Improving Cognition via Exercise (ICE): Study Protocol for a Multi-Site, Parallel-Group, Single-Blind, Randomized Clinical Trial Examining the Efficacy of Aerobic Exercise to Improve Neurocognition, Daily Functioning, and Biomarkers of Cognitive Change in Individuals with Schizophrenia

Ospina, Luz H.; Wall, Melanie M.; Jarskog, L. Fredrik; Ballon, Jacob S.; McEvoy, Joseph P.; Bartels, Matthew N.; Buchsbaum, Richard; Sloan, Richard P.; Stroup, T. Scott; Kimhy, David

doi:10.20900/jpbs.20190020

Cited by 9 publications

(13 citation statements)

References 139 publications

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“…Additionally, our results suggest AE is a non-stigmatizing, safe, and nearly side-effect-free intervention, suggesting an intervention profile with a promise for broad dissemination. This view is consistent with the European Psychiatric Association’s position paper and treatment guidelines advocating dissemination of physical activity as part of treatment for individuals with severe mental illness, [ 47 ] as well as previous reports for dissemination among fist-episode patients [ 48 ]. Additionally, within the context of the current COVID-19 pandemic, recent reports suggest AE may help protect against development of severe psychopathology [ 49 ].…”

Section: Discussionsupporting

confidence: 89%

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Enhancement of aerobic fitness improves social functioning in individuals with schizophrenia

Kimhy

Tay

Vakhrusheva

et al. 2021

Eur Arch Psychiatry Clin Neurosci

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Individuals with schizophrenia display substantial deficits in social functioning (SF), characterized by chronic, lifelong presentations. Yet, at present there are few effective interventions to enhance SF in this population. Emerging evidence from studies of clinical populations that display similar SF deficits suggests that aerobic exercise (AE) may improve social skills. However, this putative impact has not been investigated in schizophrenia. Employing a single-blind, randomized clinical trial design, 33 individuals with schizophrenia were randomized to receive 12 weeks of Treatment-As-Usual (TAU; n = 17) or TAU + AE (n = 16) utilizing active-play video games (Xbox 360 Kinect) and traditional AE equipment. Participants completed an evaluation of aerobic fitness (VO 2 max) as well as self-, informant-, and clinician-reported SF measures at baseline and after 12 weeks. Twenty-six participants completed the study (79%; TAU = 13; AE = 13). At follow-up, the AE participants improved their VO 2 max by 18.0% versus − 0.5% in the controls (group x time interaction, F 1,24 = 12.88; p = .002). Hierarchical stepwise regression analyses indicated improvements in VO 2 max significantly predicted enhancement in SF as indexed by self-, informant-, and clinician-reported measures, predicting 47%, 33%, and 25% of the variance, respectively (controlling for baseline demographics, medications, mood symptoms, and social networks). Compared to the TAU group, AE participants reported significant improvement in SF (23.0% vs. − 4.2%; group × time interaction, F 1,24 = 7.48, p = .012). The results indicate that VO 2 max enhancement leads to improvements in SF in people with schizophrenia. Furthermore, low VO 2 max represents a modifiable risk factor of SF in people with schizophrenia, for which AE training offers a safe, non-stigmatizing, and nearly side-effect-free intervention.

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Section: Discussionsupporting

confidence: 89%

“…Future studies should aim to examine the impact of AE on SF among such individuals. Our group recently started a large project that would be able to address some of these limitations [ 48 ].…”

Section: Discussionmentioning

confidence: 99%

Enhancement of aerobic fitness improves social functioning in individuals with schizophrenia

Kimhy

Tay

Vakhrusheva

et al. 2021

Eur Arch Psychiatry Clin Neurosci

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“…However, some studies have not observed this relationship, so it might be still premature to draw definitive conclusions about this issue ( 54 , 55 ). While aerobic exercise related cognitive benefits have been linked to BDNF upregulation, this putative mechanism needs confirmation ( 56 ). Holmen et al ( 57 ) found an association between cardiorespiratory fitness and cognition in schizophrenia patients, but they did not find evidence of BDNF mediating this association.…”

