Bancroft Exercise Effects on the Brain

Exercise and the Brain Karen Lindgren, Ph.D.

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Strength of mind is exercise, not rest -Alexander Pope It is exercise alone that supports the spirits, and keeps the mind in vigor - Marcus Tullius Cicero

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Goals • How does exercise benefit general health? • How does exercise benefit neurological

health? • What are specific cognitive benefits of

exercise? • What is neuroplasticity? • How does exercise benefit neuroplasticity?

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Format

• GEOGRAPHY OF THE BRAIN • WHAT IS NEUROPLASTICITY • EXERCISE

o What it is o Physiology

• EXERCISE AND THE BRAIN o Simple connections o Complex connections

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The link should be clear • Our brain is a physical organ

• Our brain is a thinking organ

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The link should be clear Exercise helps us physically • strengthens: hearts, bones, lungs, blood vessels • physical changes should be related to thinking

changes

Like our other organs, our brain is a constantly changing organ

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The brain: physical organ Geography of the brain • Brain basics • Neurons • Blood vessels • Neurotransmitters

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The brain: a thinking organ What is thinking? • Cognition refers to any mental process

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What is cognition? Areas of cognition include: • Attention • Concentration • Sensory skills • Motor skills

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What is cognition? Areas of cognition include: • Language • Visual Skills • Memory • Problem solving/judgment moral reasoning

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Brain Geography

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Neuroplasticity What is neuroplasticity? • Refers to the ability of the brain to shape itself

according to experience • Refers to physical change on a neuronal level

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Neuroplasticity What changes when we learn? • Neurons connect with other neurons • Synapses strength changes with learning • More synapses form between neurons

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What is exercise? Types • Cardiovascular • Weight training (resistance training)

Intensity • Active lifestyle • Light • Vigorous

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What happens when we exercise? Heart rate increases

Hormones respond • Pituitary gland releases human growth

hormone to increase production of bone, muscle, or connective tissue cells.

Pituitary gland regulates • Thyroid • Adrenal

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Pituitary Gland • Located in brain, limbic system

• Influences: o Thyroid: neck o Adrenal: kidneys

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What happens when we exercise? Hormones respond • Pituitary gland regulates thyroid gland

Thyroid: releases hormones

• Increase heart rate and blood pressure • Regulate body temperature • Elevate “alertness” in brain to increase

concentration and reaction time

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What happens when we exercise? Hormones respond

• Pituitary gland regulates

o Adrenal glands: In response to the ACTH (adrenocorticotropin) from the pituitary, release

o 1. cortisol: causes blood pressure to rise, triggers increase in glucose, acts as anti-inflammatory agent (repairs tissues) Curbs non-critical functions (e.g., thirst, urine, hunger). Effects immune system.

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o 2. aldosterone: bodily response to anticipate dehydration through impact on kidney function.

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o 3. adrenaline (fight or flight) mechanism. A stimulant, increases strength and frequency of heart contractions. Speeds breakdown of stored carbs into glucose for muscle energy.

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Section Break

• GEOGRAPHY OF THE BRAIN

• WHAT IS NEUROPLASTICITY • EXERCISE

o What it is o Physiology

• EXERCISE AND THE BRAIN o Simple connections o Complex connections

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Exercise and the Brain: How do we know they are linked Studies vary greatly (meta-analysis, Kramer et al) • Ages vary • Length of time looked at varies • Exercise type varies • Method of reporting varies (often self-report) • Method of reporting cognitive skill varies (e.g., MMSE

screen, neuropsych, presence of dementia)

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What is the link? Simple links

• Increased blood flow to the brain is good for us • Simple mind/body benefits: mindfulness

training, yoga

Complex links • Neuroplasticity • Preventing problems • Improved mood--- improved thinking

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Simple connections

• Exercise improves blood flow to the brain

• Is increased blood flow related to improved cognition?

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Simple connections

Physical effects of exercise • Increased blood flow to the brain

o Blood volume increases o Blood flow is more “predictable” o Small vessels grow – increase in number

• Study of 16 women aged 60 and older, walking briskly 3-4 times per week, improved blood flow up to 15 %

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Simple connections

Physical effects of exercise

• Brings O2, glucose, nutrients to brain cells, vital for cell health

• Cell growth: supports new connections, particularly in hippocampus- memory

• Blood washes away “metabolic wastes” such as “amyloid beta protein” (implicated in development of Alzheimers)

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Simple connections

Walking: • Increases blood circulation • Increased oxygen and glucose to the brain • Not strenuous- muscles do not use extra oxygen

and glucose as in more strenuous exercise

In sum, you oxygenate your brain “Clear your head”

