Neurologic benefits of sports and exercise

Voluntary running wheel exercise induces cognitive improvement post traumatic brain injury in mouse model through redressing aberrant excitation regulated by voltage-gated sodium channels 1.1, 1.3, and 1.6

Traumatic brain injury (TBI) leads to disturbed brain discharge rhythm, elevated excitability, anxiety-like behaviors, and decreased learning and memory capabilities. Cognitive dysfunctions severely affect the quality of life and prognosis of TBI patients, requiring effective rehabilitation treatment. Evidence indicates that moderate exercise after brain injury decreases TBI-induced cognitive decline. However, the underlying mechanism remains unelucidated. Our results demonstrate that TBI causes cognitive impairment behavior abnormalities and overexpression of Nav1.1, Nav1.3 and Nav1.6 proteins inside the hippocampus of mice models. Three weeks of voluntary running wheel (RW) exercise treatments before or/and post-injury effectively redressed the aberrant changes caused by TBI. Additionally, a 10% exercise-conditioned medium helped recover cell viability, neuronal sodium current and expressions of Nav1.1, Nav1.3 and Nav1.6 proteins across cultured neurons after injury. Therefore, the results validate the neuroprotection induced by voluntary RW exercise treatment before or/and post-TBI. The RW exercise-induced improvement in cognitive behaviors and neuronal excitability could be associated with correcting the Nav1.1, Nav1.3, and Nav1.6 expression levels. The current study proves that voluntary exercise is an effective treatment strategy against TBI. The study also highlights novel potential targets for rehabilitating TBI, including the Navs proteins.

Effects of Exercise Programs on Functional Capacity and Quality of Life in People With Acquired Brain Injury: A Systematic Review and Meta-Analysis

OBJECTIVE

The aims of this systematic review and meta-analyses were to evaluate the effects of exercise on the functional capacity and quality of life (QoL) of people with acquired brain injury (ABI) and to analyze the influence of training variables.

METHODS

Five electronic databases (MEDLINE, Cochrane Library, CINAHL, SportDiscus, and Web of Science) were searched until October 2021 for clinical trials or experimental studies examining the effects of exercise on the functional capacity and QoL in adults with ABI and comparing exercise interventions with non-exercise (usual care).

RESULTS

Thirty-eight studies were evaluated. A total sample of 2219 people with ABI (exercise, n = 1572; control, n = 647) were included in the quantitative analysis. A greater improvement was observed in walking endurance (z score = 2.84), gait speed (z score = 2.01), QoL physical subscale (z score = 3.42), and QoL mental subscale (z score = 3.00) was observed in the experimental group than in the control group. In addition, an improvement was also observed in the experimental group in the "Timed Up and Go" Test scores and balance without differences from the control group. Significant interactions were also observed between the rehabilitation phases, type, frequency and volume of training, and overall effects.

CONCLUSION

The results suggest that exercise improves functional capacity and QoL regardless of model training, highlighting the effectiveness of long-term exercise that includes short sessions with components such as strength, balance, and aerobic exercise.

IMPACT

The results shown in this systematic review with meta-analysis will allow physical therapists to better understand the effects of training on people with ABI.

Preventing Multiple Sclerosis: The Pediatric Perspective

Pediatric-onset multiple sclerosis (MS) is a predominantly relapsing-remitting neuroinflammatory disorder characterized by frequent relapses and high magnetic resonance imaging (MRI) lesion burden early in the disease course. Current treatment for pediatric MS relies on early initiation of disease-modifying therapies designed to prevent relapses and slow progression of disability. When considering the concept of MS prevention, one can conceptualize primary prevention (population- or at-risk population interventions that prevent the earliest facet of MS pathobiology and hence reduce disease incidence), or secondary prevention (prevention of disease consequence, such as reducing relapse frequency and lesion accrual, enhancing focal lesion repair, promoting CNS resilience against the more global facets of disease injury, and ultimately, preventing progression of neurological disability). Studying the pediatric MS population provides a unique opportunity to explore early-life exposures that contribute to the development of MS including perinatal and environmental risk determinants. Research is ongoing related to targeting these risk factors for potential MS primary prevention. Here we review these key risk factors, their proposed role in the pathogenesis of MS, and their potential implications for primary MS prevention.

The Effect of Aerobic Exercise on Concussion Recovery: A Pilot Clinical Trial

OBJECTIVE

The purpose of this study was to pilot safety and tolerability of a 1-week aerobic exercise program during the post-acute phase of concussion (14-25 days post-injury) by examining adherence, symptom response, and key functional outcomes (e.g., cognition, mood, sleep, postural stability, and neurocognitive performance) in young adults.

METHOD

A randomized, non-blinded pilot clinical trial was performed to compare the effects of aerobic versus non-aerobic exercise (placebo) in concussion patients. The study enrolled three groups: 1) patients with concussion/mild traumatic brain injury (mTBI) randomized to an aerobic exercise intervention performed daily for 1-week, 2) patients with concussion/mTBI randomized to a non-aerobic (stretching and calisthenics) exercise program performed daily for 1-week, and 3) non-injured, no intervention reference group.

