Review Article

The Effects of Exercise on Cognitive Recovery after Acquired Brain Injury in Animal Models: A Systematic Review

Table 1

Summary of exercise protocols and postexercise cognitive/emotional and cerebral changes in ABI animal models.

ReferenceABI modelAnimal, gender (age/weight)Exercise typeIntervention startDose parametersMean daily exercise distanceCognitive/emotional effectsCerebral changes

de Araujo et al.
[52]
CCAOMongolian gerbils, male (60–80 g)TreadmillEarly (12, 24, 48, or 72 hours postinjury)Max. 3 days (4 sessions), min. 1 day (1 session), 15 min/sess. Speed: 10 m/min150 mCCAO + EX after 12 hours showed a decreased number of field crossings and an increase in grooming in an open field test compared to sham + SED. No other group differences CCAO + EX after 12 hours: number of cells ↓ in CA1 + striatum compared to CCAO + EX after 24 hours

Cechetti et al. [47]CCAOWistar rats, male (3 months)TreadmillEarly (24 hours postinjury)12 weeks, 3 times/week, 20 min/session. Weeks 1-2: 12 m/min for 3 min, 24  m/min for 4 min, 36 m/min for 6 min, 24 m/min for 4 min, and 12 m/min for 3 min; weeks 3–6, at 24 m/min for 4 min, 36 m/min for 12 min, and 24 m/min for 4 min; weeks 7–10: 24 m/min for 2 min, 36 m/min for 16 min, and 24 m/min for 2 min: weeks 11-12: 36 m/min for 2 min, 48 m/min for 16 min, and 36 m/min for 2 min. 480 m/session up to 912 m/session (graded protocol)All EX groups did significantly better in a spatial acquisition and retention task as well as a working memory task than CCAO + SED No differences between groups in levels of free radicals or SOD. CCAO + SED: hippocampal lipoperoxidation and thiol-levels ↑ compared to the other groups

Chen et al. [55]NTISprague-Dawley rats (12–14 weeks)Motorized running wheelEarly (2nd postinjury day)7 consecutive days, 30 min twice daily. LowEX: 3 m/min for 10 min., 4.2 m/min for 10 min, and 5.4 m/min for 10 min. ModEX: 4.8 m/min for 10 min, 6 m/min for 10 min, and 7.2 m/min for 10 min. HighEX: 9.6 m/min for 10 min, 10.8 m/min for 10  min, and 12 m/min for 10  minNTI + LowtEX: 252 m; NTI + ModEX: 360 m; NTI + HighEX: 648 mNTI + ModEX showed significantly better acquisition of conditioning task in Y-maze than NTI + SED. No acquisition differences between NTI + LowEx and NTI + SED or NTI + HighEx and NTI + SED BrdU-positive cells in dentate gyrus ↑ in NTI + ModEX compared to NTI + SED. No BrdU-staining differences between other NTI + exercise intensity groups and NTI + SED. Positive correlation between acquisition and BrdU-positive cells

Chen et al. [57]CHIICR mice, male (7 weeks)TreadmillEarly + late (2 or 9 days postinjury)7 or 14 days (early) or 7 days (late). 1 hour/daily. Speed: 9 m/min progressively increased to 13.5 m/minBetween 540 m and 810 m (graded protocol)CHI + earlyEX spent significantly more time exploring new object in an object recognition task than CHI + SED. CHI + lateEX and CHI + SED had less time exploration time with the new object than sham animalsEarlyEX hindered progressive cell loss in the cortex and hippocampus more than lateEX. EarlyEX ↑ neurite regeneration in the early postinjury stages, lateEX hindered later stage cell loss. EarlyEX for 14 days restored lesion-induced reduction in BDNF and MKP-1

Clark et al. [45]IRRC57BL/6J mice, male + female (min. 50 days)Running wheelLate (114/142 days postinjury)54 days total, 24-hour daily access IRR + EX: 5.8 km; sham + EX: 5.7 kmNo differences in spatial learning + retention between IRR + EX and IRR + SED. Spatial learning and retention improved in sham + EX. Exercise improved retention in a contextual fear conditioning test Exercise ↑ hippocampal neurogenesis. Exercise counteracted radiation-induced reductions in neurogenesis, neuronal differentiation, and glia cell levels

