Publications by authors named "Kevin M Crombie"

16 Publications

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Registered report: A pilot investigation of acute exercise response among girls and young women with and without eating disorders.

Int J Eat Disord 2021 Jul 29. Epub 2021 Jul 29.

Department of Psychiatry and Behavioral Sciences, University of California - San Francisco, San Francisco, California, USA.

Objective: Driven exercise (DEx) is a serious and common feature of eating disorders (EDs), but current understanding of factors that give rise to and maintain DEx is limited. DEx may be reinforced through its effects on the threat reduction and reward systems. The current protocol is designed to evaluate acute psychobiological response to exercise among female participants (age 16-22) with and without EDs.

Method: Twenty medically-stable participants with restrictive-spectrum EDs and 20 healthy control (HC) participants will complete study screening and three task visits which will include two 30-minute bouts of aerobic exercise.

Results: We aim to validate and demonstrate feasibility of two tasks capturing exercise response in this sample. Further, we will estimate the degree to which a bout of exercise impacts state body image, affect, and circulating concentrations of biological markers among participants, and we will examine whether the impact of exercise on psychological outcomes may differ across ED and HC groups.

Discussion: Completion of this project will contribute to the conceptualization of DEx and how individuals' acute biological and affective responses to exercise contribute to risk for and maintenance of DEx.
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http://dx.doi.org/10.1002/eat.23587DOI Listing
July 2021

Exercise-induced increases in Anandamide and BDNF during extinction consolidation contribute to reduced threat following reinstatement: Preliminary evidence from a randomized controlled trial.

Psychoneuroendocrinology 2021 Jul 9;132:105355. Epub 2021 Jul 9.

University of Texas at Austin, Department of Psychiatry and Behavioral Sciences, 1601 Trinity St, Bldg B, Austin, TX 78712, United States.

Introduction: We recently demonstrated that moderate-intensity aerobic exercise delivered during the consolidation of fear extinction learning reduced threat expectancy during a test of extinction recall among women with posttraumatic stress disorder (PTSD). These findings suggest that exercise may be a potential candidate for improving the efficacy of exposure-based therapies, which are hypothesized to work via the mechanisms of fear extinction learning. The purpose of this secondary analysis was to examine whether exercise-induced increases in circulating concentrations of candidate biomarkers: endocannabinoids (anandamide [AEA]; 2-arachidonoylglycerol [2-AG], brain-derived neurotrophic factor (BDNF), and homovanillic acid (HVA), mediate the effects of exercise on extinction recall.

Methods: Participants (N = 35) completed a 3-day fear acquisition (day 1), extinction (day 2), and extinction recall (day 3) protocol, in which participants were randomly assigned to complete either moderate-intensity aerobic exercise (EX) or a light-intensity control (CON) condition following extinction training (day 2). Blood was obtained prior to and following EX or CON. Threat expectancy ratings during tests of extinction recall (i.e., initial fear recall and fear recall following reinstatement) were obtained 24 h following EX or CON. Mediation was tested using linear-mixed effects models and bootstrapping of the indirect effect.

Results: Circulating concentrations of AEA and BDNF (but not 2-AG and HVA) were found to mediate the relationship between moderate-intensity aerobic exercise and reduced threat expectancy ratings following reinstatement (AEA 95% CI: -0.623 to -0.005; BDNF 95% CI: -0.941 to -0.005).

Conclusions: Exercise-induced increases in peripheral AEA and BDNF appear to play a role in enhancing consolidation of fear extinction learning, thereby leading to reduced threat expectancies following reinstatement among women with PTSD. Future mechanistic research examining these and other biomarkers (e.g., brain-based biomarkers) is warranted.
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http://dx.doi.org/10.1016/j.psyneuen.2021.105355DOI Listing
July 2021

Aerobic exercise reduces anxiety and fear ratings to threat and increases circulating endocannabinoids in women with and without PTSD.

Ment Health Phys Act 2021 Mar 2;20. Epub 2020 Nov 2.

Department of Kinesiology at the University of Wisconsin-Madison, Madison, WI - USA.

