Advertisement
Review| Volume 142, 109170, May 2023

Download started.

Ok

The relationship between physical activity and cognitive function in people with epilepsy: A systematic review

      Highlights

      • Studies examining how physical activity and cognition are related in PWE are rare.
      • There is a potential positive association between physical activity and cognition in PWE.
      • Known physical activity benefits suggest its promise as a cognitive treatment in PWE.
      • Large physical activity RCTs in PWE are needed to investigate the effects on cognition.

      Abstract

      Background

      This study aimed to systematically review the published literature evaluating the association between physical activity and cognitive function in people with epilepsy (PWE).

      Methods

      A comprehensive search of PubMed, Cochrane, Embase, and PsychInfo was performed on June 20, 2022. Studies were excluded if they were not available in the English language, contained animal data only, did not include any original data, were not peer-reviewed, or did not include PWE as a discrete group. PRISMA guidelines were followed. The GRADE scale was used to assess the risk of bias.

      Results

      Six studies were identified with a total of 123 participants. These included one observational study and five interventional studies, only one of which was a randomized controlled trial. In all studies, there was a positive association between physical activity and cognitive function in PWE. Both interventional studies showed improvement in at least one domain of cognitive functioning, though there was heterogeneity in the outcome measures used.

      Conclusions

      There is a potential positive association between physical activity and cognitive function in PWE, but available data is limited by heterogeneity, small sample size, and an overall lack of published studies in this area of research. There is a need for more robust studies to be performed in larger samples of PWE.

      Keywords

      Abbreviations:

      PWE (people with epilepsy), PRISMA (Preferred Reporting Items for Systematic Review), GRADE (Grading of Recommendations Assessment Development and Evaluation), SF-36 (short form-36), PEL (physical exercise in leisure), BQ (Baecke Questionnaire of Habitual Physical Activity), IPAQ (international physical activity questionnaire), MoCA (Montreal Cognitive Assessment), HVLT (Hopkins verbal learning test), TMT (trails making test), DST (digit span test), SCWT (Stroop color and word test), CVLT-II (California verbal learning test – 2nd edition), POMS (profile of mood states), fMRI (functional magnetic resonance imaging), CAT (comprehensive attention test), CCTT (children’s color trails test), CSD (current source density), EEG (electroencephalography), WISC-III (Wechsler Intelligence Scales), CDI (children’s depression index), RCMAS (revised children’s manifest anxiety scale), CBCL (child behavior checklist), QOLCE (quality of life in childhood epilepsy)
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Epilepsy & Behavior
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

      1. In: England MJ, Liverman CT, Schultz AM, Strawbridge LM, editors. Epilepsy Across the Spectrum: Promoting Health and Understanding. Washington (DC); 2012.

      2. Centers for Disease C, Prevention. Comorbidity in adults with epilepsy--United States, 2010. MMWR Morb Mortal Wkly Rep 2013;62:849–53.

        • Giovagnoli A.R.
        • Parente A.
        • Tarallo A.
        • Casazza M.
        • Franceschetti S.
        • Avanzini G.
        Self-rated and assessed cognitive functions in epilepsy: impact on quality of life.
        Epilepsy Res. 2014; 108: 1461-1468
        • Smith D.B.
        • Craft B.R.
        • Collins J.
        • Mattson R.H.
        • Cramer J.A.
        Behavioral characteristics of epilepsy patients compared with normal controls.
        Epilepsia. 1986; 27: 760-768
        • Witt J.A.
        • Helmstaedter C.
        Should cognition be screened in new-onset epilepsies? A study in 247 untreated patients.
        J Neurol. 2012; 259: 1727-1731
        • Witt J.A.
        • Helmstaedter C.
        Cognition in the early stages of adult epilepsy.
        Seizure. 2015; 26: 65-68
        • Motamedi G.
        • Meador K.
        Epilepsy and cognition.
        Epilepsy Behav. 2003; 4: S25-S38
        • Horak P.C.
        • Meisenhelter S.
        • Song Y.
        • Testorf M.E.
        • Kahana M.J.
        • Viles W.D.
        • et al.
        Interictal epileptiform discharges impair word recall in multiple brain areas.
        Epilepsia. 2017; 58: 373-380
        • Baxendale S.
        Cognitive rehabilitation and prehabilitation in people with epilepsy.
        Epilepsy Behav. 2020; 106107027
        • Farina E.
        • Raglio A.
        • Giovagnoli A.R.
        Cognitive rehabilitation in epilepsy: An evidence-based review.
        Epilepsy Res. 2015; 109: 210-218
        • Gilliam F.
        • Carter J.
        • Vahle V.
        Tolerability of antiseizure medications: implications for health outcomes.
        Neurology. 2004; 63: S9-S12
        • Meador K.J.
        Cognitive outcomes and predictive factors in epilepsy.
        Neurology. 2002; 58: S21-S26
        • Karssemeijer E.G.A.
        • Aaronson J.A.
        • Bossers W.J.
        • Smits T.
        • Olde Rikkert M.G.M.
        • Kessels R.P.C.
        Positive effects of combined cognitive and physical exercise training on cognitive function in older adults with mild cognitive impairment or dementia: A meta-analysis.
        Ageing Res Rev. 2017; 40: 75-83
        • Norton S.
        • Matthews F.E.
        • Barnes D.E.
        • Yaffe K.
        • Brayne C.
        Potential for primary prevention of Alzheimer's disease: an analysis of population-based data.
        Lancet Neurol. 2014; 13: 788-794
      3. Bonavita S. Exercise and Parkinson's Disease. Adv Exp Med Biol 2020;1228:289–301.

