Exercise Cuts Brain Inflammation in First-Episode Psychosis

Fran Lowry

April 16, 2019

ORLANDO, Florida — Aerobic exercise reduces brain inflammation in patients with first-episode psychosis (FEP), early research suggests.

In a study involving 25 outpatients newly diagnosed with schizophrenia, aerobic exercise performed once a week led to a significant reduction in interleukin-6 (IL-6), suggesting physical activity may reduce the deleterious effects of brain inflammation.

Dr Joseph Ventura

"IL-6 has been found to be a marker for brain inflammation in schizophrenia, and schizophrenia patients have higher levels than controls," lead author Joseph Ventura, PhD, University of California, Los Angeles (UCLA) Semel Institute for Neuroscience and Human Behavior, told Medscape Medical News.

"Interleukin-6 has also been found in other psychiatric conditions to be a biomarker of brain inflammation, so inflammation is a big concern," Ventura said.

The findings were presented here at the Congress of the Schizophrenia International Research Society (SIRS) 2019.

Dose-Dependent Relationship

High levels of IL-6 have been associated with depression, said Ventura. However, he added, at this point, it's unclear whether brain inflammation leads to depressive symptoms, or whether depression increases brain inflammation. "In any event," he said, "we know that IL-6 is not good for you. So what can we do about it?"

Study participants had FEP and were being treated in the UCLA Aftercare Program, a comprehensive treatment program that includes case managers, psychiatrists, and social workers. All of the patients were within 2 years of a first psychotic episode. The average age of the patients was 22.6 years, and the average level of education was 13 years.

The patients were randomly assigned to receive either exercise plus cognitive training or cognitive training alone for 6 months.

Exercise consisted of aerobic exercises, such as jumping jacks, as well as strength training. Patients could participate in an exercise class once or twice a week.

Blood sample testing for IL-6 was conducted at baseline and at 6 months.

To assess depressive symptoms, the investigators administered the Brief Psychiatric Rating Scale (BPRS) at baseline and every 2 weeks up to the 6-month study end point.

They found that increases in levels of IL-6 were significantly related to increases in depressive symptoms (P = .04).

They also found that there was a dose-dependent relationship between the amount of exercise and reductions in IL-6 levels.

The number of completed aerobic exercise sessions was significantly correlated with the level of reduction in brain inflammation, as indicated by IL-6 levels (P = .02).

"The more they exercised, the greater their reduction in IL-6," said Ventura.

Important Data

Commenting on the findings for Medscape Medical News, Deanna L. Kelly, PharmD, BCPP, professor of psychiatry at the University of Maryland School of Medicine and director of the Treatment Research Program at the Maryland Psychiatric Research Center, Baltimore, said the findings are important.

Dr Deanna Kelly

"Inflammation in first-episode patients with schizophrenia likely has a deleterious effect on the presentation of symptoms and the course of the illness.

"Interventions to improve inflammatory processes may improve long-term prognosis and alter the course of illness. While the overall study results for the exercise and cognitive training to improve IL-6 levels relative to cognitive training alone were not significant, this study suggests that the greater exercise attendance relates to more robust decreases in inflammation and opens the door for more tailored approaches to improving inflammation early in schizophrenia," Kelly added.

The study was funded by the National Institute of Mental Health and the National Alliance for Research in Schizophrenia and Affective Disorder. Ventura has financial relationships with Posit Science, Boehringer-Ingelheim, and Genentech. Kelly has financial relationships with Lundbeck, Alkermes, and HLS Therapeutics.

Congress of the Schizophrenia International Research Society (SIRS) 2019: Abstract F12. Presented April 12, 2019.

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