Abstract
Aerobic exercise is effective in alleviating mood symptoms while the mechanism is poorly understood. There are limited clinical trials that investigated the effect of exercise on the anterior cingulate cortex (ACC), a key brain region involved in mood regulations, in adolescents with subthreshold mood syndromes. This randomized controlled trial (RCT) of aerobic exercise was undertaken in a middle school in Guangzhou, China. Participants were adolescents aged 12–14 with subthreshold mood syndromes including depressive and manic symptoms and were randomly assigned to an aerobic exercise intervention or a psychoeducation control group. Participants in the exercise group received moderate-intensity exercise intervention, consisting of 30 mins running, 4 days per week for 3 months. The primary outcome in this study was structural changes in the ACC from baseline to post intervention. The trial was registered with ClinicalTrial.gov (NCT03300778). Of 56 participants who met the criteria for subthreshold mood syndromes, 39 (41.03% males) had complete MRI data, with 20 and 19 subjects in the exercise and control group, respectively. At baseline, demographic information (e.g., age and sex), clinical symptoms, and the gray matter volume and cortical thickness of ACC were matched between the two groups. After 12 weeks of treatment, participants in the exercise group displayed increased gray matter volume of the left rostral ACC (F1,30 = 5.73, p = 0.02) and increased cortical thickness of the right rostral ACC (F1,30 = 7.83, p = 0.01) when compared with the control group. No significant differences were found for caudal ACC cortical thickness and gray matter volume. Our data demonstrate that 12-week, moderate-intensity aerobic exercise can induce structural changes in the rostral ACC in adolescents with subthreshold mood syndromes.
Highlights
At least 50% of mental health symptoms and disorders develop in youth and adolescence[1]
We identify potential changes in key brain areas implicated in mood disorders, which may improve in response to 12-week moderate-intensity aerobic exercise, i.e., gray matter (GM) volume of the left rostral anterior cingulate cortex (ACC) and cortical thickness of the right rostral ACC
The ACC investigated in this study have been identified as being impacted and reduced in adolescent with subthreshold depression and hypomania[13,29]
Summary
At least 50% of mental health symptoms and disorders develop in youth and adolescence[1]. The burden of poor mental health and wellbeing remains substantial during this key time of transition[2]. Mood disorders are a leading cause of mental health burden in adolescence[3]. A number of different treatment approaches have been proposed such as antidepressant medication[4], psychological therapy[5], and psychoeducation[6]. Antidepressant medication may have side effects[7] and possibly be related increased risk of suicide attempts[8]. Psychological therapy does not work for all adolescents[9]. There is increasing recognition that mood disorders in adolescence often co-occur with
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