Aerobic exercise and yoga improve neurocognitive function in women with early psychosis

Abstract

Impairments of attention and memory are evident in early psychosis, and are associated with functional disability. In a group of stable, medicated women patients, we aimed to determine whether participating in aerobic exercise or yoga improved cognitive impairments and clinical symptoms. A total of 140 female patients were recruited, and 124 received the allocated intervention in a randomized controlled study of 12 weeks of yoga or aerobic exercise compared with a waitlist group. The primary outcomes were cognitive functions including memory and attention. Secondary outcome measures were the severity of psychotic and depressive symptoms, and hippocampal volume. Data from 124 patients were included in the final analysis based on the intention-to-treat principle. Both yoga and aerobic exercise groups demonstrated significant improvements in working memory (P<0.01) with moderate to large effect sizes compared with the waitlist control group. The yoga group showed additional benefits in verbal acquisition (P<0.01) and attention (P=0.01). Both types of exercise improved overall and depressive symptoms (all P⩽0.01) after 12 weeks. Small increases in hippocampal volume were observed in the aerobic exercise group compared with waitlist (P=0.01). Both types of exercise improved working memory in early psychosis patients, with yoga having a larger effect on verbal acquisition and attention than aerobic exercise. The application of yoga and aerobic exercise as adjunctive treatments for early psychosis merits serious consideration. This study was supported by the Small Research Funding of the University of Hong Kong (201007176229), and RGC funding (C00240/762412) by the Authority of Research, Hong Kong.

Is there an association between cardiorespiratory fitness and stage of illness in psychotic disorders? A systematic review and meta‐analysis

“…As shown in Tables and , 38 studies met criteria for inclusion in the qualitative synthesis and all were published after 2005 .…”

“…Twenty‐two studies reported CRF data as mean scores for VO 2 (max, peak, or predicted VO2 in ml/kg/min), and 10 of these studies included data for HC (Stage 1 = 1; Stages 1 and 2 = 1; Stage 2 = 2; Stage 3 = 5; Stage 4 = 2). Figure reports the sample sizes for each group in the 10 eligible studies, and the forest plot demonstrates the overall ES for CRF (with 95% CI) for all studies and then the ES for each clinical stage.…”

“…Only one study reported CRF findings for a subsample classified as Stage 0 (122 individuals with a family history of psychosis) (13); two studies reported CRF findings in samples classified as Stage 1 (13,14). For Stage 2, three cohort studies reported CRF in army recruits and noted an association between lower CRF and the incidence of FEP (15)(16)(17); two other studies employed a casecontrol design (8,14) and six others comprised of FEP groups only (18)(19)(20)(21)(22)(23). Nineteen studies included subgroups classified as Stage 3 (24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35)(36)(37)(38)(39)(40)(41)(42), of which four included a matched HC group (30)(31)(32)40) and one included a general population reference sample (39).…”

The Efficacy of Non-Pharmacological Interventions on Brain-Derived Neurotrophic Factor in Schizophrenia: A Systematic Review and Meta-Analysis

“…Moreover, although the findings did not show a pronounced effect on plasma BDNF, some previous RCTs demonstrated the benefits of yoga therapy in schizophrenia compared with exercise training, specifically in negative symptoms and social function [70,71,72]. A recent RCT also concluded that both aerobic exercise and yoga groups for early psychosis improved neurocognitive function [73]. Several factors may cause differences in the results of this analysis, e.g., age, completion rate, exercise intensity, and duration of intervention.…”

Cognitive remediation in schizophrenia—The view from India

“…It should be noted that only one RCT in the meta analysis evaluated outcomes other than clinical severity; this study evaluated face emotion recognition, but not cognitive function (Behere et al, 2011). A study in Hong Kong also compared effect of yoga and aerobic exercise on cognition among women with early psychosis; yoga enhanced attention better than aerobic exercise (Lin et al, 2015). …”