        • Shawahna R.
        • Nairat Q.
        Research productivity in the field of physical exercise and epilepsy: A bibliometric analysis of the scholarly literature with qualitative synthesis.
        Epilepsy Behav. 2021; 121108058
        • Arida R.M.
        • Sanabria E.R.
        • da Silva A.C.
        • Faria L.C.
        • Scorza F.A.
        • Cavalheiro E.A.
        Physical training reverts hippocampal electrophysiological changes in rats submitted to the pilocarpine model of epilepsy.
        Physiol Behav. 2004; 83: 165-171
      4. Arida RM, Scorza CA, Scorza FA, Gomes da Silva S, da Graca Naffah-Mazzacoratti M, Cavalheiro EA. Effects of different types of physical exercise on the staining of parvalbumin-positive neurons in the hippocampal formation of rats with epilepsy. Prog Neuropsychopharmacol Biol Psychiatry 2007;31:814–22.

        • Gomes F.G.
        • Gomes Da Silva S.
        • Cavalheiro E.A.
        • Arida R.M.
        Beneficial influence of physical exercise following status epilepticus in the immature brain of rats.
        Neuroscience. 2014; 274: 69-81
        • Vannucci Campos D.
        • Lopim G.M.
        • da Silva D.A.
        • de Almeida A.A.
        • Amado D.
        • Arida R.M.
        Epilepsy and exercise: An experimental study in female rats.
        Physiol Behav. 2017; 171: 120-126
        • de Almeida A.A.
        • Gomes da Silva S.
        • Lopim G.M.
        • Vannucci Campos D.
        • Fernandes J.
        • Cabral F.R.
        • et al.
        Resistance Exercise Reduces Seizure Occurrence, Attenuates Memory Deficits and Restores BDNF Signaling in Rats with Chronic Epilepsy.
        Neurochem Res. 2017; 42: 1230-1239
        • Stimpson N.J.
        • Davison G.
        • Javadi A.-H.
        Joggin’ the Noggin: Towards a Physiological Understanding of Exercise-Induced Cognitive Benefits.
        Neurosci Biobehav Rev. 2018; 88: 177-186
        • Benarroch E.
        What Muscle Signals Mediate the Beneficial Effects of Exercise on Cognition?.
        Neurology. 2022; 99: 298-304
        • Binder D.K.
        • Croll S.D.
        • Gall C.M.
        • Scharfman H.E.
        BDNF and epilepsy: too much of a good thing?.
        Trends Neurosci. 2001; 24: 47-53
        • Wang X.
        • Hu Z.
        • Zhong K.
        The role of brain-derived neurotrophic factor in epileptogenesis: An update.
        Front Pharmacol. 2021; : 3405
        • Jalava M.
        • Sillanpaa M.
        Physical activity, health-related fitness, and health experience in adults with childhood-onset epilepsy: a controlled study.
        Epilepsia. 1997; 38: 424-429
        • Wong J.
        • Wirrell E.
        Physical activity in children/teens with epilepsy compared with that in their siblings without epilepsy.
        Epilepsia. 2006; 47: 631-639
        • Vancampfort D.
        • Ward P.B.
        • Stubbs B.
        Physical activity and sedentary levels among people living with epilepsy: A systematic review and meta-analysis.
        Epilepsy Behav. 2019; 99106390
        • Nakken K.O.
        • Bjorholt P.G.
        • Johannessen S.I.
        • Loyning T.
        • Lind E.
        Effect of physical training on aerobic capacity, seizure occurrence, and serum level of antiepileptic drugs in adults with epilepsy.
        Epilepsia. 1990; 31: 88-94
      5. Moher D, Liberati A, Tetzlaff J, Altman DG, Group P. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Ann Intern Med 2009;151:264–9, W64.

