Exercise Augmentation of Exposure Therapy for PTSD: Rationale and Pilot Efficacy Data

• Published in: Cognitive behaviour therapy Vol. 44; no. 4; pp. 314 - 327
• Main Authors: Powers, Mark B., Medina, Johnna L., Burns, Stephanie, Kauffman, Brooke Y., Monfils, Marie, Asmundson, Gordon J.G., Diamond, Allison, McIntyre, Christa, Smits, Jasper A.J.
• Format: Journal Article
• Language: English
• Published: England Routledge 01.01.2015; Taylor & Francis Ltd
• Subjects: Adult; anxiety disorders; augmentation; BDNF; Brain-Derived Neurotrophic Factor - blood; CBT; Cognitive therapy; Combined Modality Therapy - methods; Exercise; Exercise - psychology; Exercise Therapy - methods; exposure therapy; Female; Humans; Implosive Therapy - methods; Male; pilot data; Pilot Projects; Post traumatic stress disorder; Stress Disorders, Post-Traumatic - blood; Stress Disorders, Post-Traumatic - therapy; Young Adult; CBT; BDNF; exercise; anxiety disorders; exposure therapy; pilot data; augmentation
• ISSN: 1650-6073; 1651-2316
• DOI: 10.1080/16506073.2015.1012740

Brain-derived neurotrophic factor (BDNF) is associated with synaptic plasticity, which is crucial for long-term learning and memory. Some studies suggest that people suffering from anxiety disorders show reduced BDNF relative to healthy controls. Lower BDNF is associated with impaired learning, cognitive deficits, and poor exposure-based treatment outcomes. A series of studies with rats showed that exercise elevates BDNF and enhances fear extinction. However, this strategy has not been tested in humans. In this pilot study, we randomized participants (N = 9, 8 females, M Age  = 34) with posttraumatic stress disorder (PTSD) to (a) prolonged exposure alone (PE) or (b) prolonged exposure+exercise (PE+E). Participants randomized to the PE+E condition completed a 30-minute bout of moderate-intensity treadmill exercise (70% of age-predicted HR max ) prior to each PE session. Consistent with prediction, the PE+E group showed a greater improvement in PTSD symptoms (d = 2.65) and elevated BDNF (d = 1.08) relative to the PE only condition. This pilot study provides initial support for further investigation into exercise augmented exposure therapy.