Section: In Patients With Chronic Schizophreniamentioning

confidence: 99%

BDNF as a Biomarker of Cognition in Schizophrenia/Psychosis: An Updated Review

et al. 2021

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Brain Derived Neurotrophic Factor (BDNF) has been linked to cognitive symptoms of schizophrenia, which has been documented in previous reviews by several authors. However, a trend has recently emerged in this field moving from studying schizophrenia as a disease to studying psychosis as a group. This review article focuses on recent BDNF studies in relation to cognition in human subjects during different stages of the psychotic process, including subjects at high risk of developing psychosis, patients at their first episode of psychosis, and patients with chronic schizophrenia. We aim to provide an update of BDNF as a biomarker of cognitive function on human subjects with schizophrenia or earlier stages of psychosis, covering new trends, controversies, current research gaps, and suggest potential future developments in the field. We found that most of current research regarding BDNF and cognitive symptoms in psychosis is done around schizophrenia as a disease. Therefore, it is necessary to expand the study of the relationship between BDNF and cognitive symptoms to psychotic illnesses of different stages and origins.

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“…Exercise is a promising new area of intervention for individuals across many stages of psychosis, including for those at clinical high risk for psychosis (CHR). [1][2][3][4][5][6][7][8] Despite the benefits of this new area of intervention, substantially less work has examined unique factors of the CHR population that would have bearing on tailoring an effective, early intervention (i.e., understanding characteristic health and starting fitness levels). 7,[9][10][11] Extant research, however, has relied solely on self-report measures of physical activity to assess fitness, 9,10,[12][13][14] with few exceptions.…”

Section: Introductionmentioning

confidence: 99%

“…A growing body of research has demonstrated that exercise interventions are effective in improving cognitive function 1,4,5,11,19 and neurological function 2,11 for individuals across the psychosis spectrum including, risk mental states, CHR, the first episode of psychosis, and schizophrenia populations. Although existing psychosis literature has established that individuals with psychosis have significantly poorer physical health, 1,6,14,19,20 the evidence regarding the physiological health of individuals at CHR for psychosis is unclear.…”

Section: Introductionmentioning

confidence: 99%

Lab-Based and Self-Reported Indices of Fitness Show Lowered Fitness and Insight into Fitness in Individuals at Clinical High Risk for Psychosis

Damme¹,

Sloan

Bartels

et al. 2020

Preprint

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Introduction:Exercise is a promising intervention for clinical high-risk for psychosis (CHR) populations, who have attenuated positive symptoms, but evidence suggests that these youth may require tailored exercise interventions. Presently, the scope of the problem is unknown, as these youth may not be reliable reporters on fitness. This issue is compounded by the fact that there have been no investigations that utilized a formal fitness assessment in this critical population.The present study aims to determine the level of fitness in CHR youth with lab-based measures, test how effectively self-report measures characterize objective fitness indices, and explore clinical factors that may be interrupting reliable self-report-an important tool if these interventions are to be taken to scale.Methods: Forty CHR individuals completed an exercise survey and lab-based indices of fitness (i.e., VO2max and BMI). Forty healthy volunteers completed lab indices of fitness and a structured clinical interview ruling out the presence of psychiatric illness.Results: CHR youth showed greater BMI and lower VO2max compared to healthy volunteers. In the CHR group, abstract self-report items (perceived fitness) did not reflect lab indices of fitness, whereas specific exercise behaviors (intensity of exercise) showed stronger correlations with laboratory-based fitness measurements. Exploratory analyses suggested that positive symptoms involving grandiosity, and negative symptoms such as avolition, correlated with discrepancy between self-perception and laboratory findings of fitness. Discussion:Results suggest that CHR individuals are less objectively fit than matched controls, and that it will be important to consider unique population characteristics when weighing selfreport data.

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Improving Cognition via Exercise (ICE): Study Protocol for a Multi-Site, Parallel-Group, Single-Blind, Randomized Clinical Trial Examining the Efficacy of Aerobic Exercise to Improve Neurocognition, Daily Functioning, and Biomarkers of Cognitive Change in Individuals with Schizophrenia

Cited by 9 publications

References 139 publications

Enhancement of aerobic fitness improves social functioning in individuals with schizophrenia

Enhancement of aerobic fitness improves social functioning in individuals with schizophrenia

BDNF as a Biomarker of Cognition in Schizophrenia/Psychosis: An Updated Review

Lab-Based and Self-Reported Indices of Fitness Show Lowered Fitness and Insight into Fitness in Individuals at Clinical High Risk for Psychosis

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