The impact of endurance training and table soccer on brain metabolites in schizophrenia

Research output: Contribution to journalArticle


Higher glutamate and glutamine (together: Glx) and lower N-acetyl-aspartate (NAA) levels were reported in schizophrenia. Endurance training normalizes NAA in the hippocampus, but its effects on other metabolites in the brain and the relationship of metabolites to clinical symptoms remain unknown. For 12 weeks, 20 schizophrenia inpatients (14 men, 6 women) and 23 healthy controls (16 men, 7 women) performed endurance training and a control group of 21 schizophrenia inpatients (15 men, 6 women) played table soccer. A computer-assisted cognitive performance training program was introduced after 6 weeks. We assessed cognitive performance, psychopathological symptoms, and everyday functioning at baseline and after 6 and 12 weeks and performed single voxel magnetic resonance spectroscopy of the hippocampus, left dorsolateral prefrontal cortex (DLPFC), and thalamus. We quantified NAA, Glx, total creatine (tCr), calculated NAA/tCr and Glx/tCr and correlated these ratios with physical fitness, clinical and neurocognitive scores, and everyday functioning. At baseline, in both schizophrenia groups NAA/tCr was lower in the left DLPFC and left hippocampus and Glx/tCr was lower in the hippocampus than in the healthy controls. After 6 weeks, NAA/tCr increased in the left DLPFC in both schizophrenia groups. Brain metabolites did not change significantly in the hippocampus or thalamus, but the correlation between NAA/tCr and Glx/tCr normalized in the left DLPFC. Global Assessment of Functioning improvements correlated with NAA/tCr changes in the left DLPFC. In our study, endurance training and table soccer induced normalization of brain metabolite ratios in the brain circuitry associated with neuronal and synaptic elements, including metabolites of the glutamatergic system.


  • Boris Stephan Rauchmann
  • Farhad Ghaseminejad
  • Daniel Keeser
  • Katriona Keller-Varady
  • Thomas Schneider-Axmann
  • Shun Takahashi
  • Temmuz Karali
  • Gunther Helms
  • Peter Dechent
  • Isabel Maurus
  • Alkomiet Hasan
  • Thomas Wobrock
  • Birgit Ertl-Wagner
  • Andrea Schmitt
  • Berend Malchow
  • Peter Falkai
External organisations
  • Ludwig-Maximilian University of Munich
  • University of British Columbia
  • Wakayama Medical College
  • University Medical Center Göttingen
  • University of Göttingen
  • Hospital for Sick Children, Toronto
  • University of São Paulo
  • Universitätsklinikum Jena
Research areas and keywords

Subject classification (UKÄ) – MANDATORY

  • Neurology


  • Aerobic exercise, Clinical symptoms, Glx, MRS, NAA, Schizophrenia
Original languageEnglish
JournalBrain Imaging and Behavior
Publication statusE-pub ahead of print - 2019 Nov
Publication categoryResearch