Hippocampal volume and vasculature before and after exercise in treatment-resistant schizophrenia

Schizophr Res. 2018 Dec:202:158-165. doi: 10.1016/j.schres.2018.06.054. Epub 2018 Jun 29.


Background: Schizophrenia is associated with poor cognitive function and elevated cardiometabolic disease risk. These health concerns may exacerbate neurocognitive dysfunction associated with hippocampal abnormalities, particularly hippocampal volume reductions. Regular exercise is thought to improve symptom severity, reduce depression, and improve cognition in schizophrenia, and may trigger exercise-mediated hippocampal growth. The potential for the benefits of exercise for treatment-resistant schizophrenia patients has not been clearly assessed. This study aims to assess the effect of exercise on hippocampal plasticity and clinical outcomes in chronic schizophrenia.

Methods: Seventeen DSM-IV criteria schizophrenia or schizoaffective disorder patients completed a customized moderate intensity 12-week aerobic or weight-bearing exercise program. Adherence rates were 83% ± 9.4%) with 70% of participants completing the entire exercise program. Concomitant neuroimaging, clinical and cognitive assessments were obtained at baseline and 12-weeks.

Results: At follow-up, symptom severity scores (t(16) = -16.8, p. ≤ 0.0001) and social functioning (t(16) = 4.4, p. = 0.0004) improved. A trend for improved depression scores (t(16) = -2.0, p. = 0.06) with no change in anxiety, or extrapyramidal symptoms were seen. Hippocampal volume increased (t(16) = -2.54, p. = 0.02), specifically in the left CA-1 field (F(16) = -2.33, p. = 0.03). Hippocampal vascular volume was unchanged. Change in hippocampal volume and vascular volume was not significantly correlated with change in symptom severity or affect scores.

Conclusions: Adjunct exercise may accelerate symptom improvement in treatment-resistant psychosis patients. While the underlying mechanism remains unclear, these results indicate that chronic schizophrenia patients experience hippocampal plasticity in response to exercise.

Study registration: Clinical Trials.govNCT01392885.

Keywords: Exercise; Hippocampal plasticity; MRI; SWI; Schizophrenia; Symptoms.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Drug Resistance
  • Exercise / physiology
  • Exercise Therapy*
  • Female
  • Follow-Up Studies
  • Hippocampus / blood supply*
  • Hippocampus / diagnostic imaging*
  • Hippocampus / pathology
  • Humans
  • Longitudinal Studies
  • Magnetic Resonance Imaging
  • Male
  • Neuronal Plasticity
  • Organ Size
  • Patient Compliance
  • Psychotic Disorders / diagnostic imaging
  • Psychotic Disorders / pathology
  • Psychotic Disorders / physiopathology
  • Psychotic Disorders / therapy
  • Schizophrenia / diagnostic imaging*
  • Schizophrenia / pathology
  • Schizophrenia / physiopathology
  • Schizophrenia / therapy*
  • Schizophrenic Psychology
  • Treatment Outcome

Associated data

  • ClinicalTrials.gov/NCT01392885

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