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Aerobic Endurance Exercise Improves Executive Functions in Depressed Patients. [CME]

J Clin Psychiatry 2003;64(9):1005-1012

Background: Aerobic endurance exercise has been shown to improve higher cognitive functions such as executive control in healthy subjects. We tested the hypothesis that a 30-minute individually customized endurance exercise program has the potential to enhance executive functions in patients with major depressive disorder.

Method: In a randomized within-subject study design, 24 patients with DSM-IV major depressive disorder and 10 healthy control subjects performed 30 minutes of aerobic endurance exercise at 2 different workload levels of 40% and 60% of their predetermined individual 4-mmol/L lactic acid exercise capacity. They were then tested with 4 standardized computerized neuropsychological paradigms measuring executive control functions: the task switch paradigm, flanker task, Stroop task, and GoNogo task. Performance was measured by reaction time. Data were gathered between fall 2000 and spring 2002.

Results: While there were no significant exercise-dependent alterations in reaction time in the control group, for depressive patients we observed a significant decrease in mean reaction time for the congruent Stroop task condition at the 60% energy level (p = .016), for the incongruent Stroop task condition at the 40% energy level (p = .02), and for the GoNogo task at both energy levels (40%, p = .025; 60%, p = .048). The exercise procedures had no significant effect on reaction time in the task switch paradigm or the flanker task.

Conclusion: A single 30-minute aerobic endurance exercise program performed by depressed patients has positive effects on executive control processes that appear to be specifically subserved by the anterior cingulate.