TY - JOUR
T1 - Synergistic Benefits of Combined Aerobic and Cognitive Training on Fluid Intelligence and the Role of IGF-1 in Chronic Stroke
AU - Ploughman, Michelle
AU - Eskes, Gail A.
AU - Kelly, Liam P.
AU - Kirkland, Megan C.
AU - Devasahayam, Augustine J.
AU - Wallack, Elizabeth M.
AU - Abraha, Beraki
AU - Hasan, S. M.Mahmudul
AU - Downer, Matthew B.
AU - Keeler, Laura
AU - Wilson, Graham
AU - Skene, Elaine
AU - Sharma, Ishika
AU - Chaves, Arthur R.
AU - Curtis, Marie E.
AU - Bedford, Emily
AU - Robertson, George S.
AU - Moore, Craig S.
AU - McCarthy, Jason
AU - Mackay-Lyons, Marilyn
N1 - Publisher Copyright:
© The Author(s) 2019.
PY - 2019
Y1 - 2019
N2 - Background. Paired exercise and cognitive training have the potential to enhance cognition by “priming” the brain and upregulating neurotrophins. Methods. Two-site randomized controlled trial. Fifty-two patients >6 months poststroke with concerns about cognitive impairment trained 50 to 70 minutes, 3× week for 10 weeks with 12-week follow-up. Participants were randomized to 1 of 2 physical interventions: Aerobic (>60% VO 2peak using <10% body weight–supported treadmill) or Activity (range of movement and functional tasks). Exercise was paired with 1 of 2 cognitive interventions (computerized dual working memory training [COG] or control computer games [Games]). The primary outcome for the 4 groups (Aerobic + COG, Aerobic + Games, Activity + COG, and Activity + Games) was fluid intelligence measured using Raven’s Progressive Matrices Test administered at baseline, posttraining, and 3-month follow-up. Serum neurotrophins collected at one site (N = 30) included brain-derived neurotrophic factor (BDNF) at rest (BDNF resting ) and after a graded exercise test (BDNF response ) and insulin-like growth factor–1 at the same timepoints (IGF-1 rest , IGF-1 response ). Results. At follow-up, fluid intelligence scores significantly improved compared to baseline in the Aerobic + COG and Activity + COG groups; however, only the Aerobic + COG group was significantly different (+47.8%) from control (Activity + Games −8.5%). Greater IGF-1 response at baseline predicted 40% of the variance in cognitive improvement. There was no effect of the interventions on BDNF resting or BDNF response ; nor was BDNF predictive of the outcome. Conclusions. Aerobic exercise combined with cognitive training improved fluid intelligence by almost 50% in patients >6 months poststroke. Participants with more robust improvements in cognition were able to upregulate higher levels of serum IGF-1 suggesting that this neurotrophin may be involved in behaviorally induced plasticity.
AB - Background. Paired exercise and cognitive training have the potential to enhance cognition by “priming” the brain and upregulating neurotrophins. Methods. Two-site randomized controlled trial. Fifty-two patients >6 months poststroke with concerns about cognitive impairment trained 50 to 70 minutes, 3× week for 10 weeks with 12-week follow-up. Participants were randomized to 1 of 2 physical interventions: Aerobic (>60% VO 2peak using <10% body weight–supported treadmill) or Activity (range of movement and functional tasks). Exercise was paired with 1 of 2 cognitive interventions (computerized dual working memory training [COG] or control computer games [Games]). The primary outcome for the 4 groups (Aerobic + COG, Aerobic + Games, Activity + COG, and Activity + Games) was fluid intelligence measured using Raven’s Progressive Matrices Test administered at baseline, posttraining, and 3-month follow-up. Serum neurotrophins collected at one site (N = 30) included brain-derived neurotrophic factor (BDNF) at rest (BDNF resting ) and after a graded exercise test (BDNF response ) and insulin-like growth factor–1 at the same timepoints (IGF-1 rest , IGF-1 response ). Results. At follow-up, fluid intelligence scores significantly improved compared to baseline in the Aerobic + COG and Activity + COG groups; however, only the Aerobic + COG group was significantly different (+47.8%) from control (Activity + Games −8.5%). Greater IGF-1 response at baseline predicted 40% of the variance in cognitive improvement. There was no effect of the interventions on BDNF resting or BDNF response ; nor was BDNF predictive of the outcome. Conclusions. Aerobic exercise combined with cognitive training improved fluid intelligence by almost 50% in patients >6 months poststroke. Participants with more robust improvements in cognition were able to upregulate higher levels of serum IGF-1 suggesting that this neurotrophin may be involved in behaviorally induced plasticity.
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U2 - 10.1177/1545968319832605
DO - 10.1177/1545968319832605
M3 - Article
C2 - 30816066
AN - SCOPUS:85062463345
SN - 1545-9683
JO - Neurorehabilitation and Neural Repair
JF - Neurorehabilitation and Neural Repair
ER -