Andrea Camaz Deslandes

Exercise and Mental Health: Many Reasons to Move

The relationship between physical activity and mental health has been widely investigated, and several hypotheses have been formulated about it. Specifically, during the aging process, physical exercise might represent a potential adjunctive treatment for neuropsychiatric disorders and cognitive impairment, helping delay the onset of neurodegenerative processes. Even though exercise itself might act as a stressor, it has been demonstrated that it reduces the harmful effects of other stressors when performed at moderate intensities. Neurotransmitter release, neurotrophic factor and neurogenesis, and cerebral blood flow alteration are some of the concepts involved. In this review, the potential effects of exercise on the aging process and on mental health are discussed, concerning some of the recent findings on animal and human research. The overwhelming evidence present in the literature today suggests that exercise ensures successful brain functioning.

Physical Exercise and Clinically Depressed Patients: A Systematic Review and Meta-Analysis

Objective: The aim of this meta-analysis is to evaluate the effect of aerobic training and strength training as a treatment for depression in patients diagnosed with major depressive disorder. Methods: PubMed (Medline), ISI knowledge (Institute for Scientific Information), SciELO (Scientific Electronic Library) and Scopus databases were consulted from January 1970 to September 2011. Data were collected on variables as follows: total number of patients (pre- and postintervention), age, randomized (yes or no), diagnostic criteria, assessment instruments, and the percentage of remission and treatment response. Subsequently, we collected information on time intervention, intensity, duration, frequency, method of training (aerobic training and strength training) and type of supervision. Standardized mean differences were used for pooling continuous variables as endpoint scores. Binary outcomes, such as proportion of remission (no symptoms) and at least 50% reduction of initial scores (response), were pooled using relative risks. Random effects models were used that take into account the variance within and between studies. Results: Ten articles were selected and subdivided by their interventions, controlled training modality and levels of intensity. As there was no statistically significant difference between the two types of intervention (strength or aerobic training), we combined data which finally showed a 0.61 (95% CI: –0.88 to –0.33) standard deviation reduction in the intervention group compared to the control group. When the analysis was restricted only to those studies that used the Hamilton scale (n = 15), we observed a reduction of 3.49 points compared with the control group. Conclusion: Despite the heterogeneity of the studies, the present meta-analysis concluded that physical exercise improves the response to treatment, especially aerobic training. However, the efficacy of exercise in the treatment of depression was influenced by age and severity of symptoms.

Neuroscience of Exercise: From Neurobiology Mechanisms to Mental Health

The neuroscience of exercise is a growing research area that is dedicated to furthering our understanding of the effects that exercise has on mental health and athletic performance. The present study examined three specific topics: (1) the relationship between exercise and mental disorders (e.g. major depressive disorder, dementia and Parkinsons disease), (2) the effects of exercise on the mood and mental health of athletes, and (3) the possible neurobiological mechanisms that mediate the effects of exercise. Positive responses to regular physical exercise, such as enhanced functional capacity, increased autonomy and improved self-esteem, are frequently described in the recent literature, and these responses are all good reasons for recommending regular exercise. In addition, physical exercise may improve both mood and adherence to an exercise program in healthy individuals and might modulate both the performance and mental health of athletes. Exercise is associated with the increased synthesis and release of both neurotransmitters and neurotrophic factors, and these increases may be associated with neurogenesis, angiogenesis and neuroplasticity. This review is a call-to-action that urges researchers to consider the importance of understanding the neuroscience of physical exercise and its contributions to sports science.

Neurobiological effects of exercise on major depressive disorder: A systematic review

Exercise displays promise as an efficacious treatment for people with depression. However, no systematic review has evaluated the neurobiological effects of exercise among people with major depressive disorder (MDD). The aim of this article was to systematically review the acute and chronic biological responses to exercise in people with MDD. Two authors conducted searches using Medline (PubMed), EMBASE and PsycINFO. From the searches, twenty studies were included within the review, representing 1353 people with MDD. The results demonstrate that a single bout of exercise increases atrial natriuretic peptide (ANP), brain natriuretic peptide (BNP), copepetin and growth hormone among people with MDD. Exercise also potentially promotes long-term adaptations of copeptin, thiobarbituric acid reactive species (TBARS) and total mean frequency (TMF). However, there is limited evidence that exercise promotes adaptations on neurogenesis, inflammation biomarkers and brain structure. Associations between depressive symptoms improvement and hippocampus volume and IL-1β were found. Nevertheless, the paucity of studies and limitations presented within, precludes a more definitive conclusion of the underlying neurobiological explanation for the antidepressant effect of exercise in people with MDD. Further trials should utilize appropriate assessments of neurobiological markers in order to build upon the results of our review and further clarify the potential mechanisms associated with the antidepressant effects of exercise.

