Abstract
Executive dysfunction is common during and between mood episodes in bipolar disorder (BD), causing social and functional impairment. This study investigated the effect of acute exercise on adolescents with BD and healthy control subjects (HC) to test for positive or negative consequences on neural response during an executive task. Fifty adolescents (mean age 16.54±1.47 years, 56% female, 30 with BD) completed an attention and response inhibition task before and after 20 min of recumbent cycling at ~70% of age-predicted maximum heart rate. 3 T functional magnetic resonance imaging data were analyzed in a whole brain voxel-wise analysis and as regions of interest (ROI), examining Go and NoGo response events. In the whole brain analysis of Go trials, exercise had larger effect in BD vs HC throughout ventral prefrontal cortex, amygdala and hippocampus; the profile of these effects was of greater disengagement after exercise. Pre-exercise ROI analysis confirmed this 'deficit in deactivation' for BDs in rostral ACC and found an activation deficit on NoGo errors in accumbens. Pre-exercise accumbens NoGo error activity correlated with depression symptoms and Go activity with mania symptoms; no correlations were present after exercise. Performance was matched to controls and results survived a series of covariate analyses. This study provides evidence that acute aerobic exercise transiently changes neural response during an executive task among adolescents with BD, and that pre-exercise relationships between symptoms and neural response are absent after exercise. Acute aerobic exercise constitutes a biological probe that may provide insights regarding pathophysiology and treatment of BD.
Highlights
Cognitive dysfunction is common among adolescents with bipolar disorder (BD) during and between mood episodes, contributing to social and functional impairment.[1,2,3] Meta-analytic findings implicate attention and executive function as among the most impaired domains.[2]
heart rate (HR) exceeded the minimum of the target range for 90% of participants in at least 18 of the 20 min of aerobic activity
This study investigated the effect of an acute bout of exercise on adolescents with BD to test for positive or negative consequences on neural response during an executive control task
Summary
Cognitive dysfunction is common among adolescents with bipolar disorder (BD) during and between mood episodes, contributing to social and functional impairment.[1,2,3] Meta-analytic findings implicate attention and executive function as among the most impaired domains.[2]. Numerous studies among adults and youth with BD have examined neural activation for executive processes during sustained attention and inhibition,[13,14,15,16,17,18,19,20,21,22,23,24] using Stop-signal[14,15,16,18,22] or Go-NoGo17,19,21,24 tasks Both tasks share a sustained attention component with repeated ‘Go’ response to a stimulus and maintenance of vigilance for a Stop cue or a NoGo stimulus. Brain regions showing difference in neural response between adolescents with
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