Exercise and the Brain

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Exercise and the Brain Karen Lindgren, Ph.D.
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Our Mission
To ensure that every person is given
opportunities for lifelong learning and
fulfillment. We do this by altering
perceptions, and by supporting those with
intellectual and developmental challenges and
acquired brain injuries in achieving their life
goals as valued and respected members of our
world.
Our Core Values
Responsible Empathetic Supportive Passionate
Empowered Committed Trustworthy R E S P E C T
Our Vision
By 2014 our distinct ability to deliver high
quality individualized services in modern living,
learning and working environments will exceed
stakeholder expectations and secure Bancroft as
the regions elite provider of services to people
with intellectual and developmental disabilities
and brain injuries.
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Strength of mind is exercise, not
rest -Alexander Pope It is exercise alone
that supports the spirits, and keeps the mind in
vigor - Marcus Tullius Cicero
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• Goals
• How does exercise benefit general health?
• How does exercise benefit neurological health?
• What are specific cognitive benefits of exercise?
• What is neuroplasticity?
• How does exercise benefit neuroplasticity?

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• Format
• GEOGRAPHY OF THE BRAIN
• WHAT IS NEUROPLASTICITY
• EXERCISE
• What it is
• Physiology
• EXERCISE AND THE BRAIN
• Simple connections
• Complex connections

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• The link should be clear
• Our brain is a physical organ
• Our brain is a thinking organ

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• The link should be clear
• Exercise helps us physically
• strengthens hearts, bones, lungs, blood vessels
• physical changes should be related to thinking
  changes
• Like our other organs, our brain is a constantly
  changing organ

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• The brain physical organ
• Geography of the brain
• Brain basics
• Neurons
• Blood vessels
• Neurotransmitters

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• The brain a thinking organ
• What is thinking?
• Cognition refers to any mental process

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• What is cognition?
• Areas of cognition include
• Attention
• Concentration
• Sensory skills
• Motor skills

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• What is cognition?
• Areas of cognition include
• Language
• Visual Skills
• Memory
• Problem solving/judgment moral reasoning

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Brain Geography
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• Neuroplasticity
• What is neuroplasticity?
• Refers to the ability of the brain to shape
  itself according to experience
• Refers to physical change on a neuronal level

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• Neuroplasticity
• What changes when we learn?
• Neurons connect with other neurons
• Synapses strength changes with learning
• More synapses form between neurons

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• What is exercise?
• Types
• Cardiovascular
• Weight training (resistance training)
• Intensity
• Active lifestyle
• Light
• Vigorous

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• What happens when we exercise?
• Heart rate increases
• Hormones respond
• Pituitary gland releases human growth hormone to
  increase production of bone, muscle, or
  connective tissue cells.
• Pituitary gland regulates
• Thyroid
• Adrenal

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• Pituitary Gland
• Located in brain, limbic system
• Influences
• Thyroid neck
• Adrenal kidneys

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• What happens when we exercise?
• Hormones respond
• Pituitary gland regulates thyroid gland
• Thyroid releases hormones
• Increase heart rate and blood pressure
• Regulate body temperature
• Elevate alertness in brain to increase
  concentration and reaction time

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• What happens when we exercise?
• Hormones respond
• Pituitary gland regulates
• Adrenal glands In response to the ACTH
  (adrenocorticotropin) from the pituitary, release
  
• 1. cortisol causes blood pressure to rise,
  triggers increase in glucose, acts as
  anti-inflammatory agent (repairs tissues) Curbs
  non-critical functions (e.g., thirst, urine,
  hunger). Effects immune system.

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• What happens when we exercise?
• Hormones respond
• Pituitary gland regulates
• Adrenal glands In response to the ACTH
  (adrenocorticotropin) from the pituitary, release
  
• 2. aldosterone bodily response to anticipate
  dehydration through impact on kidney function.