        • Page M.J.
        • McKenzie J.E.
        • Bossuyt P.M.
        • Boutron I.
        • Hoffmann T.C.
        • Mulrow C.D.
        • et al.
        The PRISMA 2020 statement: an updated guideline for reporting systematic reviews.
        BMJ. 2021; 372n71
        • Neufer P.D.
        • Bamman Marcas M.
        • Muoio Deborah M.
        • Bouchard C.
        • Cooper Dan M.
        • Goodpaster Bret H.
        • et al.
        Understanding the Cellular and Molecular Mechanisms of Physical Activity-Induced Health Benefits.
        Cell Metab. 2015; 22: 4-11
      6. Guyatt GH, Oxman AD, Vist GE, Kunz R, Falck-Ytter Y, Alonso-Coello P, et al. GRADE: an emerging consensus on rating quality of evidence and strength of recommendations. BMJ 2008;336:924–6.

        • Eom S.
        • Lee M.K.
        • Park J.H.
        • Lee D.
        • Kang H.C.
        • Lee J.S.
        • et al.
        The Impact of a 35-Week Long-Term Exercise Therapy on Psychosocial Health of Children With Benign Epilepsy.
        J Child Neurol. 2016; 31: 985-990
        • Koirala G.R.
        • Lee D.
        • Eom S.
        • Kim N.Y.
        • Kim H.D.
        Altered brain functional connectivity induced by physical exercise may improve neuropsychological functions in patients with benign epilepsy.
        Epilepsy Behav. 2017; 76: 126-132
        • Popp J.L.
        • Szaflarski J.P.
        • Kaur M.
        • Martin R.C.
        • Brokamp G.A.
        • Terry D.M.
        • et al.
        Relationships between cognitive function, seizure control, and self-reported leisure-time exercise in epilepsy.
        Epilepsy Behav. 2021; 118
        • Eom S.
        • Lee M.K.
        • Park J.H.
        • Jeon J.Y.
        • Kang H.C.
        • Lee J.S.
        • et al.
        The impact of an exercise therapy on psychosocial health of children with benign epilepsy: a pilot study.
        Epilepsy Behav. 2014; 37: 151-156
        • Allendorfer J.B.
        • Brokamp G.A.
        • Nenert R.
        • Szaflarski J.P.
        • Morgan C.J.
        • Tuggle S.C.
        • et al.
        A pilot study of combined endurance and resistance exercise rehabilitation for verbal memory and functional connectivity improvement in epilepsy.
        Epilepsy Behav. 2019; 96: 44-56
        • Feter N.
        • Alt R.
        • Häfele C.A.
        • da Silva M.C.
        • Rombaldi A.J.
        Effect of combined physical training on cognitive function in people with epilepsy: Results from a randomized controlled trial.
        Epilepsia. 2020; 61: 1649-1658
        • Mahalakshmi B.
        • Maurya N.
        • Lee S.D.
        • Bharath K.V.
        Possible Neuroprotective Mechanisms of Physical Exercise in Neurodegeneration.
        Int J Mol Sci. 2020; 21
        • Fox F.A.U.
        • Diers K.
        • Lee H.
        • Mayr A.
        • Reuter M.
        • Breteler M.M.B.
        • et al.
        Association Between Accelerometer-Derived Physical Activity Measurements and Brain Structure: A Population-Based Cohort Study.
        Neurology. 2022; 99: e1202-e1215
        • Gogniat M.A.
        • Robinson T.L.
        • Jean K.R.
        • Stephen M.L.
        Physical activity moderates the association between executive function and functional connectivity in older adults.
        Aging Brain. 2022; 2100036
        • Collard S.S.
        • Ellis-Hill C.
        How do you exercise with epilepsy? Insights into the barriers and adaptations to successfully exercise with epilepsy.
        Epilepsy Behav. 2017; 70: 66-71
      7. Vancini RL, Benedito-Silva AA, Sousa BS, Gomes da Silva S, Souza-Vancini MI, Vancini-Campanharo CR, et al. Knowledge about epilepsy among health professionals: a cross-sectional survey in São Paulo, Brazil. BMJ Open 2012;2:e000919.

        • Akerlund S.
        • Varkey E.
        • Klecki J.
        • Zelano J.
        • Ben-Menachem E.
        Randomized controlled trial of moderate cardiovascular exercise for patients with drug-resistant epilepsy.
        Epilepsy Behav. 2021; 124108335
      8. SudhindraVooturi, Lakshmi ANR, Jayalakshmi S. Evaluation of factors influencing obesity and the effect of a 12-week home-based exercise program in people with epilepsy - Randomized control trial. Epilepsy Behav 2020;110:107148.