University of Colorado at Boulder, Department of Psychology and Neuroscience, Center for Neuroscience, 345 UCB, Boulder, CO 80309-0345.
Department of Psychology and Neuroscience, University of Colorado Boulder, Boulder, Colorado, USA.
J Clin Psychiatry. 2017 Nov-Dec;78(9):e1167-e1173. doi: 10.4088/JCP.16m11365.
A rapidly accumulating body of research suggests that exercise can improve symptoms and well-being in patients suffering from psychosis. Exercise may also promote neurogenesis in the hippocampus, a structure that plays an important role in the pathophysiology of psychosis. To date, there has not been an intervention focused on exercise prior to the onset of psychosis, a critical time for prevention of more serious illness.
In this pilot study, 12 young adults at ultrahigh risk (UHR) for psychosis were enrolled in a 12-week open-label exercise intervention. Participants were randomly assigned to exercise 2 or 3 times each week and exercised between 65% and 85% of maximum oxygen capacity (Vo2max) for 30 minutes each session under the supervision of an exercise physiologist. Positive and negative symptoms, social and role functioning, performance on neurocognitive tests, cardiovascular fitness, and hippocampal structure and functional connectivity were evaluated before and after the trial.
A total of 9 participants completed the exercise intervention. Participants showed improved positive and negative symptoms and social and role functioning; improvement in multiple areas of cognition; and increased functional connectivity between the left hippocampus and occipital cortex after 12 weeks of exercise.
The results of this study suggest that exercise interventions are feasible in a UHR sample and may promote improvement in clinical, social, and cognitive domains as well as changes to brain function in regions impacted by the development of psychosis. These findings set the stage for an ongoing phase 2 randomized controlled trial.
ClinicalTrials.gov identifier: NCT02155699.
越来越多的研究表明，运动可以改善精神病患者的症状和幸福感。运动还可能促进海马体的神经发生，海马体在精神病的病理生理学中起着重要作用。迄今为止，还没有针对精神病发作前的运动干预措施，这是预防更严重疾病的关键时期。
在这项初步研究中，12 名处于精神病超高风险（UHR）的年轻人参加了为期 12 周的开放性运动干预。参与者被随机分配到每周进行 2 或 3 次运动，在运动生理学家的监督下，每次运动 30 分钟，运动强度为最大摄氧量（Vo2max）的 65%至 85%。在试验前后评估阳性和阴性症状、社会和角色功能、神经认知测试表现、心血管健康以及海马体结构和功能连接。
共有 9 名参与者完成了运动干预。参与者在阳性和阴性症状以及社会和角色功能方面表现出改善；认知多个领域的改善；以及左海马体和枕叶皮质之间的功能连接增强。
这项研究的结果表明，运动干预在 UHR 样本中是可行的，并且可能促进临床、社会和认知领域的改善，以及精神病发展所影响的大脑区域的功能变化。这些发现为正在进行的 2 期随机对照试验奠定了基础。
ClinicalTrials.gov 标识符：NCT02155699。