Crane et al. [40]CCILong Evans rats, male (ca. 50 days)Running wheelEarly (immediately postinjury)7 days7-8 kmCCI + EX performed significantly worse in complex stop-signal reaction time task for the first five test days compared CCI + SED and sham groups. After a week of testing, CCI + EX returned to baseline levels CCI + EX: GFAB and IBA1 positive cells ↑ in the cortex and hippocampus, respectively; all CCI-animals: DAP1 positive cells ↓ in the cortex, hippocampus, mediodorsal nucleus and corpus callosum compared to sham + SED

Griesbach et al. [39]FPISprague-Dawley rats, male (ca. 312 g)Running wheelEarly + late (0 or 14 days postinjury)7 days total, 24-hour daily access. Wheel resistance: 100 gN/A (mean ranges of nightly running distances between approximately 300 m and approximately 3400 m)FPI + earlyEX performed significantly worse on a spatial acquisition task than all other groups. FPI + lateEX performed to the level of the sham operated animals. All FPI animals performed worse than noninjured animals on retention task FPI + lateEX and sham groups: hippocampal pCREB and BDNF ↑. FPI + earlyEX: Synapsin-I and CREB ↓

Griesbach et al. [42]FPISprague-Dawley rats, male (ca. 265 g)Running wheelLate (14 days postinjury)7 days total, 24-hour daily access. Wheel resistance: 100 gN/A FPI + EX acquired a spatial learning task and reached six criterium scores significantly faster than FPI + SED Exercise ↑ hippocampal levels of BDNF. FPI + EX: mBDNF and CREB ↑ compared to FPI + SED. Sham + EX: Synapsin-I ↑. When blocking trk-B receptors: mBDNF ↓ in FPI + EX

Hicks et al. [50]FPISprague-Dawley rats, male (360–410 g)TreadmillEarly (1 day postinjury)18 days, 11.3 m/min. Day 1: 5 min, increased by 5 min daily for 14 days until reaching 60 min. After this running 60 min again for 4 days. Inclination: 6°56.5 m/daily up to 678 m/daily (time graded protocol)No differences in spatial acquisition or retention between FPI + EX and FPI + SED BDNF mRNA levels in CA1 and CA3 ↑ in FPI + EX compared to FPI + SED. No group differences in hippocampal injury or cortical lesion volume. Left neocortex < right neocortex in FPI + SED compared to FPI + EX

Itoh et al. [46]CCIWistar rats, male (10 weeks)TreadmillEarly (1 day postinjury)7 days, 30 min/day. Speed: 22 m/min660 mCCI + EX did significantly better in a spatial acquisition and retention task than CCI + SED Lesion size ↓ in CCI + EX compared to CCI + SED. ssDNA immunopositive cells around the damaged cortical area ↓ in CCI + EX (postinjury days 1, 3, and 7), number of NeuN positive cells ↑ and GFAP positive cells ↓ (postinjury day 7) compared to CCI + SED

Kim et al. [56]CCISprague-Dawley rats, male (7 weeks)TreadmillEarly (2 days postinjury)10 days, 30 min/day. Speed: 2 m/min for 5 min, 5 m/min for 5 min, and 8 m/min for 20 min 195 m (graded protocol)CCI + EX had shorter latency times in a step-down avoidance test than CCI + SED Hippocampal DNA fragmentation, Caspase-3, and Bax ↓ in CCI + EX compared to CCI + SED. Levels of Blcl2 ↑ in CCI + EX compared to CCI + SED. No group differences in corticosterone levels

Luo et al. [41]MCAOC57BL/6 mice, male (25–30 g)Running wheel + swimmingLate (1 week postinjury)RW: 43 days total, 24-hour daily access. SWIM: 43 days total, 2 trials/day, and 60 sec/trialN/A MCAO + RW had significantly shorter latency time to find the platform in a water maze task compared to MCAO + SED. No differences between MCAO + SWIM and MCAO + SEDDentate gyrus progenitor cell survival and pCREB levels ↑ in MCAO + RW compared to control group

