Enhancing Cognitive Training Through Aerobic Exercise After a First Schizophrenia Episode: Theoretical Conception and Pilot Study

Cognitive training (CT) and aerobic exercise have separately shown promise for improving cognitive deficits in schizophrenia. Aerobic exercise releases brain-derived neurotrophic factor, which promotes synaptic plasticity and neurogenesis. Thus, aerobic exercise provides a neurotrophic platform for...

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Bibliographic Details
Published in:Schizophrenia bulletin 2016-07, Vol.42 Suppl 1 (suppl 1), p.S44-S52
Main Authors: Nuechterlein, Keith H, Ventura, Joseph, McEwen, Sarah C, Gretchen-Doorly, Denise, Vinogradov, Sophia, Subotnik, Kenneth L
Format: Article
Language:English
Subjects:
Adolescent
Adult
Cognitive Dysfunction - etiology
Cognitive Dysfunction - therapy
Cognitive Remediation - methods
Combined Modality Therapy
Exercise Therapy - methods
Female
Humans
Male
Outcome Assessment, Health Care
Pilot Projects
Schizophrenia - complications
Supplement
Young Adult
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Summary:Cognitive training (CT) and aerobic exercise have separately shown promise for improving cognitive deficits in schizophrenia. Aerobic exercise releases brain-derived neurotrophic factor, which promotes synaptic plasticity and neurogenesis. Thus, aerobic exercise provides a neurotrophic platform for neuroplasticity-based CT. The combination of aerobic exercise and CT may yield more robust effects than CT alone, particularly in the initial course of schizophrenia. In a pilot study, 7 patients with a recent onset of schizophrenia were assigned to Cognitive Training & Exercise (CT&E) and 9 to CT alone for a 10-week period. Posit Science programs were used for CT. Neurocognitive training focused on tuning neural circuits related to perceptual processing and verbal learning and memory. Social cognitive training used the same learning principles with social and affective stimuli. Both groups participated in these training sessions 2d/wk, 2h/d. The CT&E group also participated in an aerobic conditioning program for 30 minutes at our clinic 2d/wk and at home 2d/wk. The effect size for improvement in the MATRICS Consensus Cognitive Battery Overall Composite score for CT&E patients relative to CT patients was large. Functional outcome, particularly independent living skills, also tended to improve more in the CT&E than in the CT group. Muscular endurance, cardiovascular fitness, and diastolic blood pressure also showed relative improvement in the CT&E compared to the CT group. These encouraging pilot study findings support the promise of combining CT and aerobic exercise to improve the early course of schizophrenia.
ISSN:0586-7614
1745-1701
DOI:10.1093/schbul/sbw007