Reductions in state anxiety have been reported following an acute bout of aerobic exercise. However, less is known regarding anxiety and fear ratings to specific threatening stimuli following an acute bout of aerobic exercise in women with PTSD. Moreover, the mechanisms responsible for the anxiolytic effects of exercise are not fully understood, although recent studies suggest a role for the endocannabinoid (eCB) system. Thus, this study utilized a randomized, counterbalanced approach to examine anxiety and fear ratings to predictable or unpredictable electric shock administration and circulating concentrations of eCBs and mood states immediately following moderate-intensity aerobic exercise (30 min on treadmill at 70-75% maximum heart rate) and a quiet rest control condition in women with and without a history of trauma, and in women with PTSD (N=42). Results revealed that anxiety and fear ratings to unpredictable and predictable threats were significantly (<.05) lower following exercise compared to quiet rest, with correlational analyses indicating those with greater increases in circulating eCBs had greater reductions in anxiety and fear ratings to unpredictable and predictable threats following exercise. Also, there were significant (<.05) reductions in fatigue, confusion, total mood disturbance, and increases in positive affect following exercise for the entire sample. Non-trauma controls and PTSD groups reported significant (<.05) increases in vigor, with additional mood improvements following exercise for the PTSD group (i.e., decreases in state anxiety, negative affect, tension, anger, and depression). Results from this study suggest that aerobic exercise exerts psychological benefits in women with PTSD, potentially due to exercise-induced increases in circulating concentrations of eCBs.
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http://dx.doi.org/10.1016/j.mhpa.2020.100366DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8208522PMC
March 2021

Aerobic exercise and consolidation of fear extinction learning among women with posttraumatic stress disorder.

Behav Res Ther 2021 07 27;142:103867. Epub 2021 Apr 27.

University of Wisconsin, Department of Psychiatry, 6001 Research Park Boulevard, Madison, WI, 53719-1176, USA. Electronic address:

This study tested whether aerobic exercise delivered during the consolidation window following fear extinction learning reduces the return of fear among women with posttraumatic stress disorder (PTSD). Participants (n=35) completed an initial clinical assessment followed by a 3-day fear acquisition, extinction, and recall protocol. On day 1, participants completed a fear acquisition training task in which one geometric shape (conditioning stimulus; CS+) was paired (with 50% probability) with a mild electric shock (unconditioned stimulus; US), while a different shape (CS-) was never paired with the US. On day 2 (24 h later), participants completed a fear extinction training task in which the CS+ no longer predicted administration of the US. Shortly following extinction, participants were randomly assigned to complete either moderate-intensity aerobic exercise (EX) or a light-intensity exercise control (CON) condition. On day 3 (24 h later), participants completed fear recall tests assessing the return of fear (spontaneous recovery, renewal, and reinstatement). Fear responding was assessed via threat expectancy ratings and skin conductance responses (SCR). In the threat expectancy ratings, there were no significant differences between groups in spontaneous recovery; however, EX significantly (p=.02) reduced threat expectancy ratings following reinstatement relative to CON. In SCR measures, there were no significant differences between groups in spontaneous recovery, renewal, or reinstatement. These results support a role for moderate-intensity aerobic exercise during the consolidation window in reducing threat expectations following reinstatement in women with PTSD. Research should continue to examine exercise as a potential method for improving the efficacy of exposure-based therapies. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT04113798.
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http://dx.doi.org/10.1016/j.brat.2021.103867DOI Listing
July 2021

The Feasibility and Effectiveness of a Community-Based Intervention to Reduce Sedentary Behavior in Older Adults.

J Appl Gerontol 2021 Jan 27:733464820987919. Epub 2021 Jan 27.

University of Wisconsin-Madison, USA.

The purpose of this study was to examine the effectiveness and feasibility of translating a 4-week "Stand Up and Move More" (SUMM) intervention by state aging units to older adults ( = 56, age = 74 years). A randomized controlled trial assessed sedentary behavior, physical function, and health-related quality of life (HRQoL) before and after the intervention. Participants included healthy community-dwelling, sedentary (sit > 6 hr/day) and aged ≥ 55 years adults. For the primary outcome, the SUMM group ( = 31) significantly ( < .05) reduced total sedentary time post-intervention by 68 min/day on average (Cohen's = -0.56) compared with no change in the wait-list control group ( = 25, Cohen's = 0.12). HRQoL and function also improved ( < .05) in the SUMM group post-intervention. Workshop facilitators indicated the intervention was easy to implement, and participants expressed high satisfaction. The SUMM intervention reduced sedentary time, improved physical function and HRQoL, and was feasible to implement in community settings.
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http://dx.doi.org/10.1177/0733464820987919DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8313650PMC
January 2021

Differential relationships of PTSD symptom clusters with cortical thickness and grey matter volumes among women with PTSD.

