Exercise Augmentation of Exposure Therapy for PTSD: Rationale and Pilot Efficacy Data

Cogn Behav Ther. 2015;44(4):314-27. doi: 10.1080/16506073.2015.1012740. Epub 2015 Feb 23.

Abstract

Brain-derived neurotrophic factor (BDNF) is associated with synaptic plasticity, which is crucial for long-term learning and memory. Some studies suggest that people suffering from anxiety disorders show reduced BDNF relative to healthy controls. Lower BDNF is associated with impaired learning, cognitive deficits, and poor exposure-based treatment outcomes. A series of studies with rats showed that exercise elevates BDNF and enhances fear extinction. However, this strategy has not been tested in humans. In this pilot study, we randomized participants (N = 9, 8 females, M(Age) = 34) with posttraumatic stress disorder (PTSD) to (a) prolonged exposure alone (PE) or (b) prolonged exposure+exercise (PE+E). Participants randomized to the PE+E condition completed a 30-minute bout of moderate-intensity treadmill exercise (70% of age-predicted HR(max)) prior to each PE session. Consistent with prediction, the PE+E group showed a greater improvement in PTSD symptoms (d = 2.65) and elevated BDNF (d = 1.08) relative to the PE only condition. This pilot study provides initial support for further investigation into exercise augmented exposure therapy.

Trial registration: ClinicalTrials.gov NCT01199107.

Keywords: BDNF; CBT; anxiety disorders; augmentation; exercise; exposure therapy; pilot data.

Publication types

  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Brain-Derived Neurotrophic Factor / blood*
  • Combined Modality Therapy / methods
  • Exercise / psychology*
  • Exercise Therapy / methods*
  • Female
  • Humans
  • Implosive Therapy / methods*
  • Male
  • Pilot Projects
  • Stress Disorders, Post-Traumatic / blood
  • Stress Disorders, Post-Traumatic / therapy*
  • Young Adult

Substances

  • Brain-Derived Neurotrophic Factor
  • BDNF protein, human

Associated data

  • ClinicalTrials.gov/NCT01199107