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• What happens when we exercise?
• Hormones respond
• Pituitary gland regulates
• Adrenal glands In response to the ACTH
  (adrenocorticotropin) from the pituitary, release
  
• 3. adrenaline (fight or flight) mechanism. A
  stimulant, increases strength and frequency of
  heart contractions. Speeds breakdown of stored
  carbs into glucose for muscle energy.

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• Section Break
• GEOGRAPHY OF THE BRAIN
• WHAT IS NEUROPLASTICITY
• EXERCISE
• What it is
• Physiology
• EXERCISE AND THE BRAIN
• Simple connections
• Complex connections

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• Exercise and the BrainHow do we know they are
  linked
• Studies vary greatly (meta-analysis,
• Kramer et al)
• Ages vary
• Length of time looked at varies
• Exercise type varies
• Method of reporting varies (often self-report)
• Method of reporting cognitive skill varies (e.g.,
  MMSE screen, neuropsych, presence of dementia)

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• What is the link?
• Simple links
• Increased blood flow to the brain is good for us
• Simple mind/body benefits mindfulness training,
  yoga
• Complex links
• Neuroplasticity
• Preventing problems
• Improved mood--- improved thinking

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• Simple connections
• Exercise improves blood flow to the brain
• Is increased blood flow related to improved
  cognition?

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• Simple connections
• Physical effects of exercise
• Increased blood flow to the brain
• Blood volume increases
• Blood flow is more predictable
• Small vessels grow increase in number
• Study of 16 women aged 60 and older, walking
  briskly 3-4 times per week, improved blood flow
  up to 15

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• Simple connections
• Physical effects of exercise
• Brings O2, glucose, nutrients to brain cells,
  vital for cell health
• Cell growth supports new connections,
  particularly in hippocampus- memory
• Blood washes away metabolic wastes such as
  amyloid beta protein (implicated in development
  of Alzheimers)

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• Simple connections
• Walking
• Increases blood circulation
• Increased oxygen and glucose to the brain
• Not strenuous- muscles do not use extra oxygen
  and glucose as in more strenuous exercise
• In sum, you oxygenate your brain
• Clear your head

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• Complex Links
• Complex links
• Prevents primary neurologic disease
• Promotes healthy normal aging
• Neuroplasticity
• Improved mood--- improved thinking

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• Exercise prevents primary neurologic disease
• Primary Neurologic Disease
• Vascular disease
• Cholesterol lowering effects of exercise
• Exercise lowers blood pressure
• High blood pressure is related to stroke and mild
  cognitive impairment
• Increased blood flow
• Increased vessels

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• Exercise promotes healthy aging
• Normal Aging
• Ameliorates decline Canadian researchers1
  examined active lifestyle for elderly
  individuals over 2-5 years, showed stability in
  cognitive functioning for individuals who were
  active, greater change if sedentary.
• 90 of individuals with greatest daily energy
  scored consistently on tests each year
• Activities included walking, cooking, cleaning
• 1. Archives of Internal Medicine, 2011

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• Exercise promotes healthy aging
• Normal Aging
• More specifically, women in 70s with vascular
  disease showed a slower rate of cognitive decline
  than the active group. Editorial (Dr. Eric
  Larson) noted the goal was to slow the onset of
  dementia.

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• Exercise promotes healthy aging
• Normal Aging
• A second study2 showed that light duty weight
  training has neurological effects.
• After one year, older women who lifted 2x per
  week showed changes on both functional MRIs and
  cognitive tests.
• 2. Neurobiology of Aging, 2011

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• Exercise promotes healthy aging
• Normal Aging start early!
• Mayo clinic study of 1,126 individuals with
  normal cognition (as opposed to Mild cognitive
  impairment)3
• Individuals with Moderate exercise during midlife
  were less likely to develop impairment in later
  life
• 3. Archives of Neurology, 2011

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• Exercise promotes healthy aging
• Exercise prevents onset of dementia
• Meta analysis of 1600 research papers examining
  role of exercise in perserving cognitive
  abilities
• Conclusion Important therapy against dementia