Sci Rep 2021 01 19;11(1):1825. Epub 2021 Jan 19.

Department of Psychiatry, University of WI - Madison, 6001 Research Park Boulevard, Madison, WI, 53719-1176, USA.

Structural neuroimaging studies of posttraumatic stress disorder (PTSD) have typically reported reduced cortical thickness (CT) and gray matter volume (GMV) in subcortical structures and networks involved in memory retrieval, emotional processing and regulation, and fear acquisition and extinction. Although PTSD is more common in women, and interpersonal violence (IPV) exposure is a more potent risk factor for developing PTSD relative to other forms of trauma, most of the existing literature examined combat-exposed men with PTSD. Vertex-wise CT and subcortical GMV analyses were conducted to examine potential differences in a large, well-characterized sample of women with PTSD stemming from IPV-exposure (n = 99) compared to healthy trauma-free women without a diagnosis of PTSD (n = 22). Subgroup analyses were also conducted to determine whether symptom severity within specific PTSD symptom clusters (e.g., re-experiencing, active avoidance, hyperarousal) predict CT and GMV after controlling for comorbid depression and anxiety. Results indicated that a diagnosis of PTSD in women with IPV-exposure did not significantly predict differences in CT across the cortex or GMV in the amygdala or hippocampus compared to healthy controls. However, within the PTSD group, greater re-experiencing symptom severity was associated with decreased CT in the left inferior and middle temporal gyrus, and decreased CT in the right parahippocampal and medial temporal gyrus. In contrast, greater active avoidance symptom severity was associated with greater CT in the left lateral fissure, postcentral gyrus, and middle/lateral occipital cortex, and greater CT in the right paracentral, posterior cingulate, and superior occipital gyrus. In terms of GMV, greater hyperarousal symptom severity was associated with reduced left amygdala GMV, while greater active avoidance symptom severity was associated with greater right amygdala GMV. These findings suggest that structural brain alterations among women with IPV-related PTSD may be driven by symptom severity within specific symptom clusters and that PTSD symptom clusters may have a differential (increased or decreased) association with brain structures.
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http://dx.doi.org/10.1038/s41598-020-80776-2DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7815843PMC
January 2021

Distinct cortical thickness correlates of early life trauma exposure and posttraumatic stress disorder are shared among adolescent and adult females with interpersonal violence exposure.

Neuropsychopharmacology 2021 03 3;46(4):741-749. Epub 2020 Dec 3.

Department of Psychiatry, University of Wisconsin-Madison, Madison, WI, USA.

Early life trauma (ELT) exposure and posttraumatic stress disorder (PTSD) both affect neural structure, which predicts a variety of mental health concerns throughout the lifespan and may present differently between adolescents and adults. However, few studies have identified the relationship between ELT, PTSD, development, and brain structure using cortical thickness (CT). CT may reveal previously obscured alterations that are potentially clinically relevant and, furthermore, could identify specific structural correlates distinct to ELT from PTSD. Two hundred and fifty-three female adolescent and adult survivors of interpersonal violence and non-trauma-exposed demographically matched controls underwent structural MRI at two different sites. Images were processed and CT was estimated using FreeSurfer. Vertex-wise linear model tests were conducted across the cortical surface to investigate whether PTSD and ELT exposure uniquely affect CT, controlling for scanner site. Planned follow-up tests included second-level analyses of clinical symptoms for CT clusters that were significantly related to PTSD or ELT. CT in the middle cingulate cortex was inversely related to ELT in both age groups, such that individuals with more ELT demonstrated less CT in this region. Additionally, CT was significantly greater in the bilateral intraparietal sulcus and left angular gyrus in both adolescents and adults with PTSD. Furthermore, CT in these clusters was also significantly related to clinical symptom severity in the adult PTSD group. This study provides evidence for distinct CT correlates of ELT and PTSD that are present across adolescents and adults, suggesting consistent markers related to ELT and PTSD on gray matter structure in trauma-exposed individuals.
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http://dx.doi.org/10.1038/s41386-020-00918-yDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8027669PMC
March 2021

Psychological and endocannabinoid responses to aerobic exercise in substance use disorder patients.

