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      Born to move: a review on the impact of physical exercise on brain health and the evidence from human controlled trials Translated title: Nascidos para o movimento: uma revisão sobre o impacto do exercício físico na saúde do cérebro e as evidências de estudos controlados em humanos

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          Abstract

          Background:

          Physical exercise has been found to impact neurophysiological and structural aspects of the human brain. However, most research has used animal models, which yields much confusion regarding the real effects of exercise on the human brain, as well as the underlying mechanisms.

          Objective:

          To present an update on the impact of physical exercise on brain health; and to review and analyze the evidence exclusively from human randomized controlled studies from the last six years.

          Methods:

          A search of the literature search was conducted using the MEDLINE (via PubMed), EMBASE, Web of Science and PsycINFO databases for all randomized controlled trials published between January 2014 and January 2020.

          Results:

          Twenty-four human controlled trials that observed the relationship between exercise and structural or neurochemical changes were reviewed.

          Conclusions:

          Even though this review found that physical exercise improves brain plasticity in humans, particularly through changes in brain-derived neurotrophic factor (BDNF), functional connectivity, basal ganglia and the hippocampus, many unanswered questions remain. Given the recent advances on this subject and its therapeutic potential for the general population, it is hoped that this review and future research correlating molecular, psychological and image data may help elucidate the mechanisms through which physical exercise improves brain health.

          RESUMO

          Introdução:

          Evidências das últimas décadas têm mostrado que o exercício físico impacta de forma significativa aspectos neurofisiológicos e estruturais do cérebro humano. No entanto, a maioria das pesquisas emprega modelos animais, o que gera confusão no que diz respeito aos efeitos reais do exercício no cérebro humano, assim como os mecanismos adjacentes.

          Objetivo:

          Apresentar uma atualização sobre o impacto do exercício no cérebro; revisar e analisar sistematicamente as evidências provenientes exclusivamente de estudos randomizados controlados em humanos, dos últimos seis anos.

          Métodos:

          Foi conduzida uma busca na literatura usando as bases de dados MEDLINE (via PubMed), EMBASE, Web of Science e PsycINFO, para todos os estudos randomizados e controlados publicados entre janeiro de 2014 e janeiro de 2020.

          Resultados:

          Foram revisados 24 estudos randomizados controlados em humanos, que observavam a relação entre exercício físico e alterações neuroquímicas e estruturais no cérebro.

          Conclusões:

          Ainda que esta revisão tenha observado que o exercício físico melhora a plasticidade cerebral em humanos, particularmente por meio de alterações no fator neurotrófico derivado do cérebro (BDNF), conectividade funcional, núcleos da base e hipocampo, muitas questões ainda precisam ser respondidas. Dados os avanços recentes nessa temática e seu potencial terapêutico para a população em geral, espera-se que este manuscrito e pesquisas futuras que correlacionem estudos moleculares e variáveis psicológicas e de imagem possam ajudar na elucidação dos mecanismos pelos quais o exercício físico melhora a saúde cerebral.

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          Most cited references78

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          Exercise training increases size of hippocampus and improves memory.

          The hippocampus shrinks in late adulthood, leading to impaired memory and increased risk for dementia. Hippocampal and medial temporal lobe volumes are larger in higher-fit adults, and physical activity training increases hippocampal perfusion, but the extent to which aerobic exercise training can modify hippocampal volume in late adulthood remains unknown. Here we show, in a randomized controlled trial with 120 older adults, that aerobic exercise training increases the size of the anterior hippocampus, leading to improvements in spatial memory. Exercise training increased hippocampal volume by 2%, effectively reversing age-related loss in volume by 1 to 2 y. We also demonstrate that increased hippocampal volume is associated with greater serum levels of BDNF, a mediator of neurogenesis in the dentate gyrus. Hippocampal volume declined in the control group, but higher preintervention fitness partially attenuated the decline, suggesting that fitness protects against volume loss. Caudate nucleus and thalamus volumes were unaffected by the intervention. These theoretically important findings indicate that aerobic exercise training is effective at reversing hippocampal volume loss in late adulthood, which is accompanied by improved memory function.
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            Lack of exercise is a major cause of chronic diseases.

