In this article I discuss about the effect of exercise on brain health. A huge number of research have studied the effect of exercise on cardio-vascular system,endocrine system and musculoskeletal system.Many studies have provided evidence for the positive and prophylactic effect of exercise on these systems in disease and health.However as of 2014 number of research have explored the effect of exercise on brain health. In this article I wish to provide a research based overview of neurophysiological effect and therapeutic effect of exercise on CNS health, Neurodegenerative diseases and aging.
A number of studies have observed beneficial neurophysiologial effect of acute and chronic exercise in Human and animals.A study published in 2005 in Journal of Neurobiology of Ageing by psychiatrist Ronald Stanton Duman PhD states that exercise and enriched environment increases neurotrophic support in human brain by increasing cerebral blood Flow (CBF),the expression of Neurotropic Factors like BDNF, IGF-1, VEGF , NT-3,FGF-2 , GDNF , EGF and NGF as well as the induction of pro-inflammatory process by exercise promote neurogenesis, angeogenesis and synaptogenesis.
Studies have also shown that physical exercise modulates the major CNS neurotransmitters that are associated with ones state of alertness( Norepinephrine),pleasure and reward system(Dopamine) and the level of anxiety( serotonin).Besides that changes in the level of these neurotransmitters may have different consequences depending on the type of receptors and cortical areas that are activated (Sarbadhikari SN & Saha AK 2006). A study published in BJSM in 2004 by Dietrich, titled 'Endocannabenoids and exercise' says that regular physical exercise can cause a sense of well being and euphoria,anxiolytic effects,sedation and decreased sensitivity to pain in humans by promoting release of opioids and endocannabenoids. Systematic exercise and proper diet that is rich in anti-oxidants have very positive impact in brain health. Adhering to diet that is rich in anti-oxidants and anti-inflammatory components in combination with physical exercise participation would have significantly better results.Moreover,elevated Vascular Endothelial Growth Factor(VEGF) levels,accelerated metabolism might contribute to enhanced angeogenesis( Periera AC et all 2007).
In the last decade a number of studies have come up with promising evidence for considering exercise as a supportive prophylactic and therapeutic means in the treatment plans of Neuropsychatric diseases such as Major Depressive Disorder(MDD), Dementia and Parkinsons disease. Smaller hippocampal volume, which may be due to fewer Granule Neurons(GN) in the Dentate Gyrus(DG) is identified in patients suffering from MDD ( Boldrin M et all 2013). Exercise increases beta endorphin levels which might play a significant role in enhancing the birth of new neurons in the Dentate Gyrus. exercise also increases levels of VEGF and BDNF that may play a critical role in promoting the survival of new neurons in the Denate Gyrus which is indicated to undergo pathologic changes in MDD (B.R.Christie2006). Rethorst et all reviewed 75 RCTs comparing exercise versus no treatment or wait list control. 58 of the 75 studies were included in a Meta-Analysis which showed a clinically significant effect of exercise on MDD.( ES:0.80,95%CI-0.90 to 0.67).
Clinical Studies in human demonstrate that various modalities and systematic exercise can improve cognitive capacity in patients with PD.Cognitive dysfunction in Parkinsons Disease(PD) is associated with impaired executive function( Higginson CI et all 2003). In 2013 Fisher et all published an RCT in Neuroreport. Which analysed whether Treadmill exercise promotes Striatal D2 binding potential in patients with early parkinsons disease. 4 patients with early PD where randomized to receive intensive exercise( treadmil training sessions/3/week for 8 weeks) or no exercise. 2 healthy age- matched individuals participated in treadmill training. Alterations in the DA-D2R binding potential as a marker for receptor expression were determined using PET imaging with (18F) Fallypride. Turning perfromance of the patients with PD as a measure for postural control and UPDR scale scores pre-exercise and post exercise were determined. The results showed an exercise -induced inrease in 18F binding potential as well as improved postural control in patients with early PD who exercised. The researches concluded that exercise leads to positive Neuroplasticty in dopamenergic signaling and contributes to improved postural control in early stage PD.
A number of studies have also showed that Progressive Resistance Exercise also helps to enhance functionality and quality of life of patients with PD. Patients with mild to moderate PD can obtain increase in performance or strength similar to that of normal adults in the same age in a resistance training program. Resistance training can produce functional improvements in gait and may therefore be useful as part of a physical rehabilitation and/ or health maintenance program for patients with PD( Scabdalis et all 2001).
Caerphilly Cohort study, A study that monitored the health habits of 2235 men over a period of 35 years have confirmed exercise significantly reduces the risk of Dementia along with other 4 healthy behaviors low body weight, No-smoking, low alcohol , healthy diet.People who consistently followed 4 or 5 of these behaviors experienced a 60% decline in dementia and cognitive decline with exercise being the strongest mitigating factor( Peter Elwood et all 2013). A study conducted by Yerokhvin et all in 2012 analysed whether strengthening exercise programs help to improve verbal memory in patients with early dementia.This study evaluated the effect of a 10 weeks strengthening exercise intervention on cognitive function and EEG in a sample of 13 older adults with early Dementia and 9 normative controls. Results revealed beneficial effect of strengthening exercise on verbal memory coupled with frontal beta and delta power asymmetries and N200 amplitude asymmetry. Results of the study showed that strength training programs helps to enhance cognitive efficiency in people with early stage dementia.Physical exercise improves the efficiency of the capillary system and and increases the O2 supply to the brain.Thus enhancing metabolic activity and oxygen uptake in neurons and increases neurotropin levels and resistance to stress. Regular exercise and active lifestyle during adulthood have been associated with reduced risk and protective effects for mild cognitive impairment and Alzheimer's disease( Perla Kaliman 2011). Apolipoprotein (APOE) is a gene that produces an important protein called Apoplipoprotein E which is essential for packing cholesterol and other fats and carrying them through the circulation. Carriers of an allelic variant of APOE gene called APOE epsilon4 are at increased risk of Alzheminer's Disease(AD).APOE e4 causes increased deposit of amyloid beta peptides and amyloid plaques in the brain tissue of carriers of this variant. Amyloid beta peptides and amyloid plaques causes progressive death of neurons in the brain and triggers signs of AD.In APOEe4 carriers compared to non-carriers greater level of physical activity may be more effective in reducing amyloid burden and are associated with greater activation of Semantic memory related neural circuits( J C Smith et all 2013).
These research finding conclude that systematic exercise and healthy diet and way of living is a prophylactic and supportive therapeutic means in promoting brain health, preventing or preventing the progress of Neuropsychatric and Neurodegenerative conditions and a supportive therapy for array of Neuropsychatric conditions. Systematic exercise and lifestyle is also a potent mediator of anti-ageing effect in ageing brain. I hope this article will provide a scientific understanding of the neurophysiological effect of exercise and a research based understanding of the prophylactic and therapeutic effect of exercise on brain health. The main purpose of this article is like my every other articles to promote evidence based practice of exercise science among Exercise Physiologists , Clinical Exercise Specialists, Health and Fitness Specialists and other Exercise Professionals. I hope everyone will find this article informative as well.
Siby C Chacko BPE,MPE( Exercise Physiology)
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