Effects of acute aerobic exercise on neural correlates of attention and inhibition in adolescents with bipolar disorder

Objectives Over the past two decades, there has been tremendous growth in research regarding bipolar disorder (BD) among children and adolescents (ie, pediatric BD [PBD]). The primary purpose of this article is to distill the extant literature, dispel myths or exaggerated assertions in the field, and disseminate clinically relevant findings. Methods An international group of experts completed a selective review of the literature, emphasizing areas of consensus, identifying limitations and gaps in the literature, and highlighting future directions to mitigate these gaps. Results Substantial, and increasingly international, research has accumulated regarding the phenomenology, differential diagnosis, course, treatment, and neurobiology of PBD. Prior division around the role of irritability and of screening tools in diagnosis has largely abated. Gold-standard pharmacologic trials inform treatment of manic/mixed episodes, whereas fewer data address bipolar depression and maintenance/continuation treatment. Adjunctive psychosocial treatment provides a forum for psychoeducation and targets primarily depressive symptoms. Numerous neurocognitive and neuroimaging studies, and increasing peripheral biomarker studies, largely converge with prior findings from adults with BD. Conclusions As data have accumulated and controversy has dissipated, the field has moved past existential questions about PBD toward defining and pursuing pressing clinical and scientific priorities that remain. The overall body of evidence supports the position that perceptions about marked international (US vs elsewhere) and developmental (pediatric vs adult) differences have been overstated, although additional research on these topics is warranted. Traction toward improved outcomes will be supported by continued emphasis on pathophysiology and novel therapeutics.

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“…The therapeutic and preventive potential of physical exercise for PBD, for example, is an almost entirely untouched topic. 260,261 …”

Section: | Conclusionmentioning

confidence: 99%

The International Society for Bipolar Disorders Task Force report on pediatric bipolar disorder: Knowledge to date and directions for future research

et al. 2017

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“…In the domains of incomplete outcome data and selective reporting, all studies were judged as having a low risk of bias. Furthermore, with regard to the domain of "other bias", the majority of studies were judged as having an unclear bias because the study design did not meet recent recommendations [33] (e.g., it used only a posttest comparison [38,39,71,73,[99][100][101][102][103][104] and/or the prescription of exercise intensity was not optimal because it was not based on a graded exercise test [39,[71][72][73][103][104][105]).…”

Section: Risk Of Biasmentioning

confidence: 99%

“…In the reviewed studies, the acute effects of physical exercise were studied in healthy children [71,73], adolescents with and without bipolar disorder [105], younger adults with attention deficit hyperactivity disorder (ADHD) [100,102], healthy younger adults [38,39,72,99,101,102,106], and healthy older adults [103,104,107]. A detailed overview of the sample characteristics (e.g., age, gender, BMI, and cardiorespiratory fitness level) can be found in Table 1.…”

Section: Study Characteristicsmentioning

confidence: 99%

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The Contribution of Functional Magnetic Resonance Imaging to the Understanding of the Effects of Acute Physical Exercise on Cognition

et al. 2020

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The fact that a single bout of acute physical exercise has a positive impact on cognition is well-established in the literature, but the neural correlates that underlie these cognitive improvements are not well understood. Here, the use of neuroimaging techniques, such as functional magnetic resonance imaging (fMRI), offers great potential, which is just starting to be recognized. This review aims at providing an overview of those studies that used fMRI to investigate the effects of acute physical exercises on cerebral hemodynamics and cognition. To this end, a systematic literature survey was conducted by two independent reviewers across five electronic databases. The search returned 668 studies, of which 14 studies met the inclusion criteria and were analyzed in this systematic review. Although the findings of the reviewed studies suggest that acute physical exercise (e.g., cycling) leads to profound changes in functional brain activation, the small number of available studies and the great variability in the study protocols limits the conclusions that can be drawn with certainty. In order to overcome these limitations, new, more well-designed trials are needed that (i) use a more rigorous study design, (ii) apply more sophisticated filter methods in fMRI data analysis, (iii) describe the applied processing steps of fMRI data analysis in more detail, and (iv) provide a more precise exercise prescription.Brain Sci. 2020, 10, 175 2 of 31 improve cognitive domains, such as attention and/or cognitive control substantially, albeit only transiently [30][31][32][33]. However, the underlying neurobiological mechanisms of these effects are not yet fully understood. In this regard, the use of neuroimaging methods offers great potential for acquiring a deeper understanding of physical exercise-induced changes in the neural correlates of cognition, such as changes in functional brain activation [33][34][35]. The most common methods used to investigate effects on functional brain activation are functional near-infrared spectroscopy (fNIRS) [34] and electroencephalography (EEG) [36,37]; however, also functional magnetic resonance imaging (fMRI) has recently been applied in the context of acute physical exercise and cognition [38,39]. The strengths of fNIRS and EEG compared to fMRI are a higher temporal resolution, greater portability, and applicability in almost all cohorts (e.g., for individuals with metallic implants or claustrophobia) [34,40,41]. However, fNIRS and EEG have a limited spatial resolution and only allow for the evaluation of brain activation patterns in cortical areas [41][42][43]. In comparison to fNIRS and EEG, fMRI enables the assessment of brain activation changes in cortical and subcortical areas and offers a higher spatial resolution, which results in superior source localization [42][43][44]. Hence, fMRI is well suited to study the influence of acute physical exercise on subcortical structures, such as the hippocampus, which have a crucial role in cognitive processes (e.g., memory) [45][46][47][48][49...

