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A Critical Systematic Review of Current Evidence on the Effects of Physical Exercise on Whole/Regional Grey Matter Brain Volume in Populations at Risk of Neurodegeneration

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Abstract

Background

Despite the intriguing potential of physical exercise being able to preserve or even restore brain volume (grey matter volume in particular)—a tissue essential for both cognitive and physical function—no reviews have so far synthesized the existing knowledge from randomized controlled trials investigating exercise-induced changes of the brain’s grey matter volume in populations at risk of neurodegeneration. Our objective was to critically review the existing evidence regarding this topic.

Methods

A systematic search was carried out in MEDLINE and EMBASE databases primo April 2020, to identify randomized controlled trials evaluating the effects of aerobic training, resistance training or concurrent training on brain grey volume changes (by MRI) in adult clinical or healthy elderly populations.

Results

A total of 20 articles (from 19 RCTs) evaluating 3–12 months of aerobic, resistance, or concurrent training were identified and included, involving a total of 1662 participants (populations: healthy older adults, older adults with mild cognitive impairment or Alzheimer’s disease, adults with schizophrenia or multiple sclerosis or major depression). While few studies indicated a positive effect—although modest—of physical exercise on certain regions of brain grey matter volume, the majority of study findings were neutral (i.e., no effects/small effect sizes) and quite divergent across populations. Meta-analyses showed that different exercise modalities failed to elicit any substantial effects on whole brain grey volume and hippocampus volume, although with rather large confidence interval width (i.e., variability).

Conclusion

Altogether, the current evidence on the effects of physical exercise on whole/regional grey matter brain volume appear sparse and inconclusive, and does not support that physical exercise is as potent as previously proposed when it comes to affecting brain grey matter volume.

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Availability of Data and Materials

Data are available from the authors upon reasonable request.

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Author notes

  1. Lars G. Hvid and Dylan L. Harwood are the joint first authors.

Authors and Affiliations

  1. Exercise Biology, Department of Public Health, Aarhus University, Aarhus, Denmark

    Lars G. Hvid, Dylan L. Harwood & Ulrik Dalgas

  2. Center of Functionally Integrative Neuroscience, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark

    Simon F. Eskildsen

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  1. Lars G. Hvid
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Contributions

LGH, DLH, SFE, and UD contributed to the conception of the study and to the development of the search strategy. LGH and DLH conducted the systematic search and completed the acquisition of data. LGH and DLH performed the data analysis. LGH took the lead in writing the manuscript. All the authors discussed the results and contributed to the final manuscript.

Corresponding author

Correspondence to Lars G. Hvid.

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Funding

No external funding was provided for this study.

Conflict of interest

The authors (LGH, DLH, SFE, UD) declare that they have no conflicts of interest relevant to the content of this article.

Ethical approval

The manuscript does not contain patient data, and ethical approval was not required.

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Hvid, L.G., Harwood, D.L., Eskildsen, S.F. et al. A Critical Systematic Review of Current Evidence on the Effects of Physical Exercise on Whole/Regional Grey Matter Brain Volume in Populations at Risk of Neurodegeneration. Sports Med 51, 1651–1671 (2021). https://doi.org/10.1007/s40279-021-01453-6

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