Role of physical activity on the maintenance of cognition and activities of daily living in elderly with Alzheimer's disease

BACKGROUND The practice of physical activities has proved to be an efficient strategy in the improvement of independency and cognitive functions in the elderly with Alzheimers disease (AD). OBJECTIVE To evaluate the relation between the practice of physical activity, cognition and activities of daily living (ADL) of patients with AD. METHOD The cognitive and physical aspects and ADL were evaluated of 37 elders (19 normal controls, 11 sedentary with AD and 7 active with AD). RESULTS The variable that best predicts the cognitive state (MMSE) is the duration of disease for the AD sedentary group and Lawtons Scale for the AD active group. We observed a correlation between MMSE score and duration of disease in the sedentary group and between MMSE and ADL in the active group. CONCLUSION Our study showed that physical and cognitive stimulation in patients with AD can contribute to decrease cognitive and functional decline.FUNDAMENTO: A pratica de atividade fisica tem se mostrado uma estrategia eficaz na melhora da independencia e das funcoes cognitivas em idosos com doenca de Alzheimer (DA). OBJETIVO: Avaliar a relacao entre a pratica de atividade fisica, a cognicao e as atividades de vida diaria (AVD) em pacientes com DA. METODO: Foram avaliados os aspectos cognitivos, fisicos e as AVD de 37 idosos (19 controles normais, 11 com DA sedentarios e 7 com DA ativos). RESULTADOS: A variavel que melhor prediz o estado cognitivo (MEEM) foi o tempo de doenca para o grupo DA sedentarios e a Escala de Lawton para o grupo DA ativo. Observou-se correlacao entre MEEM e tempo de doenca no grupo sedentario e MEEM e AVD no grupo ativo. CONCLUSAO: O nosso estudo mostrou que a estimulacao fisica e cognitiva em pacientes com DA pode contribuir na diminuicao do declinio cognitivo e funcional.

Continuous and High-Intensity Interval Training: Which Promotes Higher Pleasure?

Objectives To compare the psychological responses to continuous (CT) and high-intensity interval training (HIT) sessions. Methods Fifteen men attended one CT session and one HIT session. During the first visit, the maximum heart rate, VO2Peak and respiratory compensation point (RCP) were determined through a maximal cardiopulmonary exercise test. The HIT stimulus intensity corresponded to 100% of VO2Peak, and the average intensity of both sessions was maintained at 15% below the RCP. The order of the sessions was randomized. Psychological and physiological variables were recorded before, during and after each session. Results There were no significant differences between the average percentages of VO2 during the two exercise sessions (HIT: 73.3% vs. CT: 71.8%; p = 0.779). Lower responses on the feeling scale (p≤0.01) and higher responses on the felt arousal scale (p≤0.001) and the rating of perceived exertion were obtained during the HIT session. Despite the more negative feeling scale responses observed during HIT and a greater feeling of fatigue (measured by Profile of Mood States) afterwards (p<0.01), the physical activity enjoyment scale was not significantly different between the two conditions (p = 0.779). Conclusion Despite the same average intensity for both conditions, similar psychological responses under HIT and CT conditions were not observed, suggesting that the higher dependence on anaerobic metabolism during HIT negatively influenced the feeling scale responses.

Electroencephalographic frontal asymmetry and depressive symptoms in the elderly.

