Role of exercise on the brain

Effects of Physical Exercise on Executive Function in Schizophrenia: Systematic Review and Meta-Analysis

Executive functions are often impaired in individuals with schizophrenia spectrum disorders. Understanding the impact of physical exercise on these cognitive domains is essential for developing effective interventions. The aim of this review is to assess the effect of physical exercise on executive functions in adults diagnosed with schizophrenia spectrum disorders. A systematic search was conducted in Web of Science, PubMed, Scopus, and EBSCO, initially from inception through January 2024, followed by an update through January 2025. Studies involved adults diagnosed with schizophrenia spectrum disorders, employed physical exercise as an intervention, and measured executive functions as outcomes. The selection followed PRISMA guidelines, with inclusion determined by consensus among multiple reviewers. Data extraction and risk of bias assessment were conducted independently by two reviewers using the Cochrane RoB 2 tool and GRADE approach for certainty of evidence. Meta-analyses were performed using random-effects models, with effect sizes (ES) and 95% confidence intervals (CI) calculated for each outcome. From 1517 records, 9 studies were included in the meta-analysis. The analysis revealed a small but significant effect of physical exercise on working memory (ES = 0.300, 95% CI = 0.060-0.539, p = 0.014; I2 = 0.0%, Q = 2.2, p = 0.951) and a non-significant effect on emotion recognition (ES = 0.51, 95% CI = -0.291-1.303, p = 0.213; I2 = 83%), inhibition (ES = 0.156, 95% CI = -0.173 to 0.484, p = 0.353; I2 = 0.0%, Q = 1.1, p = 0.781), and cognitive flexibility (ES = 0.240, 95% CI = -0.270 to 0.749, 95% PI = -1.706 to 2.185; p = 0.356; I2 = 53.2%, Q = 3.0, p = 0.094). Physical exercise, particularly aerobic exercise, appears to have a small beneficial effect on working memory in individuals with schizophrenia spectrum disorders. However, the evidence for its effect on emotion recognition is less clear and may be influenced by the type of exercise, such as yoga. Further research is needed to provide more robust conclusions. PROSPERO registration number: CRD42023392295.

Neuro-Nutrition and Exercise Synergy: Exploring the Bioengineering of Cognitive Enhancement and Mental Health Optimization

The interplay between nutrition, physical activity, and mental health has emerged as a frontier in bioengineering research, offering innovative pathways for enhancing cognitive function and psychological resilience. This review explores the neurobiological mechanisms underlying the synergistic effects of tailored nutritional strategies and exercise interventions on brain health and mental well-being. Key topics include the role of micronutrients and macronutrients in modulating neurogenesis and synaptic plasticity, the impact of exercise-induced myokines and neurotrophins on cognitive enhancement, and the integration of wearable bioelectronics for personalized monitoring and optimization. By bridging the disciplines of nutrition, psychology, and sports science with cutting-edge bioengineering, this review highlights translational opportunities for developing targeted interventions that advance mental health outcomes. These insights are particularly relevant for addressing global challenges such as stress, anxiety, and neurodegenerative diseases. The article concludes with a roadmap for future research, emphasizing the potential of bioengineered solutions to revolutionize preventive and therapeutic strategies in mental health care.

Physical Exercise Prevents the Cognitive Decline among Older Adults in Romania

Cognitive decline is one of the most important challenges related to the aging process, due to its important impact on individuals. Several studies have reported that physical exercise with a specific intensity and frequency is beneficial for maintaining cognitive health in the ageing population. The present study investigated the impact of general physical exercise on cognitive health in the older population in Romania. The study involved 60 individuals (60% male, 40% female), with a mean age of 60.78 years (SD = 2.97). The Health Interview Survey and The Minnesota Heart Survey assessed exercise frequency and intensity, while the Montreal Cognitive Assessment (MoCA) determined mild cognitive impairment (MCI) levels. The results of the statistical analysis showed that high-intensity physical exercise at a frequency of three to four times a week at the age of 40-50 years is recommended in order to significantly reduce cognitive decline. In addition, for the age of 60 years old, the results established that engaging in physical activities of a moderate intensity with a frequency of 2-3 times per month is sufficient to maintain healthy cognition. The findings suggest that exercise can serve as a behavioral intervention to mitigate cognitive dysfunction and complement past research on its cognitive health advantages.

Acute effects of high-intensity exercise on brain mechanical properties and cognitive function

Previous studies have shown that engagement in even a single session of exercise can improve cognitive performance in the short term. However, the underlying physiological mechanisms contributing to this effect are still being studied. Recently, with improvements to advanced quantitative neuroimaging techniques, brain tissue mechanical properties can be sensitively and noninvasively measured with magnetic resonance elastography (MRE) and regional brain mechanical properties have been shown to reflect individual cognitive performance. Here we assess brain mechanical properties before and immediately after engagement in a high-intensity interval training (HIIT) regimen, as well as one-hour post-exercise. We find that immediately after exercise, subjects in the HIIT group had an average global brain stiffness decrease of 4.2% (p < 0.001), and an average brain damping ratio increase of 3.1% (p = 0.002). In contrast, control participants who did not engage in exercise showed no significant change over time in either stiffness or damping ratio. Changes in brain mechanical properties with exercise appeared to be regionally dependent, with the hippocampus decreasing in stiffness by 10.4%. We also found that one-hour after exercise, brain mechanical properties returned to initial baseline values. The magnitude of changes to brain mechanical properties also correlated with improvements in reaction time on executive control tasks (Eriksen Flanker and Stroop) with exercise. Understanding the neural changes that arise in response to exercise may inform potential mechanisms behind improvements to cognitive performance with acute exercise.

Does acute aerobic exercise enhance selective attention, working memory, and problem-solving abilities in Alzheimer's patients? A sex-based comparative study

Introduction

The present study aimed to evaluate the effect of acute aerobic exercise on certain cognitive functions known to be affected by Alzheimer's disease (AD), with a particular emphasis on sex differences.

Methods

A total of 53 patients, with a mean age of 70.54 ± 0.88 years and moderate AD, voluntarily participated in the study. Participants were randomly assigned to two groups: the experimental group (EG), which participated in a 20-min moderate-intensity cycling session (60% of the individual maximum target heart rate recorded at the end of the 6-min walk test); and the control group (CG), which participated in a 20-min reading activity. Cognitive abilities were assessed before and after the physical exercise or reading session using the Stroop test for selective attention, the forward and backward digit span test for working memory, and the Tower of Hanoi task for problem-solving abilities.

