Abstract：
BACKGROUND: First-Episode Psychosis (FEP) is a devastating mental health condition that commonly emerges during early adulthood, and is characterised by a disconnect in perceptions of reality. Current evidence suggests that inflammation and perturbed immune responses are involved in the pathology of FEP and may be associated specifically with negative symptoms. Exercise training is a potent anti-inflammatory stimulus that can reduce persistent inflammation, and can improve mood profiles in general populations. Therefore, exercise may represent a novel adjunct therapy for FEP. The aim of this study was to assess the effect of exercise on biomarkers of inflammation, negative symptoms of psychosis, and physiological health markers in FEP.
METHODS: Seventeen young males (26.67 ± 6.64 years) were recruited from Birmingham Early Intervention in Psychosis Services and randomised to a 6-week exercise programme consisting of two-to-three sessions per week that targeted 60-70 % heart-rate max (HRMax), or a treatment as usual (TAU) condition. Immune T-helper (Th-) cell phenotypes and cytokines, symptom severity, functional wellbeing, and cognition were assessed before and after 6-weeks of regular exercise.
RESULTS: Participants in the exercise group (n = 10) achieved 81.11 % attendance to the intervention, with an average exercise intensity of 67.54 % ± 7.75 % HRMax. This led to favourable changes in immune cell phenotypes, and a significant reduction in the Th1:Th2 ratio (-3.86 %) compared to the TAU group (p = 0.014). After the exercise intervention, there was also a significant reduction in plasma IL-6 concentration (-22.17 %) when compared to the TAU group (p = 0.006). IL-8, and IL-10 did not show statistically significant differences between the groups after exercise. Symptomatically, there was a significant reduction in negative symptoms after exercise (-13.54 %, Positive and Negative Syndrome Scale, (PANSS) Negative) when compared to the TAU group (p = 0.008). There were no significant change in positive or general symptoms, functional outcomes, or cognition (all p > 0.05).
CONCLUSIONS: Regular moderate-to-vigorous physical activity is feasible and attainable in clinical populations. Exercise represents a physiological tool that is capable of causing significant inflammatory biomarker change and concomitant symptom improvements in FEP cohorts, and may be useful for treatment of symptom profiles that are not targeted by currently prescribed antipsychotic medication.
METHODS: Seventeen young males (26.67 ± 6.64 years) were recruited from Birmingham Early Intervention in Psychosis Services and randomised to a 6-week exercise programme consisting of two-to-three sessions per week that targeted 60-70 % heart-rate max (HRMax), or a treatment as usual (TAU) condition. Immune T-helper (Th-) cell phenotypes and cytokines, symptom severity, functional wellbeing, and cognition were assessed before and after 6-weeks of regular exercise.
RESULTS: Participants in the exercise group (n = 10) achieved 81.11 % attendance to the intervention, with an average exercise intensity of 67.54 % ± 7.75 % HRMax. This led to favourable changes in immune cell phenotypes, and a significant reduction in the Th1:Th2 ratio (-3.86 %) compared to the TAU group (p = 0.014). After the exercise intervention, there was also a significant reduction in plasma IL-6 concentration (-22.17 %) when compared to the TAU group (p = 0.006). IL-8, and IL-10 did not show statistically significant differences between the groups after exercise. Symptomatically, there was a significant reduction in negative symptoms after exercise (-13.54 %, Positive and Negative Syndrome Scale, (PANSS) Negative) when compared to the TAU group (p = 0.008). There were no significant change in positive or general symptoms, functional outcomes, or cognition (all p > 0.05).
CONCLUSIONS: Regular moderate-to-vigorous physical activity is feasible and attainable in clinical populations. Exercise represents a physiological tool that is capable of causing significant inflammatory biomarker change and concomitant symptom improvements in FEP cohorts, and may be useful for treatment of symptom profiles that are not targeted by currently prescribed antipsychotic medication.
摘要：
背景：第一集精神病（FEP）是一种破坏性的精神健康状况，通常在成年早期出现，其特点是对现实的感知脱节。目前的证据表明,炎症和扰动的免疫应答与FEP的病理学有关,并且可能与阴性症状特异性相关。运动训练是一种有效的抗炎刺激，可以减少持续的炎症，可以改善一般人群的情绪状况。因此,运动可能是FEP的一种新的辅助疗法。这项研究的目的是评估运动对炎症生物标志物的影响，精神病的阴性症状，和FEP中的生理健康标记。
方法：从伯明翰精神病早期干预服务中招募了17名年轻男性（26.67±6.64岁），并随机参加为期6周的锻炼计划，包括每周两到三次，目标是60-70％的心率最大值（HRMax）。或照常治疗（TAU）条件。免疫辅助性T细胞表型和细胞因子,症状严重程度,功能健康，在6周的常规运动前后进行认知评估。
结果：运动组（n=10）的参与者对干预的出勤率为81.11％，平均运动强度为67.54%±7.75%HRMax。这导致免疫细胞表型的有利变化，与TAU组相比，Th1：Th2比率显着降低（-3.86％）（p=0.014）。运动干预后,与TAU组相比,血浆IL-6浓度也显著降低(-22.17%)(p=0.006).运动后，两组之间的IL-8和IL-10没有显示出统计学上的显着差异。症状,运动后阴性症状显着减少（-13.54％，阳性和阴性综合征量表，（PANSS）阴性）与TAU组（p=0.008）相比。阳性或一般症状无明显变化，功能结果，或认知(均p>0.05)。
结论：在临床人群中，有规律的中等至剧烈的体力活动是可行和可实现的。运动是一种生理工具，能够在FEP队列中引起显著的炎症生物标志物变化和伴随的症状改善，并且可能对目前处方的抗精神病药物未针对的症状谱的治疗有用。
方法：从伯明翰精神病早期干预服务中招募了17名年轻男性（26.67±6.64岁），并随机参加为期6周的锻炼计划，包括每周两到三次，目标是60-70％的心率最大值（HRMax）。或照常治疗（TAU）条件。免疫辅助性T细胞表型和细胞因子,症状严重程度,功能健康，在6周的常规运动前后进行认知评估。
结果：运动组（n=10）的参与者对干预的出勤率为81.11％，平均运动强度为67.54%±7.75%HRMax。这导致免疫细胞表型的有利变化，与TAU组相比，Th1：Th2比率显着降低（-3.86％）（p=0.014）。运动干预后,与TAU组相比,血浆IL-6浓度也显著降低(-22.17%)(p=0.006).运动后，两组之间的IL-8和IL-10没有显示出统计学上的显着差异。症状,运动后阴性症状显着减少（-13.54％，阳性和阴性综合征量表，（PANSS）阴性）与TAU组（p=0.008）相比。阳性或一般症状无明显变化，功能结果，或认知(均p>0.05)。
结论：在临床人群中，有规律的中等至剧烈的体力活动是可行和可实现的。运动是一种生理工具，能够在FEP队列中引起显著的炎症生物标志物变化和伴随的症状改善，并且可能对目前处方的抗精神病药物未针对的症状谱的治疗有用。
