Exercise training for neural recovery in a restricted sample of pediatric brain tumor survivors: a controlled clinical trial with crossover of training versus no training
Lily Riggs, Janine Piscione, Suzanne Laughlin, Todd Cunningham, Brian W Timmons, Kerry S Courneya, Ute Bartels, Jovanka Skocic, Cynthia de Medeiros, Fang Liu, Nicholas Persadie, Katrin Scheinemann, Nadia Scantlebury, Kamila U Szulc, Eric Bouffet, Donald J Mabbott, Lily Riggs, Janine Piscione, Suzanne Laughlin, Todd Cunningham, Brian W Timmons, Kerry S Courneya, Ute Bartels, Jovanka Skocic, Cynthia de Medeiros, Fang Liu, Nicholas Persadie, Katrin Scheinemann, Nadia Scantlebury, Kamila U Szulc, Eric Bouffet, Donald J Mabbott
Abstract
Background: Exercise promotes repair processes in the mouse brain and improves cognition in both mice and humans. It is not known whether these benefits translate to human brain injury, particularly the significant injury observed in children treated for brain tumors.
Methods: We conducted a clinical trial with crossover of exercise training versus no training in a restricted sample of children treated with radiation for brain tumors. The primary outcome was change in brain structure using MRI measures of white matter (ie, fractional anisotropy [FA]) and hippocampal volume [mm3]). The secondary outcome was change in reaction time (RT)/accuracy across tests of attention, processing speed, and short-term memory. Linear mixed modeling was used to test the effects of time, training, training setting, and carryover.
Results: Twenty-eight participants completed training in either a group (n=16) or a combined group/home (n=12) setting. Training resulted in increased white matter FA (Δ=0.05, P<.001). A carryover effect was observed for participants ~12 weeks after training (Δ=0.05, P<.001). Training effects were observed for hippocampal volume (Δ=130.98mm3; P=.001) and mean RT (Δ=-457.04ms, P=0.36) but only in the group setting. Related carryover effects for hippocampal volume (Δ=222.81mm3, P=.001), and RT (Δ=-814.90ms, P=.005) were also observed. Decreased RT was predicted by increased FA (R=-0.62, P=.01). There were no changes in accuracy.
Conclusions: Exercise training is an effective means for promoting white matter and hippocampal recovery and improving reaction time in children treated with cranial radiation for brain tumors.
Keywords: brain recovery; cranial radiation; exercise; neuroplasticity; pediatric brain tumor.
© The Author(s) 2017. Published by Oxford University Press on behalf of the Society for Neuro-Oncology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com
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Source: PubMed