Results

At baseline, both groups had comparable cognitive performance (p > 0.05 in all tests). Regardless of sex, aerobic acute exercise improved attention in the Stroop test (p < 0.001), enhanced memory performance in both forward (p < 0.001) and backward (p < 0.001) conditions, and reduced the time required to solve the problem in the Tower of Hanoi task (p < 0.001). No significant differences were observed in the number of movements. In contrast, the CG did not significantly improve after the reading session for any of the cognitive tasks (p > 0.05). Consequently, the EG recorded greater performance improvements than the CG in most cognitive tasks tested (p < 0.0001) after the intervention session.

Discussion

These findings demonstrate that, irrespective to sex, a single aerobic exercise session on an ergocycle can improve cognitive function in patients with moderate AD. The results suggest that acute aerobic exercise enhances cognitive function similarly in both female and male patients, indicating promising directions for inclusive therapeutic strategies.

The newly discovered glymphatic system: the missing link between physical exercise and brain health?

Dementias are responsible for the most frequent neurodegenerative diseases and the seventh leading cause of death worldwide. As a result, there is a growing effort by the neuroscientific community to understand the physiopathology of neurodegenerative diseases, including how to alleviate the effects of the cognitive decline by means of non-pharmacological therapies (e.g., physical exercise). Studies have shown that exercise can improve aspects of brain health related to cognition. However, there still needs to be more knowledge regarding the mechanisms controlling these relationships, and a newly discovered cleansing system in the brain, named the glymphatic system, can be the missing link in this mechanism. The objective of this paper is to review recent findings regarding the potential impacts of physical exercise on the glymphatic system and its implications for the onset of neurodegenerative diseases. Additionally, considering the close interplay between exercise and sleep quality, we aim to explore how sleep patterns may intersect with exercise-induced effects on glymphatic function, further elucidating the complex relationship between lifestyle factors and brain health.

Motion prediction using brain waves based on artificial intelligence deep learning recurrent neural network

Electroencephalogram (EEG) research has gained widespread use in various research domains due to its valuable insights into human body movements. In this study, we investigated the optimization of motion discrimination prediction by employing an artificial intelligence deep learning recurrent neural network (gated recurrent unit, GRU) on unique EEG data generated from specific movement types among EEG signals. The experiment involved participants categorized into five difficulty levels of postural control, targeting gymnasts in their twenties and college students majoring in physical education (n=10). Machine learning techniques were applied to extract brain-motor patterns from the collected EEG data, which consisted of 32 channels. The EEG data underwent spectrum analysis using fast Fourier transform conversion, and the GRU model network was utilized for machine learning on each EEG frequency domain, thereby improving the performance index of the learning operation process. Through the development of the GRU network algorithm, the performance index achieved up to a 15.92% improvement compared to the accuracy of existing models, resulting in motion recognition accuracy ranging from a minimum of 94.67% to a maximum of 99.15% between actual and predicted values. These optimization outcomes are attributed to the enhanced accuracy and cost function of the GRU network algorithm's hidden layers. By implementing motion identification optimization based on artificial intelligence machine learning results from EEG signals, this study contributes to the emerging field of exercise rehabilitation, presenting an innovative paradigm that reveals the interconnectedness between the brain and the science of exercise.

Impact of exercising alone and exercising with others on the risk of cognitive impairment among older Japanese adults

PURPOSE

This longitudinal study investigates the influence of the stratified frequency of exercising alone and exercising with others on the prevention of cognitive impairment among older Japanese adults.

METHODS

This four-year follow-up study targeted 4,358 individuals (mean age: 76.9 ± 5.6 years, female: 51.8%) who participated in an inventory mail survey in one region of Japan. The exercise forms surveyed involved the frequency of exercising alone and with others. Cognitive impairment was assessed using the nationally standardized dementia scale proposed by the Ministry of Health, Labour and Welfare of Japan. Adjusted Cox proportional-hazard models were used to examine the association between the exercise forms and the development of cognitive impairment, and calculate population-attributable fractions (PAFs).

RESULTS

The cumulative incidence of cognitive impairment throughout the study was 7.7%. Participants who exercised ≥ 2 times/week alone (hazard ratio [HR] = 0.78; 95% confidence interval [CI] = 0.61-0.998) had a lower risk of developing cognitive impairment than those who did not exercise alone. Similarly, participants who exercised ≥ 2 times/week with others (HR = 0.66; 95% CI = 0.47-0.94) showed a lower risk of developing cognitive impairment than those who did not exercise with others. The scenarios involving PAFs demonstrated that, if all participants exercised alone or with others ≥ 2 times/week, the risk of cognitive impairment decreased by 15.1% and 29.2%, respectively.

CONCLUSION

Both forms of exercise reduced the development of cognitive impairment, with exercising with others potentially being highly effective in preventing cognitive impairment.

Effect of Combined Exercise Training on Physical and Cognitive Function in Women With Type 2 Diabetes

OBJECTIVES

One of the consequences of old age is cognitive and physical decline, which can cause a wide range of problems. These complications are more pronounced in those with type 2 diabetes (T2D). The aim of this pilot study was to investigate the effect of combined exercise training on blood biomarkers, physical fitness, and cognitive function in elderly women with T2D.

METHODS

Twenty-one elderly women with T2D were randomly allocated to training (n=12) and control (n=9) groups. The exercise training program was a combination of aerobic, resistance, and balance exercises performed 3 times per week over 12 weeks. In the same period, the control group received no training intervention. Blood markers, including brain-derived neurotrophic factor (BDNF), irisin, glycated hemoglobin (A1C), fasting blood sugar (FBS), cardiorespiratory fitness (CRF), lower and upper body strength, and cognitive function, were measured in all participants at baseline and after 12 weeks.

RESULTS

Serum BDNF levels were not significantly different between the exercise and control groups at 12 weeks (p>0.05). FBS and A1C levels in the exercise group decreased significantly compared with the control group (p<0.05). CRF, dynamic balance, and both upper and lower body strength in the exercise group improved significantly compared with the control group (p<0.05). Irisin levels decreased significantly in the control group, but levels did not change significantly in the exercise group. Greater improvements from exercise were observed on the Montreal Cognitive Assessment index compared with the control group (p=0.05), but no other group differences in cognitive function were noted.

