Physical exercise keeps the brain connected: biking increases white matter integrity in patients with schizophrenia and healthy controls.

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”

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.”

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).”

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”

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”

In the paper

“specifically, alleviation of positive symptoms and increasing white matter integrity seemed to go hand-in-hand.”

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 ).”

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

• Not checked yetcites [14] source
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• Not checked yetcites [18] source
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• Not checked yetcites [19] source

In the paper

“However, others did not find significant effect, eg, on cortical architecture. 20-22”

What the sources say

• Not checked yetcites [20] source
• Not checked yetcites [21] source
• Not checked yetcites [22] Gondoh, 2009, Effects of aerobic exercise training on brain structure and psychological well-being in young adults, J Sports Med Phys Fitness

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”

What the sources say

• Not checked yetcites [14] source
• Not checked yetcites [23] source

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

• Not checked yetcites [8] source
• Not checked yetcites [9] source
• Not checked yetcites [10] source

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

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

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

• Not checked yetcites [11] source
• Not checked yetcites [12] source
• Not checked yetcites [13] source

In the paper

“Physical exercise has been reported to affect gray matter structure. 14-19”

What the sources say

• Not checked yetcites [14] source
• Not checked yetcites [15] source
• Not checked yetcites [16] source
• Not checked yetcites [17] source
• Not checked yetcites [18] source
• Not checked yetcites [19] source

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

• Not checked yetcites [19] source
• Not checked yetcites [20] source
• Not checked yetcites [18] source

In the paper

“Significant differences in compliance between exercise and nonexercise group and patients vs controls were found.”

In the paper

“No significant differences were found between patients and controls in mean age, gender, handedness, and parental level of education.”

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

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).”

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

• Not checked yetcites [35] source
• Not checked yetcites [47] source
• Not checked yetcites [48] source

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

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.”

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

• Not checked yetcites [45] source
• Not checked yetcites [46] Scrascia, 2014, Relationship among diffusion tensor imaging, EEG activity, and cognitive status in mild cognitive impairment and Alzheimer’s disease patients, J Alzheimers Dis source

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

• Not checked yetcites [24] source
• Not checked yetcites [25] Gärtner, 2013, Brain morphometry shows effects of long-term musical practice in middle-aged keyboard players, Front Psychol source

In the paper

“These results were corrected for Family-wise error (FWEcorr) (for additional information see supplementary data).”

In the paper

“these findings may also extend to the nonphysical realm.”

In the paper

“better functional connectivity has been associated with higher cognitive functioning, 49,50”

What the sources say

• Not checked yetcites [49] source
• Not checked yetcites [50] source

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.”

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

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”

What the sources say

• Not checked yetcites [52] source
• Not checked yetcites [53] source

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”

What the sources say

• Not checked yetcites [61] source
• Not checked yetcites [62] source

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).”

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”

In the paper

“Body mass index (BMI) was significantly higher in patients as compared to healthy subjects.”

In the paper

“A positive influence of antipsychotic medication on glia cells and myelination has been demonstrated. 82,83”

What the sources say

• Not checked yetcites [82] source
• Not checked yetcites [83] source

In the paper

“Moreover, these associations imply that changes are caused by practice of an overlearned aerobic activity rather than anaerobic newly learned exercise.”

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.”

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.”

In the paper

“two randomization groups (exercise vs nonexercise)”

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

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