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Complex Links Complex links

• Prevents primary neurologic disease • Promotes healthy normal aging • Neuroplasticity • Improved mood--- improved thinking

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Exercise prevents primary neurologic disease Primary Neurologic Disease

• Vascular disease o Cholesterol lowering effects of exercise o Exercise lowers blood pressure: High blood pressure is related to stroke and

mild cognitive impairment o Increased blood flow o Increased vessels

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Exercise promotes healthy aging Normal Aging

• Ameliorates decline: Canadian researchers1 examined active lifestyle for “elderly” individuals over 2-5 years, showed stability in cognitive functioning for individuals who were active, greater change if sedentary.

• 90% of individuals with greatest daily energy scored consistently on tests each year

• Activities included walking, cooking, cleaning

1. Archives of Internal Medicine, 2011

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• More specifically, women in 70’s with vascular disease showed a slower rate of cognitive decline than the active group. Editorial (Dr. Eric Larson) noted the goal was to slow the onset of dementia.

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• A second study2 showed that light duty weight training has neurological effects.

• After one year, older women who lifted 2x per week showed changes on both functional MRIs and cognitive tests.

2. Neurobiology of Aging, 2011

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Exercise promotes healthy aging Normal Aging: start early!

• Mayo clinic study of 1,126 individuals with “normal cognition” (as opposed to Mild cognitive impairment)3

• Individuals with Moderate exercise during midlife were less likely to develop impairment in later life

3. Archives of Neurology, 2011

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Exercise promotes healthy aging

• Exercise prevents onset of dementia

• Meta analysis of 1600 research papers examining role of exercise in perserving cognitive abilities

• Conclusion: Important therapy against dementia

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Exercise promotes healthy aging “…you can make a very compelling argument for exercise as a disease-modifying strategy to prevent dementia and mild cognitive impairment, and for favorably modifying these processes once they have developed.”

-- J. Eric Ahlskog, M.D., Ph.D., neurologist, Mayo Clinic

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Exercise promotes healthy aging Other Neurologic Disease • Parkinson’s Disease

o Researchers4 followed 140,000 people with avg. age of 63 for 10 years.

o Moderate to vigorous activity levels were related to a 40% less chance to develop Parkinsons than those with light or no activity levels.

o Not clear if the relationship is focused on short term or long term (i.e., do you need to start exercising at 40?)

4. American Academy of Neurology, 2007

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Exercise promotes healthy aging Other Neurologic Disease

• Mild cognitive impairment (MCI): each year, 10-15% of individuals with mild cognitive impairment will develop dementia5.

• Study: 33 adults with MCI. 23 assigned randomly to aerobic group and exercised at high intensity levels for 45-60 minutes per day, 4 days per week, with a trainer. Control group: 10 individuals performed supervised stretching with low heart rate.

5. Archives of Neurology, 2011

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Exercise promotes healthy aging Other Neurologic Disease

• Found improved fitness (body fat analysis, metabolic markers) and improved cognition.

• Cognitive improvements were more marked in women than men. This may be related to body’s use of insulin, glucose, and cortisol, which differed between the sexes.

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Exercise and Stress • Chronic cortisol release leads to detrimental

effects: o Chronically high cortisol reduces dopamine

• Exercise initially mimics this effect

• Regular exercise training helps to reduce cortisol levels (e.g., a 20 minute walk ceases to be “stressful” to the body).

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Mood Benefits Exercise improves stress tolerance:

• Exercise causes a drop in stress hormones

• Improves “resilience” to stress

• Brain-derived neurotrophic factors (BDNF)

o “fertilizer” of the brain’s neurons o Grow more quickly, develop stronger connections o Associated with improved cognition, mood

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Mood Benefits Exercise improves stress tolerance: • Rats assigned to 4 groups6:

o Engaged in “voluntary running” o Given antidepressants o Both o Neither

• Rats then underwent a 2-day “forced swimming” procedure

6. California State University, 2001

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Mood Benefits Exercise improves stress tolerance:

• Results: o BDNF levels in untreated animals were depressed o Animals that were given physical training or

antidepressants had BDNF restored to baseline o Animals with both showed increase in

hippocampal BDNF well above baseline.