Piao et al. [31]CCIC57BL/6 mice, male (10 weeks)Running wheelLate (1 week or 5 weeks postinjury)4 weeks total, 24-hour daily acces.103.2 m (1 week), 97.2 m (5 weeks). CCI + lateEX performed significantly better in a spatial acquisition and retention task than CCI + SED. CCI + lateEX showed significant improvement in a cognitive flexibility task compared to CCI + earlyEX and CCI + SED. Retention of the flexibility task was significantly better in CCI + lateEX compared to CCI + SED. In a novel object recognition task, CCI + lateEX spent significantly longer time exploring a new object than CCI + earlyEX and CCI + SED. No locomotor differences in an open field test. In a tail suspension test, all CCI groups had increased immobility times CCI + lateEX: ↓ lesion size compared to CCI + earlyEX and CCI + SED. IL-1β levels ↑ in CCI + earlyEX (week 5) and ↓ in CCI + lateEX (week 9) compared to CCI + SED. IL-6 and IL-10 ↑ CCI + lateEX (week 9). Cortical Galectin-3 and C1qB levels ↑ increased in CCI + earlyEX, but ↓ in CCI + lateEX. Gp91phox and p22phox ↓ in CCI + lateEX. Hippocampal CREB gene expression, BDNF, IGF-1, neurogenesis, and cell survival ↑ in CCI + lateEX

Shen et al. [49]CCISprague-Dawley rats, male (250–270 g)TreadmillEarly (24 hours postinjury)14 days, 30 min/day. LowEX: week 1: 3 m/min; week 2: 3 m/min for 5 min, 5 m/min for 5 min, and 8 m/min for 20 min. HighEX: Day 1: 3 m/min; day 2: 3 m/min for 10 min, 6 m/min for 10 min, and 9 m/min for 10 min; day 3: 6 m/min for 10 min, 9 m/min for 10 min, and 12 m/min for 10 min; day 4–14: 12 m/minWeek 1: 90 m, week 2: 200 m (lowEW). Day 1: 90 m, day 2: 180 m, day 3: 270 m, day 4–14: 360 m (highEX) (graded protocols)CCI + lowEX performed better on a spatial acquisition task compared to CCI + highEX and CCI + SED. CCI + lowEX showed better task retention than CCI + SEDContralateral hippocampal BDNF and pCREB ↑ in CCI + lowEX compared to CCI + SED. No group differences in levels of Synapsin-I and CREB

Shih et al. [48]MCAOSprague-Dawley rats, male (8 weeks)TreadmillEarly (24 hours postinjury)14 days, 30 min/day. LowEX: 8 m/min, highEX: 20 m/min240 m (lowEX); 600 m (highEX)MCAO + lowEX performed better in a spatial acquisition than the two other groups and showed better retention than MCAO + SEDHippocampal BDNF, Synapsin-I (contralaterally), PSD-95, dendritic complexity and dendrite spines ↑ in MCAO + lowEX compared to MCAO + SED. Corticosterone levels ↑ in MCAO + highEX compared to MCAO + SED

Shimada et al. [58]MCAOWistar rats, male (7 weeks)TreadmillEarly (4th postinjury day)28 days, 30 min/day. LowEX: 2 m/min for 5 min, 5 m/min for the next 5 min, and 8 m/min for 20 min. HighEX: 8 m/min for 5 min, 11 m/min for 5 min, and 22 m/min for 20 min195 m (lowEX); 535 m (highEX) (graded protocols)MCAO + lowEX spent more time exploring the novel object/newly placed object in object recognition/object location tasks than MCAO + SED. MCAO + highEX explored less than MCAO + lowEX. Both EX groups showed longer latency time in a passive avoidance test compared to MCAO + SED. No group differences in locomotor activity in an open field testEX groups ↓ lesion size. EX groups ↑ number of neurons in the dentate gyrus compared with non-EX groups – higher in the ipsilateral dentate gyrus in MCAO + lowEX than MCAO + highEX. Ipsilateral dentate gyrus MAP-2 levels ↑ in MCAO + lowEX compared to MCAO + SED. Ipsilateral hippocampal MAP-2 ↓ in MCAO + highEX compared with MCAO + lowEX and sham group. Contralaterally, MAP-2 ↓ in CA1 and CA3 in MCAO + highEX compared with MCAO + lowEX