CONCLUSIONS

Combined exercise improved some physical fitness and diabetes-related surrogate factors, as well as select cognitive functions, but had no significant effect on cognition-related biochemical factors (i.e. BDNF) in women with T2D.

Amyloid Beta in Aging and Alzheimer's Disease

Alzheimer's disease (AD), is a progressive neurodegenerative disease that affects behavior, thinking, learning, and memory in elderly individuals. AD occurs in two forms, early onset familial and late-onset sporadic; genetic mutations in PS1, PS2, and APP genes cause early onset familial AD, and a combination of lifestyle, environment and genetic factors causes the late-onset sporadic form of the disease. However, accelerated disease progression is noticed in patients with familial AD. Disease-causing pathological changes are synaptic damage, and mitochondrial structural and functional changes, in addition to increased production and accumulation of phosphorylated tau (p-tau), and amyloid beta (Aβ) in the affected brain regions in AD patients. Aβ is a peptide derived from amyloid precursor protein (APP) by proteolytic cleavage of beta and gamma secretases. APP is a glycoprotein that plays a significant role in maintaining neuronal homeostasis like signaling, neuronal development, and intracellular transport. Aβ is reported to have both protective and toxic effects in neurons. The purpose of our article is to summarize recent developments of Aβ and its association with synapses, mitochondria, microglia, astrocytes, and its interaction with p-tau. Our article also covers the therapeutic strategies that reduce Aβ toxicities in disease progression and discusses the reasons for the failures of Aβ therapeutics.

Moderate physical activity alters the estimation of time, but not space

Moderate physical activity can influence cognitive functions and visual cortical activity. However, little is known about the effects of exercise on fundamental perceptual domains, such as spatial and temporal representation. Here we tackled this issue by testing the impact of physical activity on a temporal estimation task in a group of adult volunteers in three different conditions: (1) in a resting condition (baseline), (2) during moderate physical activity (cycling in place – PA), and (3) approximately 15 to 20 min following the physical activity phase, in which participants were seated and returned to a regular heart rate (POST). We show that physical activity specifically impacts time perception, inducing a consistent overestimation for durations in the range of milliseconds. Notably, the effect persisted in the POST session, ruling out the main contribution of either heart rate or cycling rhythmicity. In a control experiment, we found that spatial perception (distance estimation) was unaffected by physical activity, ruling out a major contribution of arousal and fatigue to the observed temporal distortion. We speculate that physical exercise might alter temporal estimation either by up-regulating the dopaminergic system or modulating GABAergic inhibition.

Early Life Stress Affects Bdnf Regulation: A Role for Exercise Interventions

Early life stress (ELS) encompasses exposure to aversive experiences during early development, such as neglect or maltreatment. Animal and human studies indicate that ELS has maladaptive effects on brain development, leaving individuals more vulnerable to developing behavioral and neuropsychiatric disorders later in life. This result occurs in part to disruptions in Brain derived neurotrophic factor (Bdnf) gene regulation, which plays a vital role in early neural programming and brain health in adulthood. A potential treatment mechanism to reverse the effects of ELS on Bdnf expression is aerobic exercise due to its neuroprotective properties and positive impact on Bdnf expression. Aerobic exercise opens the door to exciting and novel potential treatment strategies because it is a behavioral intervention readily and freely available to the public. In this review, we discuss the current literature investigating the use of exercise interventions in animal models of ELS to reverse or mitigate ELS-induced changes in Bdnf expression. We also encourage future studies to investigate sensitive periods of exercise exposure, as well as sufficient duration of exposure, on epigenetic and behavioral outcomes to help lead to standardized practices in the exercise intervention field.

Multimodal Benefits of Exercise in Patients With Multiple Sclerosis and COVID-19

Multiple sclerosis (MS) is a demyelinating disease characterized by plaque formation and neuroinflammation. The plaques can present in various locations, causing a variety of clinical symptoms in patients with MS. Coronavirus disease-2019 (COVID-19) is also associated with systemic inflammation and a cytokine storm which can cause plaque formation in several areas of the brain. These concurring events could exacerbate the disease burden of MS. We review the neuro-invasive properties of SARS-CoV-2 and the possible pathways for the entry of the virus into the central nervous system (CNS). Complications due to this viral infection are similar to those occurring in patients with MS. Conditions related to MS which make patients more susceptible to viral infection include inflammatory status, blood-brain barrier (BBB) permeability, function of CNS cells, and plaque formation. There are also psychoneurological and mood disorders associated with both MS and COVID-19 infections. Finally, we discuss the effects of exercise on peripheral and central inflammation, BBB integrity, glia and neural cells, and remyelination. We conclude that moderate exercise training prior or after infection with SARS-CoV-2 can produce health benefits in patients with MS patients, including reduced mortality and improved physical and mental health of patients with MS.

Physical Activity Intensity and Suspected Dementia in Older Japanese Adults: A Dose-Response Analysis Based on an 8-Year Longitudinal Study

Background: Moderate- to vigorous-intensity physical activity (PA) may reduce the risk of dementia; however, few studies have examined the effects of PA intensity on dementia risk. Objective: To prospectively examine the dose-response relationship of PA intensity with the incidence of suspected dementia in community-dwelling older adults. Methods: We conducted a baseline mail survey with an 8-year follow-up of 3,722 older adults in Japan. We assessed PA levels using the International Physical Activity Questionnaire short form and calculated the amount of time per week spent performing moderate- and vigorous-intensity PA (VPA). Information regarding suspected dementia was obtained from the city database during the follow-up period. Cox proportional-hazard models with age as time scale, and delayed entry and restricted cubic spline regression as variables were used to estimate risk of developing suspected dementia, excluding cases occurring <  1 year after baseline evaluation. Results: The cumulative incidence of suspected dementia during the follow-up period was 12.7% . Compared with those who did not practice moderate-intensity PA (MPA), those who practiced≥300 min (hazard ratio, 0.73; 95% confidence interval 0.56–0.95) of MPA showed a lower risk of developing suspected dementia. Furthermore, when the dose-response relationship was examined, the hazard of developing suspected dementia decreased almost linearly with MPA. A significantly lower hazard was observed from 815 minutes/week. There was no significant association between VPA and suspected dementia. Conclusion: This study suggested that MPA is often practiced in older adults and this PA intensity has a sufficiently favorable effect on dementia prevention.