Subst Abus 2019 Nov 15:1-12. Epub 2019 Nov 15.

Department of Kinesiology, University of Wisconsin, Madison, Wisconsin, USA.

: Exercise has been examined as an adjunctive treatment for substance use disorders (SUDs), yet few exercise interventions have been conducted among patients undergoing intensive outpatient (IOP) treatment, who may be the most vulnerable to relapse and for whom exercise could provide the most benefits. This study examined the effects of aerobic exercise, in addition to IOP treatment, on psychological variables and endocannabinoids in individuals with SUDs. : Twenty-one SUD patients (mean age 35 years) were recruited from local IOPs. Participants were randomized to either treatment-as-usual (TAU, at their outpatient clinic) or TAU plus aerobic exercise training (EX). EX participants engaged in supervised, moderate-intensity exercise for 30 min, 3 times/week for 6 weeks. TAU participants came into the laboratory once per week for assessments and a 30-min quiet rest session. Participants provided blood samples and completed questionnaires evaluating substance use, mood states, depression, anxiety, perceived stress, self-efficacy to abstain from substance use, and craving. Data were analyzed with Mann-Whitney tests or mixed model ANOVAs to determine group differences in outcomes acutely and over 6 weeks. : Over 6 weeks, there were reductions in perceived stress ( < 0.01) and craving ( < 0.05) for both groups. There were no group differences in abstinence rates or changes from baseline in self-efficacy, depression, or anxiety ( > 0.05). Acutely, both exercise and quiet rest sessions led to reductions in craving, tension, depression, anger, confusion, and total mood disturbance (all s < 0.05). In addition, the EX group experienced acute increases in vigor and circulating concentrations of the endocannabinoid, anandamide ( < 0.01). : An adjunctive aerobic exercise program during SUD treatment was associated with similar reductions in perceived stress and drug craving as standard care. Thirty minutes of exercise or quiet rest led to acute improvements in mood, but exercise produced the additional benefit of increases in vigor and circulating anandamide.
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http://dx.doi.org/10.1080/08897077.2019.1680480DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7225058PMC
November 2019

Translating a "Stand Up and Move More" intervention by state aging units to older adults in underserved communities: Protocol for a randomized controlled trial.

Medicine (Baltimore) 2019 Jul;98(27):e16272

Department of Kinesiology, University of Wisconsin-Madison.

Introduction: As aging is associated with functional decline, preventing functional limitations and maintaining independence throughout later life has emerged as an important public health goal. Research indicates that sedentary behavior (prolonged sitting) is associated with functional loss and diminished ability to carry out activities of daily living. Despite many efforts to increase physical activity, which can be effective in countering functional loss, only an estimated 8% of older adults meet national physical activity guidelines. Thus, shifting the focus to reducing sitting time is emerging as a potential new intervention strategy but little research has been conducted in this area. With community support and funding, we developed and pilot tested a 4-week "Stand Up and Move More" intervention and found decreases in sedentary behavior, increases in physical activity, and improvements in mobility and vitality in a small sample of older adults. The purpose of this project is to expand upon these pilot results and examine the effectiveness and feasibility of translating a "Stand Up and Move More" intervention by State Aging Units to older adults in underserved communities. Eighty older adults from 4 counties across Wisconsin predominantly made up of rural older adults and older African American adults are randomly assigned to intervention (n = 40) or wait-list control (n = 40) groups. The intervention consists of 4 weekly sessions plus a refresher session at 8 weeks, and is delivered by community partners in each county. The sessions are designed to elicit ideas from older adults regarding how they can reduce their sitting time, help them set practical goals, develop action plans to reach their goals, and refine their plans across sessions to promote behavior change. Sedentary behavior, physical activity levels, functional performance, and health-related quality of life are assessed before and after the intervention to examine the effectiveness of the program. Feasibility of implementing the program by our community partners is assessed via semi-structured interviews. Strengths of this project include strong community collaborations and a high need given that the older adult population is projected to increase substantially in the next 15 years.

Conclusion: This project will provide an important step in developing effective strategies for maintaining independence in older adults through determining the feasibility and impact of a community-based intervention to break up sitting time.
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http://dx.doi.org/10.1097/MD.0000000000016272DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6635154PMC
July 2019

Loss of exercise- and stress-induced increases in circulating 2-arachidonoylglycerol concentrations in adults with chronic PTSD.