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Exercise promotes healthy aging you can make a
very compelling argument for exercise as a
disease-modifying strategy to prevent dementia
and mild cognitive impairment, and for favorably
modifying these processes once they have
developed. -- J. Eric Ahlskog, M.D., Ph.D.,
neurologist, Mayo Clinic
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• Exercise promotes healthy aging
• Other Neurologic Disease
• Parkinsons Disease
• Researchers4 followed 140,000 people with avg.
  age of 63 for 10 years.
• Moderate to vigorous activity levels were related
  to a 40 less chance to develop Parkinsons than
  those with light or no activity levels.
• Not clear if the relationship is focused on short
  term or long term (i.e., do you need to start
  exercising at 40?)
• 4. American Academy of Neurology, 2007

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• Exercise promotes healthy aging
• Other Neurologic Disease
• Mild cognitive impairment (MCI) each year,
  10-15 of individuals with mild cognitive
  impairment will develop dementia5.
• Study 33 adults with MCI. 23 assigned randomly
  to aerobic group and exercised at high intensity
  levels for 45-60 minutes per day, 4 days per
  week, with a trainer. Control group 10
  individuals performed supervised stretching with
  low heart rate.
• 5. Archives of Neurology, 2011

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• Exercise promotes healthy aging
• Other Neurologic Disease
• Found improved fitness (body fat analysis,
  metabolic markers) and improved cognition.
• Cognitive improvements were more marked in women
  than men. This may be related to bodys use of
  insulin, glucose, and cortisol, which differed
  between the sexes.

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• Exercise and Stress
• Chronic cortisol release leads to detrimental
  effects
• Chronically high cortisol reduces dopamine
• Exercise initially mimics this effect
• Regular exercise training helps to reduce
  cortisol levels (e.g., a 20 minute walk ceases to
  be stressful to the body).

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• Mood Benefits
• Exercise improves stress tolerance
• Exercise causes a drop in stress hormones
• Improves resilience to stress
• Brain-derived neurotrophic factors (BDNF)
• fertilizer of the brains neurons
• Grow more quickly, develop stronger connections
• Associated with improved cognition, mood

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• Mood Benefits
• Exercise improves stress tolerance
• Rats assigned to 4 groups6
• Engaged in voluntary running
• Given antidepressants
• Both
• Neither
• Rats then underwent a 2-day forced swimming
  procedure
• 6. California State University, 2001

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• Mood Benefits
• Exercise improves stress tolerance
• Results
• BDNF levels in untreated animals were depressed
• Animals that were given physical training or
  antidepressants had BDNF restored to baseline
• Animals with both showed increase in hippocampal
  BDNF well above baseline.

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• Mood Benefits
• Improved mood improves cognition
• Exercise has an antidepressant effect
• Antidepressant effect of running was associate
  with more cell growth in hippocampus9
• 9. Proceedings of the Academy of Natural
  Sciences, 2010

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• Does exercise foster neuroplasticity?
• Exercise increased growth factors in brain making
  it easier to grow new connections10
• Mice that ran on a wheel had twice as many new
  brain cells as mice housed in standard cages11.
  As a comparison, provided mice with other
  enriched environments (e.g., free swim)- only
  running produced the effect.
• Growth was in the hippocampus (learning and
  memory)
• 10. UCLA, 2011
• 11. Nature Neuroscience, 1999

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• Does exercise foster neuroplasticity?
• Illinois researchers scanned brains of 55
  individuals aged 55-79, measured maximal O2
  during exercise12
• Used MRIs and functional imaging to examine
  age-related brain shrinkage
• Results fit subjects had less shrinkage in
  temporal, parietal, and frontal areas- crucial
  for learning and memory
• 12. Journal of Gerontology, 2003

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• Does exercise foster neuroplasticity?
• Meta-analysis of 18 controlled studies of
  cognitive function and aerobic fitness for
  individuals aged 55-8013
• 13. Psychological Sciences, 2003

