Evaluation of the effects of aerobic physical exercise program in structural brain changes and serum BDNF for people with temporal lobe epilepsy: correlations with cardiopulmonary capacity

Author(s)

Nathália Volpato

• Document type: Doctoral Thesis
• Press: Campinas, SP.
• Institution: Universidade Estadual de Campinas (UNICAMP). Faculdade de Ciências Médicas
• Defense date: 2019-08-23

Examining board members

Fernando Cendes; Cláudia Vianna Maurer Morelli; Alexandre Hideki Okano; Luiz Eduardo Betting; Bruno Rodrigues

• Advisor: Fernando Cendes

Abstract

Introduction: Temporal lobe epilepsy (TLE) is the most common epilepsy among adults, being a chronic disease that negatively influences the quality of life (QOL) of patients. Some studies demonstrate the benefits of physical exercise (PE) as a complementary treatment for people with epilepsy; however, its effects are not entirely known. In the last decade, with the advancement of technology, the number of studies demonstrating the neurological adaptations of PE and its benefits for neurological diseases has grown. The present study aimed to: (Chapter 01) compare the level of PA, cardiopulmonary capacity and QOL between people with TLE and people without epilepsy, and also between people with active and inactive TLE; (Chapter 02) Compare serum BNF level and hippocampal volume between people with TLE who are active and inactive; (Chapter 03) evaluate the effects of an aerobic exercise program on serum BDNF levels, hippocampal volume, and QOL, and its correlations with cardiopulmonary capacity in people with TLE. Methods: In chapter 01, we compared the PA level, cardiopulmonary capacity and QOL between people with TLE (G-ELT) (n = 38) and people without epilepsy (G-Control) (n = 20) as well as between people in the G-ELT who were active (n = 17) and inactive (n = 11). In Chapter 02, we evaluated people with TLE considered active (ELT-Active) (n = 17) and inactive (ELT-Inactive) (n = 11) by comparing serum BDNF levels and hippocampal volumes between groups. Chapter 03 was a longitudinal study, in which we divided people with TLE into two groups: those who underwent physical training in aerobic intensity, for 24 weeks, with one hour sessions (G-Training, n = 21) and those who were instructed to maintain their normal activity (G-No-training, n = 30). We evaluated and compared cardiopulmonary capacity, serum BDNF level, hippocampal volumes, and QoL between these two groups. Results: In chapter 01, we did not observe significant differences in PA levels between G-ELT and G-Control; however, the G-Control had significantly better cardiopulmonary capacity indices. We found a significant better cardiopulmonary capacity and QoL in the ELT-Active group compared to the ELT-Inactive. In chapter 02, we observed a lower serum BDNF level for ELT-Inactive and no significant differences in hippocampal volumes between groups. In chapter 03, we observed a multivariate effect of time after the aerobic PE intervention period, but we did not observe a significant difference between the groups. We also observed a negative correlation between cardiopulmonary capacity and BDNF at G-Training Time-post: during the 24 weeks G-No-training had decreased by 5.4% of the ipsilateral hippocampal volume and a reduction of 3.75 % of the contralateral hippocampus, in contrast, G-Training had a 1.2% increase in the ipsilateral hippocampus and a 3.32% increase in the contralateral hippocampus. G-Training also had significant improvements in QoL aspects, while G-No-training did not show significant differences between pre and post physical training intervention. Conclusion: The results suggest that people with TLE tend to have a lower cardiopulmonary capacity and QOL compared to people without epilepsy. Aerobic physical training improves cardiopulmonary capacity, and also, may slow down the progressive hippocampal neurodegeneration, and improve QoL aspects of patients with TLE (AU)

• FAPESP's process: 14/05435-8 - Evaluation of the benefits of aerobic exercise for people with mesial temporal lobe epilepsy program, and relations with structural and biochemical adaptations in the brain.
• Grantee: Nathália Volpato
• Support Opportunities: Scholarships in Brazil - Doctorate