Biol Psychol 2019 07 9;145:1-7. Epub 2019 Apr 9.

Department of Kinesiology, University of Wisconsin-Madison, 2000 Observatory Dr., Madison, WI, 53706, USA.

The endocannabinoid (eCB) system is a modulatory system that is both altered by stress and mediates the effects of acute stress, including contributing to restoration of homeostasis. Earlier studies suggest that circulating eCBs are dysregulated in adults with post-traumatic stress disorder (PTSD); however, it is not known whether circulating eCBs remain responsive to stress. The purpose of this study was to examine eCB and psychological responses to physical (exercise) and psychosocial (Trier Social Stress Test) stressors, using a randomized, counterbalanced procedure in adults with PTSD and healthy controls (N = 20, mean age = 24, SD = 7 yrs). Results from mixed-design, repeated measures ANOVAs revealed significant increases (p <  .05) in N-arachidonoylethanolamine (AEA) and oleoylethanolamide (OEA) following exercise and psychosocial stress in both groups. However, only the control group exhibited a significant increase (p < .05) in 2-arachidonoylglycerol (2-AG) following exercise and psychosocial stress exposure. These data extend our current understanding of circulating eCB responsiveness in PTSD, and provide preliminary evidence to suggest that the eCB system is hypoactive in PTSD following exposure to physical and psychosocial stressors.
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http://dx.doi.org/10.1016/j.biopsycho.2019.04.002DOI Listing
July 2019

Serum Endocannabinoid and Mood Changes after Exercise in Major Depressive Disorder.

Med Sci Sports Exerc 2019 09;51(9):1909-1917

Department of Kinesiology, University of Wisconsin-Madison, Madison WI.

The endocannabinoid (eCB) system is implicated in the pathophysiology of depression and is responsive to acute exercise in healthy adults.

Purpose: We aimed to describe acute changes in serum eCB across a prescribed moderate (MOD) and a self-selected/preferred (PREF) intensity exercise session in women with major depressive disorder (MDD) and determine relationships between changes in eCB and mood states.

Methods: Women with MDD (n = 17) exercised in separate sessions for 20 min on a cycle ergometer at both MOD or PREF in a within-subjects design. Blood was drawn before and within 10 min after exercise. Serum concentrations of eCB (anandamide [AEA], 2-arachidonoylglycerol) and related lipids (palmitoylethanolamine, oleoylethanolamine, 2-oleoylglycerol) were quantified using stable isotope-dilution, liquid chromatography/mass spectrometry/mass spectrometry. The profile of mood states and state-trait anxiety inventory (state only) were completed before, 10 min and 30 min postexercise.

Results: Significant elevations in AEA (P = 0.013) and oleoylethanolamine (P = 0.024) occurred for MOD (moderate effect sizes: Cohen's d = 0.58 and 0.41, respectively). Significant (P < 0.05) moderate negative associations existed between changes in AEA and mood states for MOD at 10 min (depression, confusion, fatigue, total mood disturbance [TMD] and state anxiety) and 30 min postexercise (confusion, TMD and state anxiety). Significant (P < 0.05) moderate negative associations existed between 2-arachidonoylglycerol and mood states at 10 min (depression and confusion) and 30 min postexercise (confusion and TMD). Changes in eCB or related lipids or eCB-mood relationships were not found for PREF.

Conclusion: Given the broad, moderate-strength relationships between improvements in mood states and eCB increases after MOD, it is plausible that the eCB system contributes to the mood-enhancing effects of prescribed acute exercise in MDD. Alternative mechanisms are likely involved in the positive mood state effects of preferred exercise.
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http://dx.doi.org/10.1249/MSS.0000000000002006DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6727944PMC
September 2019

Intervening to reduce sedentary behavior in older adults - pilot results.

Health Promot Perspect 2019 23;9(1):71-76. Epub 2019 Jan 23.

Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA.

