Exposure therapy for PTSD seems to work better when accompanied by aerobic exercise.
Intense aerobic activity seems to make exposure therapy for post-traumatic stress disorder more effective, according to a first-of-its-kind study out of the University of NSW.
Exposure therapy for anxiety disorders uses a mechanism known as extinction learning, through which unpleasant associations with stimuli are not so much unlearned as inhibited.
It’s been previously observed that bouts of exercise promote extinction learning in rats, and humans under experimental conditions, but this is the first clinical trial, according to lead researcher Professor Richard Bryant.
The team recruited 130 people with PTSD and gave them all nine 90-min weekly sessions of exposure therapy. Half the subjects undertook 10 minutes of intense aerobic activity immediately afterwards, while the other half did passive stretching.
At six-month follow-up, the aerobic group showed greater reductions in in PTSD severity, as measured by CAPS-2 scores, than those in the stretching group, with “a moderate effect size”.
The team believes exercise boosts extinction learning by promoting the growth of brain-derived neurotrophic factor (BDNF), which is involved in the plastic changes associated with learning and memory.
“It actually promotes synaptic plasticity in the brain, which is really important for learning,” Professor Bryant told the UNSW press team. “And we know that this underpins extinction learning. So if we can get this BDNF more active in the brain, at the time of exposure therapy, theoretically, that should lead to better extinction.”
With laudable restraint, Professor Bryant went on to say that it would be premature “get too excited” by one trial.
“[Y]ou always need multiple trials to actually have any faith in it. So I’m certainly not telling people to run out and start doing exercise after all your exposure therapy, because I think it’s premature after one trial. But having said that, this is very encouraging.”
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