A callosal biomarker of behavioral intervention outcomes for autism spectrum disorder? A case-control feasibility study with diffusion tensor imaging

Tentative results from feasibility analyses are critical for planning future randomized control trials (RCTs) in the emerging field of neural biomarkers of behavioral interventions. The current feasibility study used MRI-derived diffusion imaging data to investigate whether it would be possible to identify neural biomarkers of a behavioral intervention among people diagnosed with autism spectrum disorder (ASD). The corpus callosum has been linked to cognitive processing and callosal abnormalities have been previously found in people diagnosed with ASD. We used a case-control design to evaluate the association between the type of intervention people diagnosed with ASD had previously received and their current white matter integrity in the corpus callosum. Twenty-six children and adolescents with ASD, with and without a history of parent-managed behavioral intervention, underwent an MRI scan with a diffusion data acquisition sequence. We conducted tract-based spatial statistics and a region of interest analysis. The fractional anisotropy values (believed to indicate white matter integrity) in the posterior corpus callosum was significantly different across cases (exposed to parent-managed behavioral intervention) and controls (not exposed to parent-managed behavioral intervention). The effect was modulated by the intensity of the behavioral intervention according to a dose-response relationship. The current feasibility case-control study provides the basis for estimating the statistical power required for future RCTs in this field. In addition, the study demonstrated the effectiveness of purposely-developed motion control protocols and helped to identify regions of interest candidates. Potential clinical applications of diffusion tensor imaging in the evaluation of treatment outcomes in ASD are discussed.

The UP150: A Multifactorial Environmental Intervention to Promote Employee Physical and Mental Well-Being

Physical activity (PA) is a major health factor and studies suggest workplaces could promote PA by modifying office design, motivational strategies and technology. The present study aims to evaluate the efficiency of UP150, a multifactorial workplace intervention for the improvement and maintenance of the level of physical fitness (PF) and wellbeing. Forty-five employees were randomly divided into the experimental (EG) and control (CG) groups. The PF was assessed pre-post intervention using the cubo fitness test (CFT), the amount of PA was evaluated using the IPAQ questionnaire and accelerometers while the workload was assessed using the NASA-TLX questionnaire and psycho-physical health by using the SF-12 questionnaire. The EG worked in UP150 offices while the CG worked in their usual offices for 8 weeks. The EG and CG came back 4 weeks after the intervention for CFT retention. The EG improved CFT motor efficiency and the amount of moderate PA, while it reduced mental load. The EG retained reached motor efficiency levels 4 weeks after the intervention. No differences were found in IPAQ. The UP150 demonstrated to be a proactive environment and to be efficient in the promotion of PA, improving PF and mental health while decreasing mental load.

Physical exercise therapy for autoimmune neuroinflammation: Application of knowledge from animal models to patient care

Physical exercise (PE) impacts various autoimmune diseases. Accordingly, clinical trials demonstrated the safety of PE in multiple sclerosis (MS) patients and indicated beneficial outcomes. There is also an increasing body of research on the beneficial effects of exercise on experimental autoimmune encephalomyelitis (EAE), the animal model of MS, and various mechanisms underlying these effects were suggested. However, despite the documented favorable impact of PE on our health, we still lack a thorough understanding of its effects on autoimmune neuroinflammation and specific guidelines of PE therapy for MS patients are lacking. To that end, current findings on the impact of PE on autoimmune neuroinflammation, both in human MS and animal models are reviewed. The concept of personalized PE therapy for autoimmune neuroinflammation is discussed, and future research for providing biological rationale for clinical trials to pave the road for precise PE therapy in MS patients is described.

Resistance Exercise Improves Spatial Learning Ability Through Phosphorylation of 5'-Adenosine Monophosphate-Activated Protein Kinase in Parkinson Disease Mice

Purpose

Exercise is a representative noninvasive treatment that can be applied to various diseases. We studied the effect of resistance exercise on motor function and spatial learning ability in Parkinson disease (PD) mice.

Methods

The rotarod test and beam walking test were conducted to evaluate the effect of resistance exercise on motor function, and the Morris water maze test was conducted to examine the effect of resistance exercise on spatial learning ability. The effect of resistance exercise on brain-derived neurotrophic factor (BDNF) and tropomyosin receptor kinase B (TrkB) expression and 5’-adenosine monophosphate-activated protein kinase (AMPK) phosphorylation was investigated by Western blot analysis. New cell generation was confirmed by immunohistochemistry for 5-bromo-2’-deoxyuridine.

Results

Resistance exercise improved coordination, balance, and spatial learning ability in PD mice. Resistance exercise enhanced new cell production, BDNF and TrkB expression, and AMPK phosphorylation in PD mice. The effect of such resistance exercise was similar to that of levodopa application.

Conclusions

In PD-induced mice, resistance exercise enhanced AMPK phosphorylation to increase BDNF expression and new neuron generation, thereby improving spatial learning ability. Resistance exercise is believed to help improve symptoms of PD.

Harnessing the effects of endurance exercise to optimize cognitive health: Fundamental insights from Dr. Mark P. Mattson

Dr. Mark Mattson has had a highly productive and impactful tenure as a neuroscientist at the Intramural Research Program of the National Institute on Aging. He has made notable contributions to understanding the mechanisms by which energetic stress, imparted by behaviors such as physical activity and periods of fasting, promotes rejuvenation and resilience within brain regions critical for learning and memory. In honor of Dr. Mattson's work, this manuscript will highlight the fascinating mechanisms by which endurance exercise training conveys beneficial effects upon the structure and function of the nervous system; that is, by mediating the synthesis and secretion of factors that directly support brain homeostasis, including brain-derived neurotrophic factor, FNDC5/irisin, ketone bodies, growth factors, cathepsin B, serotonin, and 4-hydroxynonenal. The molecular and cellular effects of these factors are discussed herein. In the face of population aging and an overwhelming surge in the prevalence of Alzheimer's disease and related disorders, Dr. Mattson's work as a champion and role model for physically active lifestyles is more important than ever.

