as bicycling results in greater FA, especially in motor‐related tracts in both healthy individuals and those with schizophrenia (Svatkova et al., 2015).”
BackgroundThe effect of an acute bout of exercise on executive function among individuals with schizophrenia
Subramaniapillai, M., Tremblay, L., Grassmann, V., Remington, G. J., & Faulkner, G. (2016) · Psychiatry Research · doi:10.1016/j.psychres.2016.10.075 · Cited by 15
Oliva, H. N. P., Monteiro-Júnior, R. S., Oliva, I. O., & Powers, A. R. (2023) · Progress in Neuro-Psychopharmacology and Biological Psychiatry · doi:10.1016/j.pnpbp.2023.110771 · Cited by 14
Kristensen, T. D., Mandl, R. C. W., Jepsen, J. R. M., Rostrup, E., Glenthøj, L. B., Nordentoft, M., Glenthoj, B. Y., & Ebdrup, B. H. (2018) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2018.03.013 · Cited by 14
“Sixteen studies, including all patient studies and six of the nine RCTs in the cognitive domain applied (approximately) isotropic voxels and at least 30 non-collinear encoding directions (Caeyenberghs et al., 2016; Favre et al., 2015; Ghaziri et al., 2013; Hosoda et al., 2013; Lövdén et al., 2012, 2010; Mackey et al.,…”
InfluentialSelf-citationNestrašil, I., Svátková, A., Rudser, K. D., Chityala, R. N., Wakumoto, A., Mueller, B. A., Bednařík, P., Tuite, P., Wu, X., & Bushara, K. O. (2018) · Brain and Behavior · doi:10.1002/brb3.1039 · Cited by 14
Fox‐Harding, C., Tompsett, C., Sanders, R. H., & Cobley, S. P. (2018) · International Journal of Sport and Exercise Psychology · doi:10.1080/1612197x.2018.1519838 · Cited by 14
“%) reported completion rates greater than 75% (e.g. 100% participation – Acil, Dogan, & Dogan, 2008; Dodd, Duffy, Stewart, Impey, & Taylor, 2011; Svatkova et al., 2015; Takahashi et al., 2012).”
InfluentialRoell, L., Keeser, D., Papazov, B., Lembeck, M., Papazova, I., Greska, D., Muenz, S., Schneider-Axmann, T., Sykorova, E. B., Thieme, C. E., et al. (2023) · Schizophrenia Bulletin · doi:10.1093/schbul/sbad113 · Cited by 15
Resistance training in patients with schizophrenia: Concept and proof of principle trial
Maurus, I., Mantel, C., Keller-Varady, K., Schmitt, A., Lembeck, M., Röh, A., Papazova, I., Falkai, P., Schneider-Axmann, T., Hasan, A., et al. (2019) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2019.09.015 · Cited by 13
The Magic of Movement; the Potential of Exercise to Improve Cognition
Sommer, I. E., & Kahn, R. S. (2015) · Schizophrenia Bulletin · doi:10.1093/schbul/sbv031 · Cited by 12
Self-citationOspina, L., Wall, M., Jarskog, L., Ballon, J. S., McEvoy, J., Bartels, M., Buchsbaum, R., Sloan, R., Stroup, T., & Kimhy, D. (2019) · Journal of Psychiatry and Brain Science · doi:10.20900/jpbs.20190020 · Cited by 12
Tréhout, M., & Dollfus, S. (2018) · L Encéphale · doi:10.1016/j.encep.2018.05.005 · Cited by 17
White Matter Tract Integrity, Involvement in Sports, and Depressive Symptoms in Children
Gorham, L. S., & Barch, D. (2020) · Child Psychiatry and Human Development · doi:10.1007/s10578-020-00960-3 · Cited by 13
Saviola, F., Deste, G., Barlati, S., Vita, A., Gasparotti, R., & Corbo, D. (2023) · Brain Sciences · doi:10.3390/brainsci13060923 · Cited by 10
“Concerning clinical scores, the evidence was found for better overall psych tic symptomatology in schizophrenia [29,30,40,41,46] and for negative symptoms in early psychosis [45] and positive sympt m in high‐risk cohorts [23,24].”
