Physical exercise combined with cognitive training significantly improves attention deficits in early schizophrenia
A randomized controlled trial of individuals with first-episode schizophrenia found that adding physical exercise to cognitive training produced substantially larger gains in attention than cognitive training combined with healthy living education.
In a randomized clinical trial, individuals with recent first-episode schizophrenia received cognitive training 4 hours per week for 6 months. Half were randomly assigned to also participate in a physical exercise program, while the other half received healthy living training instead.
Attention and overall cognition were measured using the MATRICS Consensus Cognitive Battery at baseline, 3 months, and 6 months. The exercise group showed a T score gain of 4.6 points in Attention/Vigilance over 6 months, compared to a decline of −0.2 points in the healthy living group—a statistically significant difference (P < .01). The improvement in attention by 3 months was significantly linked to both the number of exercise sessions attended and exercise intensity during that period. By 6 months, the total metabolic energy expended during the first 3 months and the proportion of group exercise sessions attended over the full 6 months both predicted gains in attention. The study also found that brain-derived neurotrophic factor tended to increase in the exercise condition but decrease in the healthy living condition over the first 3 months, suggesting a biological mechanism. The specific sample size and demographic details were not stated in the available text, which is a limitation for fully assessing generalizability.
The dose-response relationship is striking: gains in attention at 3 months correlated with how many exercise sessions participants attended (P = .02) and how hard they exercised (P < .03). By 6 months, total metabolic expenditure in the first half of the study and group exercise participation predicted attention improvements—suggesting both intensity and adherence matter. Brain-derived neurotrophic factor (BDNF), a protein that supports brain cell survival and learning, showed a biological signal: it tended to increase only in the exercise arm while declining in the comparison arm. This aligns with longstanding evidence that aerobic exercise triggers BDNF release in the brain. The authors emphasize that the exercise gains appear to be driving the effect beyond what cognitive training achieves alone, not merely additive. The study does not specify exact sample sizes or demographic makeup, which limits certainty about how broadly these findings apply. Prior smaller studies hinted at this synergy; this trial provides stronger evidence that the combination works in early schizophrenia specifically.
The deeper explanation, the effect sizes and caveats, and what this means for your own sleep, exercise and reading — read it inside Cadence.
Open in Cadence →References
- A Physical Exercise Program Significantly Boosts the Impact of Cognitive Training on Attention Deficits After a First Episode of Schizophrenia. — Schizophrenia bulletin (Read the original)