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Mood Benefits Improved mood improves cognition:

• Exercise has an “antidepressant effect”

• Antidepressant effect of running was associate with more cell growth in hippocampus9

9. Proceedings of the Academy of Natural Sciences, 2010

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Does exercise foster neuroplasticity? • Exercise increased growth factors in brain making it easier

to grow new connections10

• Mice that ran on a wheel had twice as many new brain cells as mice housed in standard cages11. As a comparison, provided mice with other “enriched” environments (e.g., “free swim”)- only running produced the effect. o Growth was in the hippocampus (learning and

memory) 10. UCLA, 2011

11. Nature Neuroscience, 1999

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Does exercise foster neuroplasticity? • Illinois researchers scanned brains of 55 individuals

aged 55-79, measured maximal O2 during exercise12

• Used MRIs and functional imaging to examine age-related brain shrinkage

• Results: fit subjects had less shrinkage in temporal, parietal, and frontal areas- crucial for learning and memory

12. Journal of Gerontology, 2003

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Does exercise foster neuroplasticity? • Meta-analysis of 18 controlled studies of

cognitive function and aerobic fitness for individuals aged 55-8013

13. Psychological Sciences, 2003

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Does exercise foster neuroplasticity? Results: • Exercise had clear, selective cognitive benefits for

attention, organization, planning • Frontal skills • Strength training combined with aerobic fitness was

most effective • Exercise sessions of less than 30 minutes per session

had little impact

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Does exercise foster neuroplasticity?

• Brain-derived neurotrophic factors (BDNF)

• “fertilizer” of the brain’s neurons

o Grow more quickly, develop stronger connections

• Associated with improved cognition, mood

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Does exercise foster neuroplasticity? • Brain-derived neurotrophic factors (BDNF) • produced in the brain during endurance training • produced peripherally in resistance training, circulates

to the brain • University of Florida study: 20 college aged men14

o Increased neurotrophic factors at 1, 30 and 60 minutes after endurance training

14. American College of Sports Medicine, 2010

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Cognitive exercise

• Cognitive exercise has similar effects

• Two together have strongest effects

• Visualizing exercise improves neuroplasticity as well

• Best exercise is novel tasks: at any level

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Yoga is cognitive and physical

• Yoga, mind/body connection is good for us

• Yoga decreases depression, anxiety, hypertension, stress

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Yoga: the research

• Enhanced effects of meditation alone

• Study of novice participants in a 12-week yoga training program15

15. Journal of Alternative and Complementary Medicine, 2009

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Results: • EEG changes were greater in left hemisphere • Participants experienced greater ability to activate

their brain, particularly right hemisphere, through yoga

• Increased blood flow in right pre-frontal cortex • Changes in amygdala, sensorimotor cortex consistent

with changes in processing emotions and sensory phenomena

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Conclusions • Cognition is complex

• MIND-MOOD-BRAIN all connected to health

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Conclusions Exercise is shown to positively affect cognition in the following ways:

• Improving blood circulation • Increased availability of oxygen and nutrients • Clears metabolic waste

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Conclusions Exercise prevents disease:

• Cardiovascular effects decrease risk of stroke • Shown to prevent Alzheimers, Parkinsons,

mild cognitive impairment onset

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Conclusions • Regular exercise decreases our symptoms of

stress (e.g., lowers cortisol)

• Improves resiliency

• Improves mood- acts as an antidepressant

• Increases growth of neurons in key areas:

o Frontal lobes, hippocampus

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Practical Advice The Basics:

• Do something

• Stick with what you stick with

• Every bit counts: even 20 minutes of exercise facilitates brain function

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Practical Advice The Details:

• Exercise has short term effects of mood, concentration, memory and stress that last for several hours after exercise

• Moderate exercise for a six month time frame is beneficial to begin to see long term benefits

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Practical Advice The Details:

• Exercise should continue with age

• Exercise that encourages cognitive focus has additional benefits : find something that challenges you (ballroom dancing, a new class, yoga, etc.)

• Exercise that is interesting is also good (vary your walk!)

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Special Information: Brain Injury Exercise after concussion is not recommended:

• REST IS RECOMMENDED

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Special Information: Brain Injury For all these reasons, exercise is important for long term recovery from a brain injury • Promotes mood • Promotes stable sleep patterns • Promotes physical health • Promotes self-efficacy, improved views of health • Promotes neurogenesis in animal models • Increased blood flow in hippocampus

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Special Information: Brain Injury For all these reasons, exercise is important for long term recovery from a brain injury • Promotes mood • Promotes stable sleep patterns • Promotes physical health • Promotes self-efficacy, improved views of health • Promotes neurogenesis in animal models • Increased blood flow in hippocampus

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Questions?

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Health & Medicine

Bancroft Exercise Effects on the Brain