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Effects of web-based adapted physical activity on hippocampal plasticity, cardiorespiratory fitness, symptoms, and cardiometabolic markers in patients with schizophrenia: a randomized, controlled study

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Abstract

Among the lifestyle interventions, the physical activity (PA) has emerged as an adjuvant non-pharmacological treatment improving mental and physical health in patients with schizophrenia (SZPs) and increasing the hippocampus (HCP) volume. Previously investigated PA programs have been face-to-face, and not necessary adapted to patients’ physiological fitness. We propose an innovative 16-week adapted PA program delivered by real-time videoconferencing (e-APA), allowing SZPs to interact with a coach and to manage their physical condition. The primary goal was to demonstrate a greater increase of total HCP volumes in SZPs receiving e-APA compared to that observed in a controlled group. The secondary objectives were to demonstrate the greater effects of e-APA compared to a controlled group on HCP subfields, cardiorespiratory fitness, clinical symptoms, cognitive functions, and lipidic profile. Thirty-five SZPs were randomized to either e-APA or a controlled group receiving a health education program under the same conditions (e-HE). Variables were assessed at pre- and post-intervention time-points. The dropout rate was 11.4%. Compared to the e-HE group, the e-APA group did not have any effect on the HCP total volumes but increased the left subiculum volume. Also, the e-APA group significantly increased cardiorespiratory fitness (VO2max), improved lipidic profile and negative symptoms but not cognitive functions. This study demonstrated the high feasibility and multiple benefits of a remote e-APA program for SZPs. e-APA may increase brain plasticity and improve health outcomes in SZPs, supporting that PA should be an add-on therapeutic intervention. ClinicalTrial.gov on 25 august 2017 (NCT03261817).

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The data presented in this study are available on request from the corresponding author due to legal reasons.

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Acknowledgements

We thank neuropsychologists, medical doctors with Perrine Brazo and Meunier Sophie, the Mooven® company with Aline Herbinet, Lucille Bigot, and Adeline Turgis for their contribution to the study. Also, we acknowledge the patients for their participation. Finally, this work was supported by the Normandy Country Council, European Union, in the framework of the ERDF-ESF operational program 2014–2020 (15P04195) and the Pierre Deniker Foundation as funding sources.

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Authors and Affiliations

  1. PhIND “Physiopathology and Imaging of Neurological Disorders”, UMR-S U1237, GIP CYCERON, INSERM, CYCERON, CHU de Caen Normandie, Normandie Univ, Université de Caen Normandie, Campus Jules Horowitz, Bd Henri Becquerel, BP 5229, 14074, Caen, France

    E. Leroux, M. Tréhout, R. de Flores & S. Dollfus

  2. Centre Esquirol, Service de Psychiatrie Adulte, CHU de Caen Normandie, 14000, Caen, France

    M. Tréhout & S. Dollfus

  3. Service de Médecine du Sport, CHU de Caen Normandie, 14000, Caen, France

    E. Reboursiere

  4. Unité de Biostatistiques et Recherche Clinique, CHU de Caen Normandie, 14000, Caen, France

    R. Morello

  5. SHU du Rouvray, 76300, Sotteville-lès-Rouen, France

    O. Guillin

  6. Normandie Univ, UFR de Médecine, 76000, Rouen, France

    O. Guillin

  7. CHU de Rouen, 76000, Rouen, France

    O. Guillin

  8. COMETE U1075, INSERM, CYCERON, CHU de Caen, Normandie Univ, Université de Caen Normandie, 14000, Caen, France

    G. Quarck

  9. Université de Caen Normandie, Normandie Univ, UFR de Santé, 14000, Caen, France

    S. Dollfus

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  1. E. Leroux
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  8. S. Dollfus
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Contributions

EL: e-HE program conception and dispensation; participants’ planning and recruitment; acquisition and analyses of data; cognitive assessments; drafting the manuscript and figures. MT: e-HE program conception and dispensation; patients’ recruitment; clinical assessments; MRI assessments; analyses of data; revision of manuscript. ER: cardiac stress test dispensation. RF: technical assistance for HCP segmentation. RM: technical assistance for statistical analyses. OG: patients’ recruitment. GQ: conception and design of the study. SD: conception and design of the study; principal investigator; patients’ recruitment; clinical assessments; MRI assessments; revision of manuscript.

Corresponding author

Correspondence to E. Leroux.

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Conflict of interest

MT: participated in educational conferences for the following industrial laboratories: Otsuka, Lundbeck, and Janssen. SD: has been an expert and consultant or has participated in educational conferences for the following industrial laboratories or companies: Gedeon Richter, Lundbeck Otsuka, Roche, Takeda, Fabre, Janssen, ONO Pharma, and Verasci. OG: has been an expert and consultant or has participated in educational conferences for the following industrial laboratories or companies: Lundbeck Otsuka, Roche, Takeda, Fabre, Janssen, Bioprojet, and Mapreg. The other authors have no competing conflicts.

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Leroux, E., Tréhout, M., Reboursiere, E. et al. Effects of web-based adapted physical activity on hippocampal plasticity, cardiorespiratory fitness, symptoms, and cardiometabolic markers in patients with schizophrenia: a randomized, controlled study. Eur Arch Psychiatry Clin Neurosci (2024). https://doi.org/10.1007/s00406-024-01818-8

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