CCRT and aerobic exercise: a randomised controlled study of processing speed, cognitive flexibility, and serum BDNF expression in schizophrenia

Abstract

Computerised cognitive remediation therapy (CCRT) and aerobic exercise are often used to rehabilitate social functioning in patients with schizophrenia. However, there is limited knowledge regarding the effects of CCRT combined with aerobic exercise on cognitive function and brain-derived neurotrophic factor (BDNF) levels in patients with schizophrenia and cognitive impairment. Ninety-six patients with schizophrenia and cognitive impairment were included in this study and randomly divided into control, aerobic exercise (AE), and CCRT combined with aerobic exercise (CAE) groups. Changes in processing speed and cognitive flexibility at week 8 were evaluated as primary and secondary cognitive outcomes using the Trail Making Test: Part A, the Brief Assessment of Cognition in Schizophrenia: Symbol Coding Test, and the Stroop Colour-Word Test. Positive and Negative Syndrome Scale (PANSS) scores and serum BDNF expression were determined as other secondary outcomes. The CAE group showed significantly better performance in terms of changes in processing speed and cognitive flexibility than the control and AE groups at week 8 (p < 0.05); however, no significant improvements in processing speed and cognitive flexibility were found between the control and AE groups. The CAE group showed significant improvements in the PANSS negative symptoms than the control group at week 8 (p < 0.05), but the AE group showed no significant difference in the changes of PANSS negative symptoms when compared with the other two groups. The CAE group and AE group showed a greater increase in serum BDNF levels than the control group (p < 0.01), but there was no significant difference in serum BDNF expression between the CAE group and AE group. In conclusion, 8-week CCRT combined with aerobic exercise may improve some cognitive performance and negative symptoms in patients with schizophrenia. Aerobic exercise may have an immediate effect on serum BDNF levels rather than cognitive function.

Efficacy of Functional Remediation on Cognitive and Psychosocial Functioning in Patients with Bipolar Disorder: Study Protocol for a Randomized Controlled Study

“…Finally, if the results of the present study confirm the effectiveness of FR in BD, FR could be integrated into structured rehabilitation programs and combined with other nonpharmacological interventions targeting cognitive performance and aiming for functional improvement, such as physical exercise [82][83][84][85][86] or neurostimulation [85]. Establishing whether combined interventions provide greater or faster improvements, as has been observed in trials including participants diagnosed with schizophrenia [86][87][88], could provide valuable information for clinicians and mental health services.…”

Combined Exercise and Vitamin D on Brain-Derived Neurotrophic Factor

“…For example, after a program of aerobic exercise, individuals with stroke [48], MS (16), and Parkinson's disease (15) have shown improvements in walking, functional ability, and motor performance. In addition to gains in cardiorespiratory fitness, exercise-induced increases in BDNF levels in the motor cortex and hippocampus have also been associated with enhanced learning and memory [49]. Additionally, it guides decision-making processes for motor tasks and healthy behaviors.…”