Association between aerobic fitness and the functional connectome in patients with schizophrenia

Abstract

Schizophrenia is accompanied by widespread alterations in static functional connectivity associated with symptom severity and cognitive deficits. Improvements in aerobic fitness have been demonstrated to ameliorate symptomatology and cognition in people with schizophrenia, but the intermediary role of macroscale connectivity patterns remains unknown. Therefore, we aim to explore the relation between aerobic fitness and the functional connectome in individuals with schizophrenia. Further, we investigate clinical and cognitive relevance of the identified fitness-connectivity links. 58 patients with schizophrenia were included in the resting-state fMRI analysis. Multilevel Bayesian partial correlations between aerobic fitness and functional connections across the whole brain as well as between static functional connectivity patterns and clinical and cognitive outcome were performed. Preliminary causal inferences were enabled based on a mediation analysis. Static functional connectivity between the subcortical nuclei and the cerebellum as well as between temporal seeds mediated the attenuating impact of aerobic fitness on total symptom severity. Functional connections between cerebellar seeds affected the positive link between aerobic fitness and global cognition, while the functional interplay between central and limbic seeds drove the beneficial relation between aerobic fitness and emotion recognition. The current study provides first insights into the interactions between aerobic fitness, the functional connectome and clinical and cognitive outcome in people with schizophrenia, but results have to be interpreted carefully. Further interventional aerobic exercise studies are needed in order to replicate the current findings and to enable conclusive causal inferences.

Effects of aerobic exercise on hippocampal formation volume in people with schizophrenia – a systematic review and meta-analysis with original data from a randomized-controlled trial

“…However, evidence is heterogeneous with comparable examinations contradicting these findings (51)(52)(53)(54)(55). From a network perspective, first evidence suggests that aerobic fitness and exercise in patients with schizophrenia or at high clinical risk for psychosis affect multiple FC patterns across the whole brain (56) with a particular focus on hippocampal FC (16,54,55). Therefore, we aim to investigate the clinical relevance of potential aerobic exercise effects on the volume and connectivity of the HF.…”