Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, Ontario, Canada.
Postgrad Med. 2010 Nov;122(6):107-16. doi: 10.3810/pgm.2010.11.2228.
Neurocognitive dysfunction associated with bipolar disorder (BD) is pervasive, persistent across illness phases, and is demonstrated to predispose and portend psychosocial impairment. Moreover, no approved therapies for various phases of BD have been shown to reliably improve any dimension of neurocognitive performance. In this article, we emphasize that aerobic physical exercise is a viable neurocognitive-enhancing adjunctive treatment for patients with BD. The overarching aim of this review is to emphasize that aerobic physical exercise is a viable neurocognitive-enhancing adjunctive treatment for patients with BD.
We conducted PubMed and Google Scholar searches of all English-language articles published between January 1966 and February 2010 using the search terms bipolar disorder, major depressive disorder, depression, exercise, and physical activity cross-referenced with each other and the following terms: cognition, executive function, learning, memory, attention, emotion, and behavior. Articles selected for review were based on adequacy of sample size, use of standardized experimental procedures, validated assessment measures, and overall quality.
Available studies have documented an array of persisting neurocognitive deficits across disparate bipolar populations. Abnormalities in verbal working memory are highly replicated; deficits in executive function, learning, attention, and processing speed are also a consistent abnormality. The effect sizes of neurocognitive deficits in BD are intermediate between those reported in schizophrenia and major depressive disorder. Several original reports and reviews have documented the neurocognitive-enhancing effects of aerobic exercise in the general population as well as across diverse medical populations and ages. Proposed mechanisms involve nonexclusive effects on neurogenesis, neurotrophism, immunoinflammatory systems, insulin sensitivity, and neurotransmitter systems. Each of these effector systems are implicated in both normal and abnormal neurocognitive processes in BD.
Available evidence provides a rationale for empirically evaluating the neurocognitive benefits of aerobic exercise in BD.
与双相情感障碍（BD）相关的神经认知功能障碍普遍存在，贯穿疾病各阶段，并被证明易导致和预示社会心理障碍。此外，尚无针对 BD 各阶段的经批准的治疗方法被证明能可靠地改善神经认知表现的任何方面。在本文中，我们强调有氧运动是 BD 患者可行的神经认知增强辅助治疗方法。本文的总体目标是强调有氧运动是 BD 患者可行的神经认知增强辅助治疗方法。
我们使用搜索词“双相情感障碍”、“重性抑郁障碍”、“抑郁”、“运动”和“身体活动”，在 PubMed 和 Google Scholar 上进行了所有 1966 年 1 月至 2010 年 2 月期间以英文发表的文章的检索，并相互交叉引用，以及以下术语：认知、执行功能、学习、记忆、注意力、情绪和行为。选择用于审查的文章基于样本量是否足够、使用标准化实验程序、验证评估措施以及整体质量。
现有研究记录了不同双相人群中存在的一系列持续的神经认知缺陷。言语工作记忆异常高度重现；执行功能、学习、注意力和处理速度缺陷也是常见的异常。BD 中神经认知缺陷的效应量介于精神分裂症和重性抑郁障碍报告的效应量之间。一些原始报告和综述记录了有氧运动在一般人群以及各种医学人群和年龄组中的神经认知增强作用。提出的机制涉及神经发生、神经营养、免疫炎症系统、胰岛素敏感性和神经递质系统的非排他性作用。这些效应系统都与 BD 中正常和异常的神经认知过程有关。
现有证据为在 BD 中评估有氧运动的神经认知益处提供了依据。
