%0 Journal Article
%T Synergistic Benefits of Combined Aerobic and Cognitive Training on Fluid Intelligence and the Role of IGF
%A Arthur R. Chaves
%A Augustine J. Devasahayam
%A Beraki Abraha
%A Craig S. Moore
%A Elaine Skene
%A Elizabeth M. Wallack
%A Emily Bedford
%A Gail A. Eskes
%A George S. Robertson
%A Graham Wilson
%A Ishika Sharma
%A Jason McCarthy
%A Laura Keeler
%A Liam P. Kelly
%A Marie E. Curtis
%A Marilyn Mackay-Lyons
%A Matthew B. Downer
%A Megan C. Kirkland
%A Michelle Ploughman
%A S. M. Mahmudul Hasan
%J Neurorehabilitation and Neural Repair
%@ 1552-6844
%D 2019
%R 10.1177/1545968319832605
%X Background. Paired exercise and cognitive training have the potential to enhance cognition by ¡°priming¡± the brain and upregulating neurotrophins. Methods. Two-site randomized controlled trial. Fifty-two patients >6 months poststroke with concerns about cognitive impairment trained 50 to 70 minutes, 3¡Á week for 10 weeks with 12-week follow-up. Participants were randomized to 1 of 2 physical interventions: Aerobic (>60% VO2peak using <10% body weight¨Csupported treadmill) or Activity (range of movement and functional tasks). Exercise was paired with 1 of 2 cognitive interventions (computerized dual working memory training [COG] or control computer games [Games]). The primary outcome for the 4 groups (Aerobic + COG, Aerobic + Games, Activity + COG, and Activity + Games) was fluid intelligence measured using Raven¡¯s Progressive Matrices Test administered at baseline, posttraining, and 3-month follow-up. Serum neurotrophins collected at one site (N = 30) included brain-derived neurotrophic factor (BDNF) at rest (BDNFresting) and after a graded exercise test (BDNFresponse) and insulin-like growth factor¨C1 at the same timepoints (IGF-1rest, IGF-1response). Results. At follow-up, fluid intelligence scores significantly improved compared to baseline in the Aerobic + COG and Activity + COG groups; however, only the Aerobic + COG group was significantly different (+47.8%) from control (Activity + Games £¿8.5%). Greater IGF-1response at baseline predicted 40% of the variance in cognitive improvement. There was no effect of the interventions on BDNFresting or BDNFresponse; nor was BDNF predictive of the outcome. Conclusions. Aerobic exercise combined with cognitive training improved fluid intelligence by almost 50% in patients >6 months poststroke. Participants with more robust improvements in cognition were able to upregulate higher levels of serum IGF-1 suggesting that this neurotrophin may be involved in behaviorally induced plasticity
%K rehabilitation
%K fluid intelligence
%K brain-derived neurotrophic factor
%K insulin-like growth factor¨C1
%K neuroplasticity
%K cognition
%U https://journals.sagepub.com/doi/full/10.1177/1545968319832605