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• Does exercise foster neuroplasticity?
• Results
• Exercise had clear, selective cognitive benefits
  for attention, organization, planning
• Frontal skills
• Strength training combined with aerobic fitness
  was most effective
• Exercise sessions of less than 30 minutes per
  session had little impact

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• Does exercise foster neuroplasticity?
• Brain-derived neurotrophic factors (BDNF)
• fertilizer of the brains neurons
• Grow more quickly, develop stronger connections
• Associated with improved cognition, mood

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• Does exercise foster neuroplasticity?
• Brain-derived neurotrophic factors (BDNF)
• produced in the brain during endurance training
• produced peripherally in resistance training,
  circulates to the brain
• University of Florida study 20 college aged
  men14
• Increased neurotrophic factors at 1, 30 and 60
  minutes after endurance training
• 14. American College of Sports Medicine, 2010

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• Cognitive exercise
• Cognitive exercise has similar effects
• Two together have strongest effects
• Visualizing exercise improves neuroplasticity as
  well
• Best exercise is novel tasks at any level

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• Yoga is cognitive and physical
• Yoga, mind/body connection is good for us
• Yoga decreases depression, anxiety, hypertension,
  stress

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• Yoga is cognitive and physical
• Yoga the research
• Enhanced effects of meditation alone
• Study of novice participants in a 12-week yoga
  training program15
• 15. Journal of Alternative and Complementary
  Medicine, 2009

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• Yoga is cognitive and physical
• Results
• EEG changes were greater in left hemisphere
• Participants experienced greater ability to
  activate their brain, particularly right
  hemisphere, through yoga
• Increased blood flow in right pre-frontal cortex
• Changes in amygdala, sensorimotor cortex
  consistent with changes in processing emotions
  and sensory phenomena

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• Conclusions
• Cognition is complex
• MIND-MOOD-BRAIN all connected to health

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• Conclusions
• Exercise is shown to positively affect cognition
  in the following ways
• Improving blood circulation
• Increased availability of oxygen and nutrients
• Clears metabolic waste

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• Conclusions
• Exercise prevents disease
• Cardiovascular effects decrease risk of stroke
• Shown to prevent Alzheimers, Parkinsons, mild
  cognitive impairment onset

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• Conclusions
• Regular exercise decreases our symptoms of stress
  (e.g., lowers cortisol)
• Improves resiliency
• Improves mood- acts as an antidepressant
• Increases growth of neurons in key areas
• Frontal lobes, hippocampus

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• Practical Advice
• The Basics
• Do something
• Stick with what you stick with
• Every bit counts even 20 minutes of exercise
  facilitates brain function

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• Practical Advice
• The Details
• Exercise has short term effects of mood,
  concentration, memory and stress that last for
  several hours after exercise
• Moderate exercise for a six month time frame is
  beneficial to begin to see long term benefits

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• Practical Advice
• The Details
• Exercise should continue with age
• Exercise that encourages cognitive focus has
  additional benefits find something that
  challenges you (ballroom dancing, a new class,
  yoga, etc.)
• Exercise that is interesting is also good (vary
  your walk!)

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• Special Information Brain Injury
• Exercise after concussion is not recommended
• REST IS RECOMMENDED

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• Special Information Brain Injury
• For all these reasons, exercise is important for
  long term recovery from a brain injury
• Promotes mood
• Promotes stable sleep patterns
• Promotes physical health
• Promotes self-efficacy, improved views of health
• Promotes neurogenesis in animal models
• Increased blood flow in hippocampus

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• Special Information Brain Injury
• For all these reasons, exercise is important for
  long term recovery from a brain injury
• Promotes mood
• Promotes stable sleep patterns
• Promotes physical health
• Promotes self-efficacy, improved views of health
• Promotes neurogenesis in animal models
• Increased blood flow in hippocampus

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Questions?
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