Exercise and the brain in multiple sclerosis

While people with multiple sclerosis (PwMS) historically were advised to avoid physical activity to reduce symptoms such as fatigue, they are now encouraged to remain active and to enlist in programs of exercise. However, despite an extensive current literature that exercise not only increases physical well-being but also their cognition and mental health, many PwMS are not meeting recommended levels of exercise. Here, we emphasize the impact and mechanisms of exercise on functional and structural changes to the brain, including improved connectome, neuroprotection, neurogenesis, oligodendrogenesis, and remyelination. We review evidence from animal models of multiple sclerosis (MS) that exercise protects and repairs the brain, and provide supportive data from clinical studies of PwMS. We introduce the concept of MedXercise, where exercise provides a brain milieu particularly conducive for a brain regenerative medication to act upon. The emphasis on exercise improving brain functions and repair should incentivize PwMS to remain physically active.

Voluntary Physical Exercise Reduces Motor Dysfunction and Hampers Tumor Cell Proliferation in a Mouse Model of Glioma

Currently, high-grade gliomas are the most difficult brain cancers to treat and all the approved experimental treatments do not offer long-term benefits regarding symptom improvement. Epidemiological studies indicate that exercise decreases the risk of brain cancer mortality, but a direct relationship between physical exercise and glioma progression has not been established so far. Here, we exploited a mouse model of high-grade glioma to directly test the impact of voluntary physical exercise on the tumor proliferation and motor capabilities of affected animals. We report that exposing symptomatic, glioma-bearing mice to running wheels (i) reduced the proliferation rate of tumors implanted in the motor cortex and (ii) delayed glioma-induced motor dysfunction. Thus, voluntary physical exercise might represent a supportive intervention that complements existing neuro-oncologic therapies, contributing to the preservation of functional motor ability and counteracting the detrimental effects of glioma on behavioral output.

Impact of exercise on hippocampal neurogenesis in hyperglycemic diabetes

Hyperglycemic diabetes is a chronic metabolic disorder characterized by high level of plasma glucose. Numerous studies have shown that hy-perglycemic diabetes leads to brain dysfunction including cognitive im-pairment and emotional disorders. This study evaluated the impact of exercise on brain dysfunction, hippocampal neurogenesis, and cogni-tive impairment in hyperglycemic diabetes. The present study suggests that exercise improves hyperglycemic control and prevents decline of cognition through increasing hippocampal neurogenesis. Understanding the mechanism of exercise for hippocampal neurogenesis can lead to the development of therapeutic strategies for metabolic disorders.

Physical activity types and risk of dementia in community-dwelling older people: the Three-City cohort

BACKGROUND

Physical activity may decrease the risk of dementia; however, previous cohort studies seldom investigated the different types of physical activity and household activities. Our objective was to analyze the links between two physical activity types and dementia in older people.

METHODS

The study used data from the prospective observational Three-city cohort and included 1550 community-dwelling individuals aged 72 to 87 without dementia at baseline. Physical activity was assessed with the Voorrips questionnaire. Two sub-scores were calculated to assess household/transportation activities and leisure/sport activities. Restricted cubic spline and proportional hazard Cox models were used to estimate the non-linear exposure-response curve for the dementia risk and the appropriate activity level thresholds. Models were adjusted for possible confounders, including socio-demographic variables, comorbidities, depressive symptoms and APOE genotype.

RESULTS

The median age was 80 years, and 63.6% of participants were women. After a median follow-up of 4.6 years, dementia was diagnosed in 117 participants (7.6%). An inverse J-shaped association was found between household/transportation physical activity sub-score and dementia risk, which means that the risk is lowest for the moderately high values and then re-increases slightly for the highest values. The results remained significant when this sub-score was categorized in three classes (low, moderate, and high), with hazard ratios (95% confidence interval) of 0.55 (0.35-0.87) and 0.62 (0.38-1.01) for moderate and high activity levels, respectively. No significant effect was found for leisure/sport activities.

CONCLUSIONS

The 5-year risk of dementia was significantly and negatively associated with the household/transportation activity level, but not with the leisure and sport activity sub-score. This highlights the importance of considering all physical activity types in 72 years or older people.

Effect of aerobic exercise combined with cognitive remediation on cortical thickness and prediction of social adaptation in patients with schizophrenia

Aerobic exercise is a promising intervention for patients with schizophrenia, but structural neuroplastic effects on brain regions relevant to the pathophysiology of the disease remain unclear. This study aimed to elucidate longitudinal changes in cortical thickness after aerobic exercise intervention in schizophrenia patients and the relationship of these changes to clinical correlates. We investigated 21 schizophrenia patients and 23 healthy controls who performed aerobic exercise and 21 schizophrenia patients who played table soccer. The 12-week exercise intervention was combined with computer-assisted cognitive remediation training from week 6 to week 12. Magnetic resonance imaging (MRI) scans were acquired at baseline and weeks 6, 12, and 24. The thickness of the entorhinal, parahippocampal, and lateral and medial prefrontal cortices was assessed with FreeSurfer 6.0. The schizophrenia aerobic exercise group showed a significant increase of cortical thickness in the right entorhinal cortex at week 6, and we found a significant correlation between the cortical thickness of the right lateral prefrontal cortex at baseline and improvement of social adaptation at week 12. In the schizophrenia table soccer and healthy control groups, we found no significant longitudinal change in cortical thickness through the intervention and follow-up period and no correlation of cortical thickness at baseline with clinical measures. Our results suggest that aerobic exercise in schizophrenia modulates the thickness of the entorhinal cortex, a structure adjacent to the hippocampus. Greater cortical thickness of the right lateral prefrontal cortex appears to predict better clinical response to an aerobic exercise intervention in patients with schizophrenia.

The role of exercise in brain DNA damage

Cells are constantly subjected to cytotoxic and genotoxic insults resulting in the accumulation of unrepaired damaged DNA, which leads to neuronal death. In this way, DNA damage has been implicated in the pathogenesis of neurological disorders, cancer, and aging. Lifestyle factors, such as physical exercise, are neuroprotective and increase brain function by improving cognition, learning, and memory, in addition to regulating the cellular redox milieu. Several mechanisms are associated with the effects of exercise in the brain, such as reduced production of oxidants, up-regulation of antioxidant capacity, and a consequent decrease in nuclear DNA damage. Furthermore, physical exercise is a potential strategy for further DNA damage repair. However, the neuroplasticity molecules that respond to different aspects of physical exercise remain unknown. In this review, we discuss the influence of exercise on DNA damage and adjacent mechanisms in the brain. We discuss the results of several studies that focus on the effects of physical exercise on brain DNA damage.

Does brain-derived neurotrophic factor mediate the effects of exercise on memory?

