Bedeutung von Ausdauersport für die Verbesserung von Kognition und Remission bei post-akuter Schizophrenie

Zusammenfassung

Die Schizophrenie geht häufig mit einer verminderten sozialen Funktion aufgrund kognitiver Defizite einher, die mit gehirnstrukturellen Veränderungen wie einer Verminderung des Hippocampusvolumens assoziiert sind. In einer ersten Studie haben wir eine Verbesserung des episodischen Gedächtnisses und eine Volumenvergrößerung des Hippocampus nach aerobem Sporttraining bei Menschen mit einer Mehrfacherkrankung einer Schizophrenie gefunden. In einer Folgestudie unter Kombination mit kognitivem Training konnten wir eine Vergrößerung des temporalen Kortex zeigen, allerdings fanden wir für die Gesamtgruppe keine signifikante Zunahme des Hippocampusvolumens. Bei diesen Patienten war jedoch ein erhöhter polygenetischer Risikofaktor (Polygenetic Risk Score, PRS) mit einer verminderten Volumenzunahme des Hippocampus assoziiert sowie verbesserter körperlicher Fitness und psychosozialen Funktionsniveau. In der Sportstudie (Clinical-Trials.gov ID: NCT03466112) des „Enhancing Schizophrenia Prevention and Recovery through Innovative Treatments” (ESPRIT) Forschungsnetzwerkes zu psychischen Erkrankungen erweitern wir die Dauer des Trainings nach den Richtlinien des American College of Sports Medicine. Langzeiteffekte des Ausdauertrainings auf Kognition, Symptome und funktionelle Genesung werden verglichen mit einer Kontrollgruppe, die Gleichgewichtsübungen und Muskeltonustraining durchführt.

Summary

Schizophrenia is often associated with poor psychosocial functioning due to cognitive deficits connected to brain structural abnormalities like hippocampal volume decrease. We could previously demonstrate an improvement of episodic memory in patients with multi-episode schizophrenia after 3-month endurance training with bicycle ergometer accompanied by an increase of hippocampal volume. In a subsequent aerobic exercise study combined with cognitive remediation, we found a volume increase of the temporal cortex but we did not detect a significant increase in hippocampal volume in the whole group. However, in these patients an increased schizophrenia polygenic risk score (PRS) was associated with a reduced ability of volume changes after aerobic exercise. Furthermore, physical fitness and psychosocial functioning were improved in this group of patients. In the current study (ClinicalTrials.gov ID: NCT03466112) in recent-onset schizophrenia in the “Enhancing Schizophrenia Prevention and Recovery through Innovative Treatments” (ESPRIT) research network, we are extending the duration of training as suggested by the American College of Sport Medicine. We are investigating long-term effects of this endurance training compared to a balance and tone program as control condition on cognition, psychopathological symptoms and functional recovery.

Schlüsselwörter

Schizophrenie - Sporttherapie - Symptomatik - Hippocampusvolumen - Schizophrenie assoziierter PRS

Keywords

Schizophrenia - aerobic exercise training - symptoms - hippocampus volume - schizophrenia PRS

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