RESULTS

Mixed-model analysis of variance results indicated a significant decrease in symptom severity scores from pre- to post-intervention (mean difference = -7.44, 95% CI [-12.37, -2.20]) for both concussion groups. However, the pre- to post-change was not different between groups. Secondary outcomes all showed improvements by post-intervention, but no differences in trajectory between the groups. By three months post-injury, all outcomes in the concussion groups were within ranges of the non-injured reference group.

CONCLUSIONS

Results from this study indicate that the feasibility and tolerability of administering aerobic exercise via stationary cycling in the post-acute time frame following post-concussion (14-25 days) period are tentatively favorable. Aerobic exercise does not appear to negatively impact recovery trajectories of neurobehavioral outcomes; however, tolerability may be poorer for patients with high symptom burden.

Short-Term High-Intensity Treadmill Exercise Promotes Ceramide-Dependent Extracellular Vesicle Secretion in the Central Nervous System of Mice

Background

A lack of physical exercise, a critical aspect of a healthy lifestyle, contributes to several cerebral diseases, such as cognitive impairment, Parkinson disease (PD), and Alzheimer disease (AD). The purpose of the present study was to evaluate the effect of physical exercise on cerebral disease via released extracellular vesicles (EVs).

Material/Methods

Short-term high-intensity treadmill exercise was applied to assess the effect of physical activity on EVs in the serum and brain tissue. Immunofluorescence staining and western blot analysis were used to analyze biomarkers of EVs, including TSG101, HSC70, and CD63. Nanoparticle tracking analysis (NTA) was used to analyze the size and concentration of EVs.

Results

Short-term high-intensity exercise increased the number of neuronal EVs in the brain. In the peripheral blood serum, the level of HSC70 showed a temporary increase after exercise and quickly returned to the normal level, whereas the levels of CD63 and TSG101 showed no obvious change in response to physical exercise. In brain tissue, the levels of HSC70 and TSG101 increased dramatically after exercise, while the level of CD63 remained unchanged. The concentration of EVs was significantly increased after exercise, while the mean diameter of the EVs showed no significant change. The levels of ceramide were significantly increased after exercise, and quickly returned to normal levels.

Conclusions

These data suggest that the secretion of EVs in the brain and blood is a transitory response to physical exercise and is dependent on ceramide synthesis.

Preventive Effects of Different Aerobic Exercise Intensities on the Decline of Cognitive Function in High-Fat Diet-Induced Obese Growing Mice

Background and Objectives: The purpose of this study was to elucidate the effects of different exercise intensities in preventing the decline of cognitive function and lipolysis associated with a high-fat diet-induced obesity in growing mice. Material and Methods: Forty male C57BL/6 mice, aged 4 weeks, were divided into the normal diet (CO, n = 10) and high-fat diet (HF, n = 30) groups to induce obesity for 8 weeks. Subsequently, the HF group was subdivided equally into the HF, HF + low-intensity training (HFLT), and HF + high-intensity training (HFHT) groups, and mice were subjected to treadmill training for 8 weeks. Results: Following the 8-week training intervention, body weight and fat mass were significantly lower in the training groups than in the HF group (p < 0.05). Adipose triglyceride lipase (ATGL), hormone-sensitive lipase (HSL), and monoglyceride lipase levels were significantly higher in the training groups than in the HF group (p < 0.05), and the ATGL and HSL levels were significantly higher in the HFHT group than in the HFLT group (p < 0.05). The Y-maze test showed that the training groups had a higher number of total entries and percent alternation than the HF group (p < 0.05). Hippocampal nerve growth factor, brain-derived neurotrophic factor, and neurotrophin-3 levels were significantly higher in the training group than in the HF group (p < 0.05). However, there was no significant difference according to the exercise intensity among the groups. Conclusions: The results of this study suggested that low-intensity exercise is as effective as a high-intensity exercise in preventing the decline of cognitive function and lipolysis, and far more effective in terms of an expected efficiency of workload and prevention of side effects.

Emotional stimulation during motor exercise: An integration to the holistic rehabilitation framework

Over the recent years, plenty of studies have been carried out concerning disabilities and rehabilitation. However, very few of them have focused on proposing or creating a holistic framework meant to maximize the merits of rehabilitation treatments. More importantly, an even smaller number has taken into consideration the immense impact of emotions and the crucial role they display concerning patients' performance during rehabilitation. The purpose of this study is to examine and highlight the direct connection of patients' performance quality with an artificially induced positive or negative emotional state. For that reason, we conducted an experiment regarding the convergence of emotions with the motor exercise. Specifically, our study was conducted with 45 participants and the GAPED database was employed as an emotional classifier. The effect of the visual stimulus was combined with a simple bicep exercise which introduces the motor element in our study. Statistical analysis of the yielding EMG & Acellerometer signals demonstrated a considerable difference in the quality of the physical activity of each subject induced by different emotional triggers. As a result, it is pivotal to integrate a holistic approach to rehabilitation in future clinical trials, aiming to reinforce the patient involvement and engagement process and thus the efficacy of the treatment.