BackgroundInfluentialExercise ameliorates deficits in neural microstructure in a Disc1 model of psychiatric illness
Barnett, B. R., Anderson, J. M., Torres-Velázquez, M., Yi, S. Y., Rowley, P., & Yu, J.-P. J. (2019) · Magnetic Resonance Imaging · doi:10.1016/j.mri.2019.05.021 · Cited by 10
“There has been only one study examining white matter changes in schizophrenic humans following aerobic exercise, and this study focused on whether practicing an already learned activity can improve white matter structure, not specifically focusing on exercise as an intervention [24].”
BackgroundResultInfluentialMaudrich, T., Kenville, R., Lepsien, J., Villringer, A., Ragert, P., & Steele, C. J. (2017) · Frontiers in Human Neuroscience · doi:10.3389/fnhum.2017.00485 · Cited by 9
“In support of this, Svatkova et al. (2015) specifically showed an increase in the integrity of motor relevant fibers passing through the CC (measured by fractional anisotropy—FA) induced by an erobic cycling regimen for several weeks.”
BackgroundChen, Y., Yang, M. J., Huang, H., Fang, Y., Zhou, X., Yu, Z., Wang, M., Bohnet-Joschko, S., & Luo, X. (2025) · Journal of Clinical Neuroscience · doi:10.1016/j.jocn.2025.111181 · Cited by 6
Lambert, M., Wurz, A. J., Smith, A. M., Fang, Z., & Brunet, J. (2021) · Brain Plasticity · doi:10.3233/bpl-210124 · Cited by 7
Semler, E., Herpich, F., Zellner, L., Zwick, S., Zwanzger, P., & Brunnauer, A. (2024) · European Archives of Psychiatry and Clinical Neuroscience · doi:10.1007/s00406-024-01773-4 · Cited by 6
“Concerning mnestic processes, previous studies demonstrated that on a structural level, cardiorespiratory fitness induces an increase of brain volume and white matter integrity in specific brain regions like the hippocampus [43, 54–56].”
Schizophrenia Treatment - The New Facets
Shen, Y. (2016) · InTech eBooks · doi:10.5772/62958 · Cited by 6
Exercise, spinogenesis and cognitive functions
Zhang, L., & So, K. (2019) · International review of neurobiology · doi:10.1016/bs.irn.2019.07.005 · Cited by 7
Cempa, K., Jurys, T., Kluczyński, S., & Andreew-Gamza, M. (2022) · Psychiatria Polska · doi:10.12740/pp/140053 · Cited by 5
“Most of the qualified studies concerned the improvement of fitness, cardiovascular parameters and motor deficits [30-37].”
Exercise as an Adjuvant Treatment of Schizophrenia: A Review
Abbas, M. S., Nassar, S. T., Tasha, T., Desai, A. V., Bajgain, A., Ali, A., Dutta, C., Pasha, K., Paul, S., & Venugopal, S. (2023) · Cureus · doi:10.7759/cureus.42084 · Cited by 5
“Overall, exercise increases the cognition needed for daily life functioning, an aspect very important for patients with schizophrenia [25].”
BackgroundImpact of Non-pharmacological Interventions on Brain Structure and Function in Schizophrenia
Hegde, R. R., Kelly, S., Guimond, S., & Keshavan, M. S. (2020) · Springer eBooks · doi:10.1007/978-3-030-35206-6_20 · Cited by 4
Wang, Z., Li, J., Wang, L., & Wei, Q. (2025) · Psychiatry Research · doi:10.1016/j.psychres.2025.116665 · Cited by 4
Abdullahi, A., Wong, T. W. L., & Ng, S. S. M. (2024) · Schizophrenia Research · doi:10.1016/j.schres.2024.10.004 · Cited by 6
Lehmann, N., Villringer, A., & Taubert, M. (2020) · Cerebral Cortex Communications · doi:10.1093/texcom/tgaa075 · Cited by 4
“2019), structural (Voss, Heo, et al. 2013; Mueller et al. 2015; Svatkova et al. 2015), and functional connectivity (Voss et al.”
BackgroundResultOh, J. Y., Crockett, R. A., Hsu, C. L., Dao, E. A., Tam, R. C., & Liu-Ambrose, T. Y. L. (2023) · Journal of Alzheimer s Disease Reports · doi:10.3233/adr-220113 · Cited by 6
Sporttherapie bei schizophrenen Psychosen: Von der Idee bis zur Leitlinie
Falkai, P., Schwaiger, R., Schmitt, A., Röll, L., & Maurus, I. (2023) · Das Gesundheitswesen · doi:10.1055/a-2129-7421 · Cited by 4
“For example, there was an increase in the thickness of the cortex in the anterior cingulate [65], an increase in the volume of the left hemisphere [66], and an improvement in the integrity of the white matter [67].”
