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David Kimhy, PhD, joined the Department of Psychiatry at the Icahn School of Medicine at Mount Sinai In September of 2017 as an Associate Professor, Leader in New Interventions in Schizophrenia, and Director of the Experimental Psychopathology Laboratory.
Dr. Kimhy’s current focus is on improving daily function in people with psychosis. In 2017 he received, along with co-investigator Dr. T. Scott Stroup of Columbia University, a 4-year, $6.2 million research grant from the National Institute of Mental Health for a multi-site, single-blind, randomized clinical trial entitled Improving Cognition via Exercise in Schizophrenia, the largest study of its kind. The goal of the study is to confirm the impact of aerobic exercise training on cognitive functioning, along with examining its impact on daily functioning and biomarkers of neuroplasticity and cognitive change.
Background
Schizophrenia is commonly characterized by psychotic symptoms such as hallucinations and delusions. However, it is often the accompanying cognitive deficits (e.g., difficulties with poor attention, memory, processing speed, and executive functioning) that lead to life-long functional difficulties and disability. Such deficits can get in the way of attending school, gaining and maintaining employment, as well as developing relationships with family, friends, and romantic partners. While antipsychotic medications have been found to relieve psychotic symptoms, available treatments offer limited benefits for cognitive deficits.
Targeting these deficits, in 2014 Dr. Kimhy demonstrated that such deficits in people with schizophrenia are closely associated with poor aerobic fitness. A year later, he tested a novel intervention to improve cognitive functioning in people with schizophrenia. Completing a small clinical trial, he demonstrated that individuals with schizophrenia who participated in a 12-week aerobic exercise program using active-play video games (i.e., Xbox Kinect) improved their cognitive functioning by 15% (compared to minimal change in the control group). The cognitive improvements were associated with upregulation of Brain rived Neurotrophic Factor (BDNF), a biomarker of neuroplasticity.
Beyond Medication: Hope for Patients
In the present study, Dr. Kimhy is aiming to replicate these results in a larger cohort, employing a similar intervention to study 200 participants with schizophrenia across four sites in New York, North Carolina, Georgia, and California. Participants engage in a 12-week, 3 times per week, 1-hour training program with a trainer using active-play video games along with traditional exercise equipment. “Our innovative use of active-play video games as part of exercise is fun, as well as inexpensive and scalable,” said Dr. Kimhy.
“This study is important for a number of reasons. Primarily, it highlights poor aerobic fitness as a modifiable risk factor for cognitive deficits in schizophrenia, for which aerobic exercise is a safe, non-stigmatizing, and nearly side-effect free intervention,” said Dr. Kimhy. Additionally, aerobic exercise may potentially improve mood symptoms and poor physical health, as well as minimize the risk of premature death—all issues that are prevalent among people with schizophrenia. Results from this efficacy study will inform policy makers’ “go/no-go” decisions regarding the dissemination of aerobic exercise to target cognitive deficits in people with schizophrenia.