            Chronic diseases are major killers in the modern era. Physical inactivity is a primary cause of most chronic diseases. The initial third of the article considers: activity and prevention definitions; historical evidence showing physical inactivity is detrimental to health and normal organ functional capacities; cause versus treatment; physical activity and inactivity mechanisms differ; gene-environment interaction (including aerobic training adaptations, personalized medicine, and co-twin physical activity); and specificity of adaptations to type of training. Next, physical activity/exercise is examined as primary prevention against 35 chronic conditions [accelerated biological aging/premature death, low cardiorespiratory fitness (VO2max), sarcopenia, metabolic syndrome, obesity, insulin resistance, prediabetes, type 2 diabetes, nonalcoholic fatty liver disease, coronary heart disease, peripheral artery disease, hypertension, stroke, congestive heart failure, endothelial dysfunction, arterial dyslipidemia, hemostasis, deep vein thrombosis, cognitive dysfunction, depression and anxiety, osteoporosis, osteoarthritis, balance, bone fracture/falls, rheumatoid arthritis, colon cancer, breast cancer, endometrial cancer, gestational diabetes, pre-eclampsia, polycystic ovary syndrome, erectile dysfunction, pain, diverticulitis, constipation, and gallbladder diseases]. The article ends with consideration of deterioration of risk factors in longer-term sedentary groups; clinical consequences of inactive childhood/adolescence; and public policy. In summary, the body rapidly maladapts to insufficient physical activity, and if continued, results in substantial decreases in both total and quality years of life. Taken together, conclusive evidence exists that physical inactivity is one important cause of most chronic diseases. In addition, physical activity primarily prevents, or delays, chronic diseases, implying that chronic disease need not be an inevitable outcome during life. © 2012 American Physiological Society. Compr Physiol 2:1143-1211, 2012.
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              Network modelling methods for FMRI.

              There is great interest in estimating brain "networks" from FMRI data. This is often attempted by identifying a set of functional "nodes" (e.g., spatial ROIs or ICA maps) and then conducting a connectivity analysis between the nodes, based on the FMRI timeseries associated with the nodes. Analysis methods range from very simple measures that consider just two nodes at a time (e.g., correlation between two nodes' timeseries) to sophisticated approaches that consider all nodes simultaneously and estimate one global network model (e.g., Bayes net models). Many different methods are being used in the literature, but almost none has been carefully validated or compared for use on FMRI timeseries data. In this work we generate rich, realistic simulated FMRI data for a wide range of underlying networks, experimental protocols and problematic confounds in the data, in order to compare different connectivity estimation approaches. Our results show that in general correlation-based approaches can be quite successful, methods based on higher-order statistics are less sensitive, and lag-based approaches perform very poorly. More specifically: there are several methods that can give high sensitivity to network connection detection on good quality FMRI data, in particular, partial correlation, regularised inverse covariance estimation and several Bayes net methods; however, accurate estimation of connection directionality is more difficult to achieve, though Patel's τ can be reasonably successful. With respect to the various confounds added to the data, the most striking result was that the use of functionally inaccurate ROIs (when defining the network nodes and extracting their associated timeseries) is extremely damaging to network estimation; hence, results derived from inappropriate ROI definition (such as via structural atlases) should be regarded with great caution. Copyright © 2010 Elsevier Inc. All rights reserved.
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                Author and article information

                Journal
                Arq Neuropsiquiatr
                Arq Neuropsiquiatr
                anp
                Arquivos de Neuro-Psiquiatria
                Academia Brasileira de Neurologia - ABNEURO
                0004-282X
                1678-4227
                23 June 2021
                June 2021
                : 79
                : 6
                : 536-550
                Affiliations
                [1 ] orgnameUniversidade Tiradentes orgdiv1Laboratório de Biociências orgdiv2Departamento de Medicina Aracaju SE Brazil originalUniversidade Tiradentes, Departamento de Medicina, Laboratório de Biociências da Cinética Humana, Aracaju SE, Brazil.
                [2 ] orgnameUniversidade Federal do Estado do Rio de Janeiro orgdiv1Laboratório de Biociências da Cinética Humana Rio de Janeiro RJ Brazil originalUniversidade Federal do Estado do Rio de Janeiro, Laboratório de Biociências da Cinética Humana, Rio de Janeiro RJ, Brazil.
                [3 ] orgnameUniversity of Massachusetts orgdiv1Department of Psychology Dartmouth MA United States originalUniversity of Massachusetts, Department of Psychology, Dartmouth MA, United States.
                [4 ] orgnameUniversidade Estácio orgdiv1Departamento de Psicologia Aracaju SE Brazil originalUniversidade Estácio, Departamento de Psicologia, Aracaju SE, Brazil.
                Author notes
                Correspondence: Camila Vorkapic; E-mail: camilavorkapic@ 123456gmail.com .

                Conflict of interest: There is no conflict of interest to declare.

                Authors’ contributions: CFV: designed and implemented the study, designed the data extraction, carried out data analysis and wrote the manuscript with support from SL, HA and AB. EHMD: helped with data extraction and literature search. EHMD and MD gave support in the interpretation of the data. All authors read and approved the final version.

                Author information
                https://orcid.org/0000-0002-0809-3964
                https://orcid.org/0000-0003-0473-7205
                https://orcid.org/0000-0002-6102-7616
                https://orcid.org/0000-0003-2564-1464
                https://orcid.org/0000-0002-0106-7210
                https://orcid.org/0000-0003-0981-8020
                Article
                10.1590/0004-282X-ANP-2020-0166
                9394576
                34320058
                f5cd0309-ac8b-4344-b554-df0429ac4a07

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 06 May 2020
                : 26 August 2020
                : 17 September 2020
                Page count
                Figures: 3, Tables: 2, Equations: 0, References: 74, Pages: 15
                Categories
                View and Review

                physical activity,exercise,brain,mental health,review,atividade física,exercício físico,cérebro,saúde mental,revisão

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