Abstract
Weight gain has been identified as being responsible for increased morbidity and mortality rates of schizophrenia patients. For the management of weight gain, exercise is one of the most acknowledged interventions. At the same time, exercise and sports have been recognized for their positive impact on psychiatric symptoms of schizophrenia. However, the neurobiological basis for this remains poorly understood. We aimed to examine the effect of sports participation on weight gain, psychiatric symptoms and brain activation during sports observation in schizophrenia patients. Thirteen schizophrenia patients who participated in a 3-month program, including sports participation and 10 control schizophrenia patients were studied. In both groups, body mass index (BMI), Positive and Negative Syndrome Scale (PANSS), and brain activation during observation of sports-related actions measured by functional magnetic resonance imaging were accessed before and after a 3-month interval. BMI and general psychopathology scale of PANSS were significantly reduced in the program group but not in the control group after a 3-month interval. Compared with baseline, activation of the body-selective extrastriate body area (EBA) in the posterior temporal-occipital cortex during observation of sports-related actions was increased in the program group. In this group, increase in EBA activation was associated with improvement in the general psychopathology scale of PANSS. Sports participation had a positive effect not only on weight gain but also on psychiatric symptoms in schizophrenia. EBA might mediate these beneficial effects of sports participation. Our findings merit further investigation of neurobiological mechanisms underlying the therapeutic effect of sports for schizophrenia.
Highlights
Exercise is being increasingly implemented for the management of obesity and weight gain in schizophrenia,[6,7,33] and the patients participating in the current program succeeded in reducing body mass index (BMI)
We demonstrated that sports participation had a positive effect on psychiatric symptoms in schizophrenia
A recent magnetic resonance imaging study demonstrated that improvement of short-term memory induced by exercise was associated with an increase in hippocampal volume in older adults.[34]
Summary
Obesity and weight gain were identified as factors responsible for increased morbidity and mortality rates of patients with schizophrenia long before the introduction of second-generation antipsychotics.[1,2] With their introduction, awareness of weight gain has increased considerably among many healthcare professionals and patients.[3,4,5] For the management of obesity and weight gain, exercise is one of the most acknowledged interventions.[6,7] At the same time, obesity was associated with negative effects on memory in schizophrenia,[8] and exercise/sports have been recognized to have a positive impact on cognition and psychiatric symptoms of schizophrenia.[9,10] Recent neuroscience research has presented increasing evidence concerning the neurobiological mechanism involved in the positive effect of exercise on cognition in the general population.[11] In addition, a recent study has demonstrated that exercise induced an increase in hippocampal volume and improvement in short-term memory in schizophrenia.[12] the neurobiological basis of the positive impact of exercise on psychiatric symptoms of schizophrenia remains poorly understood
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