Although neurophysiological changes of aging are well known, there is still much to learn about cortical asymmetry in older depressed subjects. This study aimed at assessing differences between depressed and normal elderly subjects on alpha asymmetry, and to observe the correlations of this measure with depressive symptoms and quality of life. Thirty-six subjects (14 normal and 22 depressed) were assessed by EEG, depression rating scales, and SF-36. Despite the fact that compared to healthy elderly, depressive elderly subjects showed relatively greater right frontal activity (F4F3) and relatively greater left parietal activity (P4P3); this difference was not significant. The relationship between depression and frontal asymmetry was better observed in healthy elderly, where relatively greater left frontal activity was associated with less depressive symptoms.

Effect of aerobic training on EEG alpha asymmetry and depressive symptoms in the elderly: a 1-year follow-up study

The effect of physical exercise on the treatment of depressive elderly adults has not been investigated thus far in terms of changes in cortical hemispheric activity. The objective of the present study was to identify changes in depressive symptoms, quality of life, and cortical asymmetry produced by aerobic activity. Elderly subjects with a diagnosis of major depressive disorder (DSM-IV) were included. Twenty patients (70% females, 71 +/- 3 years) were divided into an exercise group (pharmacological treatment plus aerobic training) and a control group (undergoing pharmacological treatment) in a quasi-experimental design. Pharmacological treatment was maintained stable throughout the study (antidepressants and anxiolytics). Subjects were evaluated by depression scales (Beck Depression Inventory, Hamilton Depression Rating Scale, Montgomery-Asberg Depression Rating Scale) and the Short Form Health Survey-36, and electroencephalographic measurements (frontal and parietal alpha asymmetry) before and after 1 year of treatment. After 1 year, the control group showed a decrease in cortical activity on the right hemisphere (increase of alpha power), which was not observed in the exercise group. The exercise group showed a significant decrease of depressive symptoms, which was not observed in the control group. This result was also accompanied by improved treatment response and remission rate after 1 year of aerobic exercise associated with treatment. This study provides support for the effect of aerobic training on alpha activity and on depressive symptoms in elderly patients. Exercise facilitates the treatment of depressive elderly adults, leading to clinical and physical improvement and protecting against a decrease in cortical activity.

Acute exercise improves cognition in the depressed elderly: the effect of dual-tasks

OBJECTIVE: The goal of this study was to assess the acute effect of physical exercise on the cognitive function of depressed elderly patients in a dual-task experiment. INTRODUCTION: Physical exercise has a positive effect on the brain and may even act as a treatment for major depressive disorder. However, the effects of acute cardiovascular exercise on cognitive function during and after one session of aerobic training in elderly depressive patients are not known. METHODS: Ten elderly subjects diagnosed with major depressive disorder performed neuropsychological tests during and after a moderate physical exercise session (65-75%HRmax). A Digit Span Test (Forward and Backward) and a Stroop Color-Word Test were used to assess cognitive function. The elderly participants walked on an electric treadmill for 30 minutes and underwent the same cognitive testing before, during, immediately after, and 15 minutes after the exercise session. In the control session, the same cognitive testing was conducted, but without exercise training. RESULTS: The results of the Digit Span Test did not change between the control and the exercise sessions. The results of the Stroop Color-Word Test improved after physical exercise, indicating a positive effect of exercise on cognition. CONCLUSIONS: These data suggest that the cognitive functions of depressed elderly persons, especially attention and inhibitory control, are not impaired during and after an acute session of physical exercise. In contrast, the effect of dual-tasks showed beneficial results for these subjects, mainly after exercise. The dual-task may be a safe and useful tool for assessing cognitive function.

Beta and alpha electroencephalographic activity changes after acute exercise.

Exercise has been widely related to changes in cortical activation and enhanced brain functioning. Quantitative electroencephalography (qEEG) is frequently used to investigate normal and pathological conditions in the brain cortex. Therefore, the aim of the present study was to observe absolute power alterations in beta and alpha frequency bands after a maximal effort exercise. Ten healthy young volunteers were submitted to an eight-minute resting EEG (eyes closed) followed by a maximal exercise test using a mechanical cycle ergometer. Immediately after the exercise, another identical eight-minute EEG was recorded. Log transformation and paired students t-test compared the pre and post exercise values (p<0.05). Results indicated a significant absolute power increase in beta after exercise at frontal (Fp1, F3 and F4) and central (C4) areas, which might be related to increased cortical activation.