Older adults spend most of their day in sedentary behavior (SB) (i.e., prolonged sitting), increasing risk for negative health outcomes, functional loss, and diminished ability for activities of daily living. The purpose of this study was to develop and pilot test an intervention designed to reduce SB in older adults that could be translated to communities. Two pilot studies implementing a 4-week SB intervention were conducted. SB,physical function, and health-related quality of life were measured via self-report and objective measures. Participants (N=21) completed assessments pre- and post-intervention (studies 1 and 2) and at follow-up (4-weeks post-intervention; study 2). Due to the pilot nature of this research, data were analyzed with Cohen's d effect sizes to examine the magnitude of change in outcomes following the intervention. Results for study 1 indicated moderate (d=0.53) decreases in accelerometry-obtained total SB and increases (d=0.52) in light intensity physical activity post-intervention. In study 2,there was a moderate decrease (d=0.57) in SB evident at follow-up. On average SB decreased by approximately 60 min/d in both studies. Also, there were moderate-to-large improvements in vitality (d=0.74; study 1) and gait speed (d=1.15; study 2) following the intervention. Further,the intervention was found to be feasible for staff to implement in the community. These pilot results informed the design of an ongoing federally funded randomized controlled trial with a larger sample of older adults from underserved communities. Effective,feasible, and readily-accessible interventions have potential to improve the health and function of older adults.
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http://dx.doi.org/10.15171/hpp.2019.09DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6377700PMC
January 2019

Psychobiological Responses to Aerobic Exercise in Individuals With Posttraumatic Stress Disorder.

J Trauma Stress 2018 02 1;31(1):134-145. Epub 2018 Feb 1.

Department of Kinesiology, University of Wisconsin-Madison, Madison, Wisconsin, USA.

Previous reports have shown improvements in mood and increases in endocannabinoids in healthy adults following a session of aerobic exercise, but it is unclear whether adults with posttraumatic stress disorder (PTSD) experience similar responses. The purpose of this study was to examine psychobiological responses (plasma endocannabinoids [eCBs], mood, and pain) to aerobic exercise in a sample of adults with a diagnosis of PTSD (n = 12) and healthy controls (n = 12). Participants engaged in an aerobic exercise session in which they ran on a treadmill for 30 min at a moderate intensity (70 to 75% maximum heart rate [MHR]). Results indicated improvements in mood states and reductions in pain for both groups following exercise, ds = 0.19 to 1.53. Circulating concentrations of N-arachidonylethanolamine (AEA), 2-arachidonoylglycerol (2-AG), and oleoylethanolamide (OEA) significantly increased (ps = .000 to .050) following the aerobic exercise session for both groups. There were no significant time, group, or interaction effects (ps = .062 to .846) for palmitoylethanolamide (PEA) and 2-oleoylglycerol (2-OG). Although eCBs increased significantly for both groups, within-group effect size calculations indicated the healthy controls experienced a greater magnitude of change for AEA when compared with adults with PTSD, d = 1.21 and d = 0.45, respectively; as well as for 2-AG, d = 0.43 and d = 0.21, respectively. The findings from this study indicated that adults with and without PTSD reported significant mood improvements following 30 min of moderate-intensity aerobic exercise. In addition, the endocannabinoid system was activated in adults with and without PTSD, although effect sizes suggest that adults with PTSD may have a blunted endocannabinoid response to exercise.
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http://dx.doi.org/10.1002/jts.22253DOI Listing
February 2018

Endocannabinoid and Opioid System Interactions in Exercise-Induced Hypoalgesia.

Pain Med 2018 01;19(1):118-123

Department of Kinesiology, University of Wisconsin-Madison, Madison, Wisconsin.

Objective: The purpose of this study was to examine the interaction between the endogenous opioid and endocannabinoid (eCB) systems in a pain modulatory process known as exercise-induced hypoalgesia (EIH).

Design: Randomized controlled trial.

Setting: Clinical research unit in a hospital.

Subjects: Fifty-eight healthy men and women (mean age = 21 ± 3 years) participated in this study.

Methods: Participants were administered (randomized, double-blind, counterbalanced procedure) an opioid antagonist (i.e., naltrexone) and a placebo prior to performing pain testing and isometric exercise.

Results: Results indicated that 2-arachidonoylglycerol (2-AG) and 2-oleoylglycerol (2-OG) increased significantly (P < 0.05) following exercise in both placebo and naltrexone conditions. In comparison, N-arachidonylethanolamine (AEA) and oleoylethanolamine (OEA) increased significantly (P < 0.05) following exercise in the placebo condition but not the naltrexone condition. There were no significant (P > 0.05) differences in palmitolethanolamine (PEA) between the placebo and naltrexone conditions.

