A Physical Exercise Program Significantly Boosts the Impact of Cognitive Training on Attention Deficits After a First...

Our initial smaller study and other recent research suggest that adding a physical exercise program to cognitive training has promise for enhancing the impact on attention and overall cognition. We hypothesized that this would be the case even compared to adding a healthy living training program.

In a randomized clinical trial of individuals with a recent first episode of schizophrenia, we provided cognitive training, 4 h/week for 6 months for all participants. Half were randomized to a physical exercise program and half to a healthy living group. The MATRICS Consensus Cognitive Battery was administered at baseline, 3, and 6 months, with a focus on Attention/Vigilance. Exercise was measured by the International Physical Activity Questionnaire and the number of exercise sessions completed.

Attention/Vigilance was differentially enhanced by cognitive training and physical exercise compared to cognitive training and healthy living group (T score gain of 4.6 vs. -0.2 over 6 months, P < .01). Improvement in Attention/Vigilance by 3 months was significantly associated with number of exercise sessions attended (P = .02) and exercise intensity (P < .03) during that period. Attention/Vigilance gain by 6 months was significantly predicted by total metabolic energy expended during the first 3 months (P = .04) and proportion of group exercise sessions attended (P < .01) over 6 months. In the first 3 months, brain-derived neurotropic factor tended to increase in the exercise condition but decrease in the comparison condition.

Adding an exercise program to cognitive training enhances the impact on the core deficit in attention in schizophrenia. The gains in attention are significantly related to the amount and intensity of exercise, consistent with the view that physical exercise is driving the attention improvements beyond the effect of cognitive training.