Yilmaz, D., Papiol, S., Keeser, D., Cole, J. H., Malchow, B., Walter, H., Meyer‐Lindenberg, A., Hirjak, D., Hasan, A., Schmitt, A., et al. (2025) · NeuroImage Clinical · doi:10.1016/j.nicl.2025.103881 · Cited by 7
“…Malchow et al., 2016), anterior left temporal gyrus volume (Malchow et al., 2016), white matter integrity in tracts related to motor functioning (Svatkova et al., 2015), and serum BDNF levels — a mediator of structural and functional neuroplasticity (Kim et al., 2014; Colucci--D ’ Amato et al.,…”
Roell, L., Lindner, C., Maurus, I., Keeser, D., Malchow, B., Schmitt, A., & Falkai, P. (2025) · European Psychiatry · doi:10.1192/j.eurpsy.2025.10129 · Cited by 3
Schizophrenia spectrum disorders and physical exercise
Makris, K., & Kollias, K. (2021) · Psychiatriki · doi:10.22365/jpsych.2021.019 · Cited by 3
Lee, E., Adamowicz, D. H., & Frangou, S. (2023) · American Journal of Geriatric Psychiatry · doi:10.1016/j.jagp.2023.01.019 · Cited by 3
Yilmaz, D., Papiol, S., Keeser, D., Cole, J. H., Malchow, B., Schmitt, A., Falkai, P., Maurus, I., & Roell, L. (2025) · medRxiv · doi:10.1101/2025.01.08.24319554 · Cited by 3
Fiorin, F. D. S., & Chung, M.-K. (2026) · Neuroscience · doi:10.1016/j.neuroscience.2026.03.007 · Cited by 2
Chang, K.-T., Goh, K. K., Latthirun, K., & Yang, C.-T. (2024) · Progress in brain research · doi:10.1016/bs.pbr.2024.01.002 · Cited by 2
Effects of Adapted Physical Activity on White Matter Integrity in Patients with Schizophrenia
Leroux, E., Masson, L., Tréhout, M., & Dollfus, S. (2024) · Brain Sciences · doi:10.3390/brainsci14070710 · Cited by 2
“Taken together, these results suggest that brain plasticity mechanisms in SZPs are preserved and that e-APA may contribute to improved brain connectivity, in accordance with Svatkova et al. [26].”
BackgroundResultSelected lifestyle elements in adolescents attending high schools
Szczepańska, E., Janota, B., & Janion, K. (2020) · Roczniki Państwowego Zakładu Higieny · doi:10.32394/rpzh.2020.0109 · Cited by 2
Shimada, T., Ito, S., Yamanushi, A., Koizumi, A., & Kobayashi, M. (2025) · Psychiatry Research · doi:10.1016/j.psychres.2025.116454 · Cited by 1
Metadata
- Authors
- Svatkova, A., Mandl, R. C. W., Scheewe, T. W., Cahn, W., Kahn, R. S., & Hulshoff Pol, H. E.
- Affiliations
- University Medical Center Utrecht (NL)
- Venue
- Schizophrenia Bulletin
- Publisher
- Oxford University Press (OUP)
- Published
- 2015-03-31
- Volume
- 41
- Issue
- 4
- Pages
- 869-878
- ISSN
- 0586-7614 (ISSN-L)
- 1745-1701
- PMC
- PMC4466190
- OpenAlex
- W2133556985
- Semantic Scholar
- 95b6b395f1b96b2eca5911b379e5ac4feca243e7
- Cited by
- 120
- References
- 84
- Citations by year
- 2026: 3 · 2025: 9 · 2024: 7 · 2023: 10 · 2022: 10 · 2021: 15 · 2020: 15 · 2019: 15 · 2018: 9 · 2017: 12 · 2016: 10 · 2015: 5
- FWCI
- 9.73
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Schizophrenia Bulletin (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Utrecht University Repository (Utrecht University) (submittedVersion, other-oa)
- Utrecht University Repository (Utrecht University) (submittedVersion)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Advanced Neuroimaging Techniques and Applications
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Physical Activity and Health
- Keywords
- physical activity, cycling
- MeSH terms
- Adult, Bicycling, Exercise Therapy, Female, Follow-Up Studies, Humans, Male, Schizophrenia, Treatment Outcome, Young Adult, Diffusion Tensor Imaging, White Matter
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