Structural brain abnormalities consistently reported in schizophrenia include smaller grey matter volume, enlargement of lateral and third ventricles, decreased hippocampal volume, and cortical thinning. These are likley to progress over time and poorer outcome is associated with increased brain loss.Loss is attributed to various factors. One such factor is physical inactivity and poor cardiorespiratory fitness.Physical exercise is shown to increases cerebral grey and white matter and hippocampal volumes in normal individuals.A small study have previously shown that (Pajonk et al., 2010) hippocampal volume increases with three months of exercise in male schizophrenia patients.
Thomas W. Scheewe and team of researchers from Netherlands examined the effect of exercise therapy on global brain volume, hippocampus, and cortical thickness in schizophrenia patients and healthy controls.
63 patients with a schizophrenia spectrum disorder on stable antipsychotic medications with no substance use problems and 55 healthy controls, were randomly allocated to exercise therapy or occupational therapy whereas controls were assigned to exercise therapy or life as usual for six months. ie 31 patients were randomised to exercise therapy and 32 patients to occupational therapy, whereas 27 healthy controls were randomised to exercise therapy and 28 to life- as-usual.Cardiorespiratory fitness (CRF) was measured and volumetric MRI scans performed.
To start with, patients had significantly lower baseline volumes of the cerebrum and cerebral grey matter,higher baseline volumes of the third ventricle ,and a thinner cortex.
Exercise therapy (once to twice a week for 1 h during six months) did not increase global brain volume, hippocampal volume, or cortical thickness in schizophrenia patients or healthy controls. CRF improvement was significantly related to cerebral matter volume increase, lateral ventricle and third ventricle volume decrease in patients but not in healthy controls. CRF improvement was significantly associated with thickening (or less thin- ning) in the left hemisphere (large parts of the frontal, temporal and cingulate cortex) in both controls and patients.
Limitations: Exercise frequency was limited namely one to two 1-h sessions weekly.The trial did not include a ‘treatment as usual’ for patients. No follow-up measurements were performed.
Conclusion: Improvement in cardiorespiratory fitness is associated with cortical thickening in most areas of the left frontal, temporal, and cingulate cortices in schizophrenia patients and healthy controls
Summary of the article:
Scheewe TW, van Haren NE, Sarkisyan G, Schnack HG, Brouwer RM, de Glint M, Hulshoff Pol HE, Backx FJ, Kahn RS, Cahn W.Eur Neuropsychopharmacol. (2013) 23, 675–685