Objective: Brain-derived neurotrophic factor (BDNF) has been hypothesized as a potential mechanism through which exercise may subserve memory function. The present review specifically evaluates this hypothesis.Methods: Studies were identified using electronic databases, including PubMed, PsychInfo, Sports Discus and Google Scholar.Results: In total, 52 articles met the study criteria, and among these, 36 were conducted in an animal model and 16 among humans. Among the animal experiments, 100% of them demonstrated that chronic exercise improved memory function; 97% demonstrated an exercise-induced increase in BDNF; and among the eight evaluating BDNF as a mediator, 100% provided evidence that BDNF mediated the relationship between exercise and memory. The findings in the human studies were mixed. Among the human studies, 44% demonstrated that varying exercise protocols improved memory and increased BDNF levels, and among the studies evaluating BDNF as a mediator, 40% provided evidence that BDNF mediated the relationship between exercise and memory.Conclusion: In animal models, chronic exercise training robustly increases BDNF and improves memory performance, with reasonable evidence to also suggest that BDNF may mediate the exercise-memory interaction. These interrelationships, however, are less clear among humans. Future research among humans, in particular, is needed to evaluate the extent to which BDNF may mediate the relationship between exercise and memory.

Modulation of Cognition: The Role of Gnidia glauca on Spatial Learning and Memory Retention in High-Fat Diet-Induced Obese Rats

Chronic exposures to high-fat diets are linked to neuropathological changes that culminate in obesity-related cognitive dysfunction and brain alteration. Learning, memory performance, and executive function are the main domains affected by an obesogenic diet. There are limited effective therapies for addressing cognitive deficits. Thus, it is important to identify additional and alternative therapies. In African traditional medicine, Gnidia glauca has putative efficacy in the management of obesity and associated complications. The use of Gnidia glauca is largely based on its long-term traditional use. Its therapeutic application has not been accompanied by sufficient scientific evaluation to validate its use. Therefore, the current study sought to explore the modulatory effects of dichloromethane leaf extracts of Gnidia glauca on cognitive function in the high-fat diet- (HFD-) induced obese rats. Obesity was induced by feeding the rats with prepared HFD and water ad libitum for 6 weeks. The in vivo antiobesity effects were determined by oral administration of G. glauca at dosage levels of 200, 250, and 300 mg/kg body weight in HFD-induced obese rats from the 6th to the 12th weeks. The Lee obesity index was used as a diagnostic criterion of obesity. The Morris water maze was employed to test spatial learning and memory retention in rats. The results indicated that Gnidia glauca showed potent antiobesity effects as indicated in the reduction of body weight and obesity index in extract-treated rats. Moreover, Gnidia glauca exhibited cognitive-enhancing effects in obese rats. The positive influences on cognitive functions might be attributed to the extracts' phytochemicals that have been suggested to confer protection against obesity-induced oxidative damage, reduction of central inflammation, and increased neurogenesis. The therapeutic effects observed suggest that Gnidia glauca might be an alternative to current medications for the symptomatic complications of obesity, such as learning and memory loss. Further studies are therefore needed to establish its toxicity profiles.

Evaluation of exercise-induced modulation of glial activation and dopaminergic damage in a rat model of Parkinson's disease using [11C]PBR28 and [18F]FDOPA PET

Evidence suggests that exercise can modulate neuroinflammation and neuronal damage. We evaluated if such effects of exercise can be detected with positron emission tomography (PET) in a rat model of Parkinson's disease (PD). Rats were unilaterally injected in the striatum with 6-hydroxydopamine (PD rats) or saline (controls) and either remained sedentary (SED) or were forced to exercise three times per week for 40 min (EX). Motor and cognitive functions were evaluated by the open field, novel object recognition, and cylinder tests. At baseline, day 10 and 30, glial activation and dopamine synthesis were assessed by [¹¹C]PBR28 and [¹⁸F]FDOPA PET, respectively. PET data were confirmed by immunohistochemical analysis of microglial (Iba-1) / astrocyte (GFAP) activation and tyrosine hydroxylase (TH). [¹¹C]PBR28 PET showed increased glial activation in striatum and hippocampus of PD rats at day 10, which had resolved at day 30. Exercise completely suppressed glial activation. Imaging results correlated well with post-mortem Iba-1 staining, but not with GFAP staining. [¹⁸F]FDOPA PET, TH staining and behavioral tests indicate that 6-OHDA caused damage to dopaminergic neurons, which was partially prevented by exercise. These results show that exercise can modulate toxin-induced glial activation and neuronal damage, which can be monitored noninvasively by PET.

Physical Exercise for Individuals with Hypertension: It Is Time to Emphasize its Benefits on the Brain and Cognition

Hypertension affects more than 40% of adults worldwide and is associated with stroke, myocardial infarction, heart failure, and other cardiovascular diseases. It has also been shown to cause severe functional and structural damage to the brain, leading to cognitive impairment and dementia. Furthermore, it is believed that these cognitive impairments affect the mental ability to maintain productivity at work, ultimately causing social and economic problems. Because hypertension is a chronic condition that requires clinical treatment, strategies with fewer side effects and less-invasive procedures are needed. Physical exercise (PE) has proven to be an efficient and complementary tool for hypertension management, and its peripheral benefits have been widely supported by related studies. However, few studies have specifically examined the potential positive effects of PE on the brain in hypertensive individuals. This narrative review discusses the pathophysiological mechanisms that hypertension promotes in the brain, and suggests PE as an important tool to prevent and reduce cognitive damage caused by hypertension. We also provide PE recommendations for hypertensive individuals, as well as suggestions for promoting PE as a method for increasing cognitive abilities in the brain, particularly for hypertensive individuals.

A new counterintuitive training for adult amblyopia

Objectives

The aim of this study was to investigate whether short-term inverse occlusion, combined with moderate physical exercise, could promote the recovery of visual acuity and stereopsis in a group of adult anisometropic amblyopes.

Methods

Ten adult anisometropic patients underwent six brief (2 h) training sessions over a period of 4 weeks. Each training session consisted in the occlusion of the amblyopic eye combined with physical exercise (intermittent cycling on a stationary bike). Visual acuity (measured with ETDRS charts), stereoacuity (measured with the TNO test), and sensory eye dominance (measured with binocular rivalry) were tested before and after each training session, as well as in follow-up visits performed 1 month, 3 months, and 1 year after the end of the training.

