Improving cognitive function after brain injury: The use of exercise and virtual reality

Grealy, Madeleine; Johnson, David A.; Rushton, Simon K.

doi:10.1016/s0003-9993(99)90169-7

Cited by 311 publications

(169 citation statements)

References 36 publications

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“…Previous exercise trials have shown increased hippocampal volume in healthy older adults, 12,30 increased white matter structure in adults with schizophrenia, 31 increased organization of brain activation in overweight but otherwise healthy children, 32 and improved cognitive performance in adults with acquired brain injury. 33 To our knowledge, ours is the first trial to provide neuroimaging evidence of exercise-related recovery in multiple regions of the brain well after injury, supporting the effectiveness of interventions long past the original trauma: The mean time from diagnosis to training was 5.25 years for our sample. Our findings are particularly striking when considering that pediatric brain tumor survivors treated with radiation display increasingly perturbed white matter, smaller hippocampi, slowed processing speed, and delayed cognitive development over time.…”

Section: Discussionmentioning

confidence: 54%

Exercise training for neural recovery in a restricted sample of pediatric brain tumor survivors: a controlled clinical trial with crossover of training versus no training

Riggs

Piscione

Laughlin

et al. 2016

NEUONC

106

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Background. Exercise promotes repair processes in the mouse brain and improves cognition in both mice and humans. It is not known whether these benefits translate to human brain injury, particularly the significant injury observed in children treated for brain tumors. Methods. We conducted a clinical trial with crossover of exercise training versus no training in a restricted sample of children treated with radiation for brain tumors. The primary outcome was change in brain structure using MRI measures of white matter (ie, fractional anisotropy [FA]) and hippocampal volume [mm 3 ]). The secondary outcome was change in reaction time (RT)/accuracy across tests of attention, processing speed, and short-term memory. Linear mixed modeling was used to test the effects of time, training, training setting, and carryover. Results. Twenty-eight participants completed training in either a group (n=16) or a combined group/home (n=12) setting. Training resulted in increased white matter FA (Δ=0.05, P<.001). A carryover effect was observed for participants ~12 weeks after training (Δ=0.05, P<.001). Training effects were observed for hippocampal volume (Δ=130.98mm 3 ; P=.001) and mean RT (Δ=-457.04ms, P=0.36) but only in the group setting. Related carryover effects for hippocampal volume (Δ=222.81mm 3 , P=.001), and RT (Δ=-814.90ms, P=.005) were also observed. Decreased RT was predicted by increased FA (R=-0.62, P=.01). There were no changes in accuracy. Conclusions. Exercise training is an effective means for promoting white matter and hippocampal recovery and improving reaction time in children treated with cranial radiation for brain tumors. Key wordsbrain recovery | cranial radiation | exercise | neuroplasticity | pediatric brain tumor

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Section: Discussionmentioning

confidence: 54%

Exercise training for neural recovery in a restricted sample of pediatric brain tumor survivors: a controlled clinical trial with crossover of training versus no training

Riggs

Piscione

Laughlin

et al. 2016

NEUONC

106

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“…In recent years, virtual reality technologies have begun to be used as an assessment and treatment tool in rehabilitation (for example, Rizzo et al, 1997;Christiansen et al, 1998;Grealy et al, 1999;Riva et al, 1999;Rose et al, 1999;Naveh et al, 2000;Schultheis and Rizzo, 2001). Virtual environments give patients safe access to interactive, true-to-life situations that would otherwise be inaccessible to them because of motor, cognitive and psychological limitations (Rose et al, 1999).…”

Section: Applications Of Virtual Reality In Rehabilitationmentioning

confidence: 99%

Design and testing of a virtual environment to train stroke patients with unilateral spatial neglect to cross a street safely

Weiss

Naveh

Katz

2003

Occupation Therapy Intl

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“…There is also evidence that exercise can contribute to recovery after injury. Exercise can facilitate recovery of function both in humans and in animal models that include brain and spinal cord injury (Grealy et al, 1999;Griesbach et al, 2004;Engesser-Cesar et al, 2005). Identifying mechanisms responsible for the ability of exercise to maintain and improve neural function is a current, extensive research focus (Cotman and Berchtold, 2002).…”

Section: Introductionmentioning

confidence: 99%

Voluntary exercise produces antidepressant and anxiolytic behavioral effects in mice

et al. 2008

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Reports of beneficial effects of exercise on psychological health in humans are increasingly supported by basic research studies. Exercise is hypothesized to regulate antidepressant-related mechanisms and we therefore characterized the effects of chronic exercise in mouse behavioral paradigms relevant to antidepressant actions. Mice given free access to running wheels showed antidepressant-like behavior in learned helplessness, forced-swim (FST) and tail suspension paradigms. These responses were similar to responses of antidepressant drug-treated animals. When tested under conditions where locomotor activity was not altered, exercising mice also showed reduced anxiety compared to sedentary control mice. In situ hybridization analysis showed that BDNF mRNA was increased in specific subfields of hippocampus after wheel running. We chose one paradigm, the FST, in which to investigate a functional role for brain-derived neurotrophic factor (BDNF) in the behavioral response to exercise. We tested mice heterozygous for a deletion of the BDNF gene in the FST after wheel-running. Exercising wild-type mice showed the expected antidepressant-like behavioral response in the FST but exercise was ineffective in improving FST performance in heterozygous BDNF knockout mice. A possible functional contribution of a BDNF signaling pathway to FST performance in exercising mice was investigated using the specific MEK inhibitor PD184161 to block the MAPK signaling pathway. Subchronic administration of PD184161 to exercising mice blocked the antidepressant-like behavioral response seen in vehicle-treated exercising mice in the FST. In summary, chronic wheel-running exercise in mice results in antidepressant-like behavioral changes that may involve a BDNF related mechanism similar to that hypothesized for antidepressant drug treatment.

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Improving cognitive function after brain injury: The use of exercise and virtual reality

Cited by 311 publications

References 36 publications

Exercise training for neural recovery in a restricted sample of pediatric brain tumor survivors: a controlled clinical trial with crossover of training versus no training

Exercise training for neural recovery in a restricted sample of pediatric brain tumor survivors: a controlled clinical trial with crossover of training versus no training

Design and testing of a virtual environment to train stroke patients with unilateral spatial neglect to cross a street safely

Voluntary exercise produces antidepressant and anxiolytic behavioral effects in mice

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