Sim et al. [53]CCAOMongolian gerbils, male (11–13 weeks)TreadmillEarly (2nd postinjury day)10 days. 30 min/day. Speed: 2 m/min for the first 5 min, 5 m/min for the next 5 min, and 8 m/min 20 min195 m (graded protocol)CCAO + EX showed longer latency times in a step-down avoidance task than CCAO + SEDTUNEL-positive and Caspase-3 positive cells ↓ in CCAO + EX compared to CCAO + SED. Cell proliferation ↑ in CCAO + SED and sham + EX

Sim et al. [54]CCAOMongolian gerbils, male (11–13 weeks)TreadmillEarly (1st postinjury day)4 weeks, 30 min/day. Speed: 2 m/min for the first 5 min, 5 m/min for the next 5 min, and 8 m/min 20 min195 m (graded protocol)CCAO + EX showed longer latencies in a step-down avoidance task than CCAO + SED TUNEL-positive and Caspase-3 positive cells ↓ in CCAO + EX compared to CCAO + SED

Song et al. [51]PTSprague-Dawley rats, male (10 weeks)SwimmingEarly (1 day postinjury)4 weeks, 5 days/week, 20 min/dayN/ANo significant differences between any treatment groups and lesioned controls on a spatial acquisition taskHippocampal SOD-levels ↑ and MDA-levels ↓ in all treatment groups compared to lesioned controls. Number of cells in CA3 ↑ in the treatment groups compared to controls

Winocur et al. [44]IRRLong Evans rats, male (5 months)Running wheelLate (25th postinjury day)25 days total, 24-hour daily accessIRR + EX: 8.4 km; sham + EX: 3.6 kmNo group differences in visual discrimination task acquisition. IRR + EX in high-interference group performed significantly better in retention task than IRR + SED in low-interference group. Sham + EX performed significantly better in retention task than Sham + SEDExercise ↑ hippocampal DCX and ki67 in all groups

Wong-Goodrich et al. [43]IRRC57BL/6 mice, female (8 weeks)Running wheelLate (1 month postinjury)111 days total, 8–12-hour daily accessIRR + EX: 0.56 km; sham + EX: 0.52 km IRR + EX: longer latency to complete spatial acquisition task on day 1; by day 3 no group differences. IRR + EX also showed improved task retention. No group differences in tail suspension test No group differences in dentate gyrus size. Hippocampal BrdU- and NeuN-positive cells ↑ in IRR + EX. Levels of TNF-α, INF-γ, and IL-6 ↑ in IRR groups. Levels of IGF ↑ in IRR + EX compared to IRR + SED. Levels of BDNF and VEGF ↓ in IRR + EX and IRR + SED. Running partially restored VEGF-levels in IRR

Wu et al. [38]FPISprague-Dawley rats, N/A (200–240 g)Running wheelEarly (postinjury day 0)12 days total, daily access: N/AN/AFPI + EX + REG and FPI + SED + DHA did significantly better in a spatial acquisition task compared to FPI + SED + REG. FPI + EX + DHA did significantly better than all other FPI groups Levels of DHA, Acox1, 17β-HSD4, Sir2, iPLA2, and p-TrkB ↑ and 4-HHE ↓ in FPI groups subjected to either EX or DHA; this was even more pronounced in FPI + EX + DHA compared to FPI + SED + REG. Levels of STX-3 and BDNF ↑ in FPI + EX + DHA

Early: postinjury days 0–6; late: postinjury days 7 and onwards. Data from personal communication with corresponding author.
CCAO: common carotid artery occlusion; CCI: controlled cortical impact; CHI: closed head injury; DHA: docosahexaenoic acid diet; earlyEX: early initiated exercise; EX: exercised animals; FPI: fluid percussion injury; highEX: high intensity exercise; IRR: irradiation; lateEX: late initiated exercise; lowEX: low intensity exercise; MCAO: middle cerebral artery occlusion; ModEX: moderate intensity exercise; N/A: information not available; NTI: neurotoxic injury; PT: photothrombosis; REG: regular diet; RW: running wheel exercise; SED: sedentary (nonexercised) animals; Sham: nonlesioned animals; SWIM: swimming exercise.