Aerobic Exercise and Mind-body Exercise (Yoga): neurocognitive and clinical effects of a novel treatment

Abstract

BACKGROUND: Impairments of attention and memory are detectable in early psychosis, and often result in severe, longstanding functional impairments. Pharmacological interventions for cognitive impairments have been largely unsuccessful. The current study aimed to explore the effects of aerobic exercise and mind-body exercise (yoga) on cognitive functioning and clinical symptoms in female patients with early psychosis. The potential neuromechanism underlying the clinical consequences was also investigated. METHODS: Female patients (n = 120) diagnosed with schizophrenia spectrum disorders, brief psychosis, psychosis not otherwise specified, or delusional disorder were recruited from 3 hospital / clinic sites. They were randomized into integrated yoga therapy group, aerobic exercise programme group, and waiting list as the control group. Both interventions were held 3 times weekly for 12 weeks. Clinical symptoms, cognitive functions, quality of life, and fitness levels were assessed pre- and post-interventions. Magnetic resonance imaging (MRI) data were collected from half of the participants. The effects of yoga and aerobic exercise were compared with repeated measures. RESULTS: Completed clinical and cognitive data were collected in 85 patients, and completed MRI data of good quality were collected in 39 patients. Three groups were matched at baseline. Both yoga and aerobic exercise groups demonstrated significant improvements in verbal memory and working memory with moderate to large effect sizes compared to control groups. The yoga group showed significantly enhanced attention and concentration. Both yoga and aerobic exercise significantly improved overall clinical symptoms and depressive symptoms. Increases in the cortical thickness and subcortical volume were observed in both intervention groups, as well as a statistical significance in the correlation between memory and brain structure. DISCUSSION: Both types of exercise improved memory in early psychosis patients, with yoga having a superior effect on attention than aerobic exercise. Observed increments in the cortical thicknesses and volume may indicate improved neurogenesis.