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Neuroimage Clin. 2018 Mar 5;18:972-985. doi: 10.1016/j.nicl.2018.02.021. eCollection 2018.

Repairing the brain with physical exercise: Cortical thickness and brain volume increases in long-term pediatric brain tumor survivors in response to a structured exercise intervention.

Author information

1
Neurosciences and Mental Health, Hospital for Sick Children, Toronto, Ontario, Canada.
2
Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada.
3
Division of Hematology/Oncology, Hospital for Sick Children, Toronto, Ontario, Canada.
4
Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada.
5
Diagnostic Imaging, Hospital for Sick Children, Toronto, Ontario, Canada.
6
Mouse Imaging Centre, Hospital for Sick Children, Toronto, Ontario, Canada.
7
Department of Medical Biophysics, University of Toronto, Toronto, Ontario, Canada.
8
Department of Psychology, University of Toronto, Toronto, Ontario, Canada.

Abstract

There is growing evidence that exercise induced experience dependent plasticity may foster structural and functional recovery following brain injury. We examined the efficacy of exercise training for neural and cognitive recovery in long-term pediatric brain tumor survivors treated with radiation. We conducted a controlled clinical trial with crossover of exercise training (vs. no training) in a volunteer sample of 28 children treated with cranial radiation for brain tumors (mean age = 11.5 yrs.; mean time since diagnosis = 5.7 yrs). The endpoints were anatomical T1 MRI data and multiple behavioral outcomes presenting a broader analysis of structural MRI data across the entire brain. This included an analysis of changes in cortical thickness and brain volume using automated, user unbiased approaches. A series of general linear mixed effects models evaluating the effects of exercise training on cortical thickness were performed in a voxel and vertex-wise manner, as well as for specific regions of interest. In exploratory analyses, we evaluated the relationship between changes in cortical thickness after exercise with multiple behavioral outcomes, as well as the relation of these measures at baseline. Exercise was associated with increases in cortical thickness within the right pre and postcentral gyri. Other notable areas of increased thickness related to training were present in the left pre and postcentral gyri, left temporal pole, left superior temporal gyrus, and left parahippocampal gyrus. Further, we observed that compared to a separate cohort of healthy children, participants displayed multiple areas with a significantly thinner cortex prior to training and fewer differences following training, indicating amelioration of anatomical deficits. Partial least squares analysis (PLS) revealed specific patterns of relations between cortical thickness and various behavioral outcomes both after training and at baseline. Overall, our results indicate that exercise training in pediatric brain tumor patients treated with radiation has a beneficial impact on brain structure. We argue that exercise training should be incorporated into the development of neuro-rehabilitative treatments for long-term pediatric brain tumor survivors and other populations with acquired brain injury. (ClinicalTrials.gov, NCT01944761).

KEYWORDS:

Brain recovery; Cortical thickness; Cranial radiation; Exercise; Neuroplasticity; Pediatric brain tumor

PMID:
29876282
PMCID:
PMC5987848
DOI:
10.1016/j.nicl.2018.02.021
[Indexed for MEDLINE]
Free PMC Article

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