Results

After six brief (2 h) training sessions, visual acuity improved in all 10 patients (0.15 ± 0.02 LogMar), and six of them also recovered stereopsis. The improvement was preserved for up to 1 year after training. A pilot experiment suggested that physical activity might play an important role for the recovery of visual acuity and stereopsis.

Conclusions

Our results suggest a noninvasive training strategy for adult human amblyopia based on an inverse-occlusion procedure combined with physical exercise.

Rewiring the Addicted Brain Through a Psychobiological Model of Physical Exercise

Drug addiction is a worldwide public health problem, resulting from multiple phenomena, including those both social and biological. Chronic use of psychoactive substances has been shown to induce structural and functional changes in the brain that impair cognitive control and favor compulsive seeking behavior. Physical exercise has been proven to improve brain function and cognition in both healthy and clinical populations. While some studies have demonstrated the potential benefits of physical exercise in treating and preventing addictive behaviors, few studies have investigated its cognitive and neurobiological contributions to drug-addicted brains. Here, we review studies in humans using cognitive behavioral responses and neuroimaging techniques, which reveal that exercise can be an effective auxiliary treatment for drug addictive disorders. Moreover, we describe the neurobiological mechanisms by which exercise-induced neuroplasticity in the prefrontal cortex improves executive functions and may decrease compulsive behaviors in individuals prone to substance use disorders. Finally, we propose an integrative cognitive-psychobiological model of exercise for use in future research in drug addiction and practical guidance in clinical settings.

The Neuroprotective Effects of Exercise: Maintaining a Healthy Brain Throughout Aging

Physical activity plays an essential role in maintaining a healthy body, yet it also provides unique benefits for the vascular and cellular systems that sustain a healthy brain. While the benefit of exercise has been observed in humans of all ages, the availability of preclinical models has permitted systematic investigations into the mechanisms by which exercise supports and protects the brain. Over the past twenty-five years, rodent models have shown that increased physical activity elevates neurotrophic factors in the hippocampal and cortical areas, facilitating neurotransmission throughout the brain. Increased physical activity (such as by the voluntary use of a running wheel or regular, timed sessions on a treadmill) also promotes proliferation, maturation and survival of cells in the dentate gyrus, contributing to the process of adult hippocampal neurogenesis. In this way, rodent studies have tremendous value as they demonstrate that an 'active lifestyle' has the capacity to ameliorate a number of age-related changes in the brain, including the decline in adult neurogenesis. Moreover, these studies have shown that greater physical activity may protect the brain health into advanced age through a number of complimentary mechanisms: in addition to upregulating factors in pro-survival neurotrophic pathways and enhancing synaptic plasticity, increased physical activity promotes brain health by supporting the cerebrovasculature, sustaining the integrity of the blood-brain barrier, increasing glymphatic clearance and proteolytic degradation of amyloid beta species, and regulating microglia activation. Collectively, preclinical studies demonstrate that exercise initiates diverse and powerful neuroprotective pathways that may converge to promote continued brain health into old age. This review will draw on both seminal and current literature that highlights mechanisms by which exercise supports the functioning of the brain, and aids in its protection.

Neurobiology of substance use in adolescents and potential therapeutic effects of exercise for prevention and treatment of substance use disorders

Substance use (e.g., alcohol, marijuana, opioids, cocaine., etc,) use often initiates during adolescence, a critical period of physiological and social development marked by an increase in risk-taking due, in part, to heightened motivation to obtain arousal from rewards. Substance use during adolescence has been associated with a greater risk of substance use disorders (SUD) in adulthood. Although use rates for most substances have remained relatively stable, the frequency of marijuana use and the perception that regular marijuana use is not harmful has increased in adolescents. Furthermore, the nonmedical use of opioids has increased, particularly in the South, Midwest, and rural low-income communities. Substance use in adolescence has been associated with adverse structural and functional brain changes and, may exacerbate the natural "imbalance" between frontal/regulatory and cortical-subcortical circuits, leading to further heightened impulsive and reward-driven behaviors. Exercise increases growth and brain-derived neurotrophic factors that stimulate endogenous dopaminergic systems that, in turn, enhance general plasticity, learning, and memory. Exercise may help to reinforce the "naïve" or underdeveloped connections between neurological reward and regulatory processes in adolescence from the "bottom up" and "offset" reward seeking from substances, while concomitantly improving cardiovascular health, as well as academic and social achievement. In this review, we provide an overview of the current state of substance use in adolescents and rationale for the utilization of exercise, particularly "assisted" exercise, which we have shown increases neural activity in cortical-subcortical regions and may modulate brain dopamine levels during adolescence, a unique window of heightened reward sensitivity and neural plasticity, for the prevention and adjunctive treatment of SUD.

Structural Connectivity Related to Persistent Symptoms After Mild TBI in Adolescents and Response to Aerobic Training: Preliminary Investigation

OBJECTIVE

To quantify structural connectivity abnormalities in adolescents with mild traumatic brain injury (mTBI) and to investigate connectivity changes following aerobic training using graph theory and diffusion tensor imaging tractography.

SETTING

Outpatient research setting.

PARTICIPANTS

Twenty-two children (age: 15.83 ± 1.77 years, 10 females) with 4 to 16 weeks of persistent symptoms after mTBI and a matched healthy comparison group.

DESIGN

Randomized clinical trial of aerobic training and stretching comparison combined with case-control comparison.

MAIN MEASURES

(1) Five global network measures: global efficiency (Eglob), mean local efficiency, modularity, normalized clustering coefficient (γ), normalized characteristic path length (λ), and small-worldness (σ). (2) The self-reported Post-Concussion Symptom Inventory score.

RESULTS

At initial enrollment, adolescents with mTBI had significantly lower Eglob and higher γ, λ, and σ (all P < .05) than healthy peers. After the intervention, significantly increased Eglob and decreased λ (both P < .05) were found in the aerobic training group. Improvement in Post-Concussion Symptom Inventory scores was significantly correlated with the Eglob increase and λ decrease in the aerobic training and λ decrease in the stretching comparison group (all P < .05).

CONCLUSION

This pilot study showed initial evidence that structural connectivity analysis was sensitive to brain network abnormalities and may serve as an imaging biomarker in children with persistent symptoms after mTBI.