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“…For example, a recent study examining the effects of acute exercise on adolescents completing a measure of executive functioning (go/no-go task) has shown that acute aerobic exercise is able to influence deficits in deactivating attention and activating inhibition 27. This line of inquiry is important to understand the potential therapeutic efficacy of exercise for bipolar disorder.…”

Section: Neurobiological Effects Of Exercisementioning

confidence: 99%

Exercising control over bipolar disorder

Malhi

Byrow

2016

Evid Based Mental Health

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Following extensive research exercise has emerged as an effective treatment for major depressive disorder, and it is now a recognised therapy alongside other interventions. In contrast, there is a paucity of research examining the therapeutic effects of exercise for those with bipolar disorder. Given that dysfunctional reward processing is central to bipolar disorder, research suggests that exercise can perhaps be framed as a reward-related event that may have the potential to precipitate a manic episode. The behavioural activation system (BAS) is a neurobehavioural system that is associated with responding to reward and provides an appropriate framework to theoretically examine and better understand the effects of exercise treatment on bipolar disorder. This article discusses recent research findings and provides an overview of the extant literature related to the neurobiological underpinnings of BAS and exercise as they relate to bipolar disorder. This is important clinically because depending on mood state in bipolar disorder, we postulate that exercise could be either beneficial or deleterious with positive or negative effects on the illness. Clearly, this complicates the evaluation of exercise as a potential treatment in terms of identifying its optimal characteristics in this population. INTRODUCTIONBehavioural activation is a commonly used psychological treatment for major depressive disorder (MDD) that broadly refers to the development of activity scheduling and also targets cognitive processes that are linked to avoidance.1 Research findings suggest that for MDD behavioural activation is generally an effective therapeutic intervention, 2 with some studies suggesting that it is equally as effective as cognitive therapies or a combination of cognitive and behavioural activation therapies.3 Behavioural activation is particularly relevant to depressive episodes, where individuals experience difficulty engaging in physical activity because of psychomotor retardation; feeling slowed down physically and mentally. The converse is true in mania where individuals usually experience increased energy and activity levels. This may partly explain why behavioural activation has been extensively studied in relation to MDD, but there is little research as yet, investigating its effectiveness in treating bipolar disorder. Therefore, in this article, we consider the emerging research findings examining the therapeutic effectiveness of exercise as a behavioural activation strategy for those with bipolar disorder. Furthermore, we propose the use of a neurobehavioural model for understanding the effects of this treatment strategy on depressive and manic mood states. Pertinent literature was identified using Google Scholar and PubMed, with relevant search terms-such as 'bipolar disorder', 'exercise' and acceptable variations of these (update: June 2016). Given the paucity of the literature, the reference lists of all identified papers were then inspected for further potential resources with particular attention paid t...

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Effects of acute aerobic exercise on neural correlates of attention and inhibition in adolescents with bipolar disorder

Cited by 40 publications

References 66 publications

The International Society for Bipolar Disorders Task Force report on pediatric bipolar disorder: Knowledge to date and directions for future research

The International Society for Bipolar Disorders Task Force report on pediatric bipolar disorder: Knowledge to date and directions for future research

The Contribution of Functional Magnetic Resonance Imaging to the Understanding of the Effects of Acute Physical Exercise on Cognition

Exercising control over bipolar disorder

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