Conclusions: As reductions in pain (i.e., EIH) were observed following both conditions, these results suggest that the opioid system may not be the primary system involved in exercise-induced hypoalgesia and that 2-AG and 2-OG could contribute to nonopioid exercise-induced hypoalgesia. Moreover, as exercise-induced increases in AEA and OEA were blocked by naltrexone pretreatment, this suggests that the opioid system may be involved in the increase of AEA and OEA following exercise.
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http://dx.doi.org/10.1093/pm/pnx058DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6454785PMC
January 2018

Endocannabinoid and Mood Responses to Exercise in Adults with Varying Activity Levels.

Med Sci Sports Exerc 2017 08;49(8):1688-1696

1Department of Kinesiology, University of Wisconsin-Madison, Madison, WI; and 2Neuroscience Research Center and Department of Pharmacology and Toxicology, Medical College of Wisconsin, Milwaukee, WI.

Acute aerobic exercise improves mood and activates the endocannabinoid (eCB) system in physically active individuals; however, both mood and eCB responses to exercise may vary based on habitual levels of physical activity.

Purpose: This study aimed to examine eCB and mood responses to prescribed and preferred exercises among individuals with low, moderate, and high levels of physical activity.

Methods: Thirty-six healthy adults (21 ± 4 yr) were recruited from low (≤60 min moderate-vigorous physical activity [MVPA] per week), moderate (150-299 min MVPA per week), and high (≥300 MVPA per week) physical activity groups. Participants performed both prescribed (approximately 70%-75% max) and preferred (i.e., self-selected) aerobic exercise on separate days. Mood states and eCB concentrations were assessed before and after exercise conditions.

Results: Both preferred and prescribed exercise resulted in significant increases (P < 0.01) in circulating eCB (N-arachidonoylethanolamine [AEA] and 2-arachidonoylglycerol); however, increases in AEA (P < 0.05) were larger in the prescribed condition. Likewise, both preferred and prescribed exercise elicited positive mood improvements compared with preexercise values, but changes in state anxiety, total mood disturbance, and confusion were greater in the preferred condition (P < 0.05). Changes in 2-arachidonoylglycerol concentrations were found to negatively correlate with changes in depression, tension, and total mood disturbance in the preferred condition (P < 0.05), and changes in AEA were positively associated with changes in vigor in the prescribed condition (P < 0.05). There were no significant group differences for mood or eCB outcomes.

Conclusion: These results indicate that eCB and mood responses to exercise do not differ significantly between samples with varying physical activity levels. This study also demonstrates that in addition to prescribed exercise, preferred exercise activates the eCB system, and this activation may contribute to positive mood outcomes with exercise.
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http://dx.doi.org/10.1249/MSS.0000000000001276DOI Listing
August 2017

Psychosocial Influences on Exercise-Induced Hypoalgesia.

Pain Med 2017 03;18(3):538-550

Department of Kinesiology, University of Wisconsin-Madison, Madison, Wisconsin, USA.

Objective: The purpose of this study was to examine psychosocial influences on exercise-induced hypoalgesia (EIH).

Design: Randomized controlled trial.

Setting: Clinical research unit in a hospital.

Subjects: Fifty-eight healthy men and women (mean age = 21 ± 3 years) participated in this study.

Methods: Participants were first asked to complete a series of baseline demographic and psychological questionnaires including the Pain Catastrophizing Scale, the Fear of Pain Questionnaire, and the Family Environment Scale. Following this, they were familiarized with both temporal summation of heat pain and pressure pain testing protocols. During their next session, participants completed the Profile of Mood States, rated the intensity of heat pulses, and indicated their pressure pain thresholds and ratings before and after three minutes of submaximal, isometric exercise. Situational catastrophizing was assessed at the end of the experimental session.

Results: Results indicated that experimental pain sensitivity was significantly reduced after exercise ( P  < 0.05). Men and women did not differ on any of the measured psychosocial variables ( P  > 0.05). Positive family environments predicted attenuated pain sensitivity and greater EIH, whereas negative and chronic pain-present family environments predicted worse pain and EIH outcomes. Situational catastrophizing and negative mood state also predicted worse pain and EIH outcomes and were additionally associated with increased ratings of perceived exertion and muscle pain during exercise.

Conclusions: This study provides preliminary evidence that psychosocial variables, such as the family environment and mood states, can affect both pain sensitivity and the ability to modulate pain through exercise-induced hypoalgesia.
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http://dx.doi.org/10.1093/pm/pnw275DOI Listing
March 2017
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