Automatic machine-learning based identification of jogging periods from accelerometer measurements of adolescents under field conditions

Background

Assessment of health benefits associated with physical activity depend on the activity duration, intensity and frequency, therefore their correct identification is very valuable and important in epidemiological and clinical studies. The aims of this study are: to develop an algorithm for automatic identification of intended jogging periods; and to assess whether the identification performance is improved when using two accelerometers at the hip and ankle, compared to when using only one at either position.

Methods

The study used diarized jogging periods and the corresponding accelerometer data from thirty-nine, 15-year-old adolescents, collected under field conditions, as part of the GINIplus study. The data was obtained from two accelerometers placed at the hip and ankle. Automated feature engineering technique was performed to extract features from the raw accelerometer readings and to select a subset of the most significant features. Four machine learning algorithms were used for classification: Logistic regression, Support Vector Machines, Random Forest and Extremely Randomized Trees. Classification was performed using only data from the hip accelerometer, using only data from ankle accelerometer and using data from both accelerometers.

Results

The reported jogging periods were verified by visual inspection and used as golden standard. After the feature selection and tuning of the classification algorithms, all options provided a classification accuracy of at least 0.99, independent of the applied segmentation strategy with sliding windows of either 60s or 180s. The best matching ratio, i.e. the length of correctly identified jogging periods related to the total time including the missed ones, was up to 0.875. It could be additionally improved up to 0.967 by application of post-classification rules, which considered the duration of breaks and jogging periods. There was no obvious benefit of using two accelerometers, rather almost the same performance could be achieved from either accelerometer position.

Conclusions

Machine learning techniques can be used for automatic activity recognition, as they provide very accurate activity recognition, significantly more accurate than when keeping a diary. Identification of jogging periods in adolescents can be performed using only one accelerometer. Performance-wise there is no significant benefit from using accelerometers on both locations.

High-intensity interval exercise improves cognitive performance and reduces matrix metalloproteinases-2 serum levels in persons with multiple sclerosis: A randomized controlled trial

BACKGROUND

Aerobic exercise can improve cognitive performance in healthy elderly people.

OBJECTIVE

The aim of this study was to investigate the influence of a 3-week high-intensity aerobic exercise programme (high-intensity training group (HIT)) on cognitive performance in persons with multiple sclerosis (MS) compared with a standard exercise programme (control training (CT)).

METHODS

A total of 60 persons with MS (Expanded Disability Status Scale (EDSS): 1.0-6.5) were randomized to a HIT group (3×/week for 20 minutes, including five 3-minute exercise intervals at 80% of peak oxygen uptake (VO_2-peak)) or a CT group (continuously 5×/week for 30 minutes/session at 65% of VO_2-peak). Cognitive performance was assessed using the Brief International Cognitive Assessment for MS at entry ( t₀) and discharge ( t₁). Furthermore, VO_2-peak, brain-derived neurotrophic factor, serotonin and matrix metalloproteinases (MMP)-2 and -9 were measured.

RESULTS

Compared to CT, HIT significantly improved verbal memory. Significant improvements over time in executive functions were found in both groups. Secondary outcomes indicated significant improvements in VO_2-peak and a significant reduction in MMP-2 in the HIT group only.

CONCLUSION

HIT represents a promising strategy to improve verbal memory and physical fitness in persons with MS. Further research is needed to determine the impact of exercise on biomarkers in MS.

Influence of Personalized Exercise Recommendations During Rehabilitation on the Sustainability of Objectively Measured Physical Activity Levels, Fatigue, and Fatigue-Related Biomarkers in Patients With Breast Cancer

Purpose. Only one-third of patients with breast cancer reach the recommended activity level of 15 to 25 MET h/wk. The aim of this study was to determine the influence of personalized exercise recommendations during rehabilitation on patients’ physical activity level, fatigue, and self-perceived cognitive function as well as on side effect–associated biomarkers. Methods. Total metabolic rate, physical activity level, mean MET and steps, fatigue, self-perceived cognitive functioning , and biomarkers (C-reactive protein [CRP], interleukin 6, macrophage migration inhibiting factor [MIF], tumor necrosis factor [TNF]-α, brain-derived neurotrophic factor [BDNF], insulin-like growth factor 1 [IGF1]) were assessed in 60 patients with breast cancer in the aftercare phase before (t₀) and 8 months after (t₁) the intervention. The rehabilitation program consisted of an initial 3-week period and a 1-week stay after 4 months. Results. Paired t-test indicated a statistically significant increase in all activity outcomes from t₀ to t₁. Patients’ mean activity level significantly increased from 14.89 to 17.88 MET h/wk. Fatigue and self-perceived cognitive functioning significantly improved from t₀ to t₁. CRP levels significantly decreased, and BDNF as well as IGF1 levels significantly increased over time. Correlation analysis revealed statistically significant negative associations between fatigue, physical activity, and markers of inflammation (TNF-α and MIF). Furthermore, significant positive correlations between subjective cognitive functioning and all dimensions of fatigue were observed. Conclusions. The results support the importance of personalized exercise recommendations to increase physical activity levels in patients with breast cancer. Furthermore, the results highlighti an association between physical activity, fatigue, and inflammation.

Comparison of the behavioral effects of exercise and high fat diet on cognitive function in adolescent rats

Adolescence is a critical period for neurodevelopment, neuronal plasticity, and cognitive function. Experiences of adolescence can be exerted positive and negative effects on brain development. Physical exercise has a positive effect on brain function, which is characterized by improving memory function and increased neural plasticity. High fat diet (HFD)-induced obesity has a negative effect on brain function, which is characterized by insulin resistance and neuroinflammation and reduced microvessel constructure. Although the positive effect of exercise and negative effect of obesity on cognitive function have been documented, it has not been well whether comparison of the effects of exercise and obesity on cognitive function in adolescent rats. In the present study, we evaluated the behavioral changes related to cognitive function induced by exercise and obesity in adolescent rats. Male Wistar rats were randomly divided into three groups: the control group (CON), the exercise group (Ex), the high fat diet group (HFD). The HFD containing fat 60% was freely provided. The present results showed that spatial learning ability and short-term memory did not show significant effect exercise as compared to the control group. The present results showed that spatial learning ability and short-term memory was significantly decreased HFD-induced obesity group as compared to the control group. These results suggest that positive effect of physical exercise in adolescence rats may be exerted no significant effect on cognitive function. But, negative effect of HFD-induced obesity might induce cognitive impairment. HFD-induced obesity in adolescent rats may be used as an animal model of neurodevelopmental disorders.