The article “Medial temporal lobe cortical changes in response to exercise interventions in people with

early psychosis: A randomized controlled trial” by Woodward, M. L., Lin, et al, (2020) studies the impacts
of an exercise intervention strategies on frontal-temporal cortical plasticity in females with early
psychosis. Previous research in this field has been mainly focused on using male participants. The
authors of the study however recognize that women are more vulnerable to risks for metabolic side
effects of antipsychotic side effects such as increased cholesterol levels and increased weight gain. The
aim of the study is to investigate the impacts of exercise on the brain of females suffering from early
psychosis. The relevance of the study lies on the fact that there lies unclear potential of the positive
impacts of exercise in inducing growth in part of the brain past the hippocampus.

Dysfunction in the entorhinal cortex and the prefrontal limbic functioning is pivotal in the schizophrenia
pathophysiology. MRI scans on psychosis and a reduced volume in medial temporal lobe show cortical
deficits in the frontal and temporal lobe which are associated to severity on psychosis symptoms and
cognitive impairment. Cardo-respiratory wellness is linked to an increase in temporal cortical grey
matter and serum growth levels. Exercises have been seen to have positive impacts on the temporal
cortex by increasing grey matter in patients with early psychosis. Psychosis patients have less
participation in physical activities and often live highly sedentary lives which leads to an increased risk to
cardiovascular related diseases and mortality. Cardiovascular diseases are usually the primary cause of
premature deaths in schizophrenic patients. Metabolic dysfunction and weight gain occur as effects of
some of the antipsychotic medications and contributed to cardio-metabolic complications in the
treatment process. The medications also cause reductions in cortical grey matter. Exercises such as
treadmill running, stationary cycling and yoga have been incorporated as intervention strategies for
psychosis patients.

To investigate the factual truth in the exercise’s effects, the authors investigate the impacts of a twelve
weeks Hatha yoga or moderate intensity aerobic or waitlist group exercises. The controlled trial of 140
female patients with early psychosis was conducted in Hong Kong from October 2010 to May 2014. The
random selection of participants from a randomization list with a block size of twelve was done whereby
four would be assigned to the yoga group, four to the waitlist group and four to the aerobic exercise
group. 51 patients from this group were successfully done brain MRI at the start and in a twelve week
follow up. MRI scans were also collected from eleven healthy volunteers of the same sex and age. The
psychotic participants were diagnosed the disorder using the structured clinical interview of the fourth
edition (DSM-IV) Diagnostic and Statistical Manual of Mental Disorder. They all had an onset of psychotic
symptoms within the last five years. The participants were mainly aged sixteen to sixty who were
psychologically stable. Also, they had participated in less than ten hours or intense aerobics within the
three months prior to the research. The selection process excluded people based on factors such as
significant physical disease, MRI contradictions, pregnancy. Diagnosed intellectual disability, history of
brain trauma and comorbid substance dependence. Yoga therapy was conducted consisted of breathing
techniques, series of Hatha yoga body postures. Aerobic exercises involved stationary cycling and
treadmill walking by a certified exercise physiologist. Participants that completed the program attended
51.4% of the yoga sessions and 57.7 % of the aerobic exercise sessions. The instructors, research
assistants, exercise trainers and psychiatrists involved were blinded to the dynamics of specific details of
participating group.
The results showed that the participants with psychosis did not differ across ages, diagnosis,
antipsychotic dose, period of time of illness and education at base line level. Over the course of the 12
weeks there was an increase in the volume of the entorhinal cortical for people with psychosis in the
groups after the twelve weeks. The aerobic group recorded a more significant increase in fusiform
cortical thickness and entorhinal cortical thickness than the other groups. Insignificant effects for the
orbitofrontal and parahippocampal cortical regions were recorded. The most significant reduction I BMI
was recorded in the aerobic group.

In conclusion, the finding from the study showed that aerobic exercises induced neuroplasticity in
medical temporal cortical areas. Such alterations can potenti9lly be associated to the improvement s
made in psychosis symptoms effects. This shows that people diagnosed with early psychosis may
incorporate exercise interventions with aerobic exercises being the most recommendable. Aerobics
therefore can be alternative to address physical, clinical and neuroanatomic health concerns.

References

Woodward, M. L., Lin, J., Gicas, K. M., Su, W., Hui, C. L., Honer, W. G., ... & Lang, D. J. (2020). Medial
temporal lobe cortical changes in response to exercise interventions in people with early psychosis: A
randomized controlled trial. Schizophrenia Research, 223, 87-95.