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Physical Activity Reduces Epilepsy Incidence : a Retrospective Cohort Study in Swedish Cross-Country Skiers and an Experimental Study in Seizure-Prone Synapsin II Knockout Mice

Ahl, Matilda LU ; Avdic, Una LU ; Strandberg, Maria Compagno LU ; Chugh, Deepti LU ; Andersson, Emelie LU ; Hållmarker, Ulf ; James, Stefan ; Deierborg, Tomas LU and Ekdahl, Christine T. LU (2019) In Sports Medicine - Open 5(1).
Abstract

Background: Epilepsy patients commonly exercise less than the general population. Animal studies indicate beneficial effects of physical activity in established epilepsy, while its effect on the development is currently less known. Methods: Here, we investigated the incidence of epilepsy during 20 years in a cohort of participants from the long-distance Swedish cross-country ski race Vasaloppet (n = 197,685) and compared it to the incidence of non-participating-matched controls included in the Swedish population register (n = 197,684). Individuals diagnosed with diseases such as stroke and epilepsy before entering the race were excluded from both groups. Experimentally, we also determined how physical activity could affect the... (More)

Background: Epilepsy patients commonly exercise less than the general population. Animal studies indicate beneficial effects of physical activity in established epilepsy, while its effect on the development is currently less known. Methods: Here, we investigated the incidence of epilepsy during 20 years in a cohort of participants from the long-distance Swedish cross-country ski race Vasaloppet (n = 197,685) and compared it to the incidence of non-participating-matched controls included in the Swedish population register (n = 197,684). Individuals diagnosed with diseases such as stroke and epilepsy before entering the race were excluded from both groups. Experimentally, we also determined how physical activity could affect the development of epilepsy in epilepsy-prone synapsin II knockout mice (SynIIKO), with and without free access to a running wheel. Results: We identified up to 40–50% lower incidence of epilepsy in the Vasaloppet participants of all ages before retirement. A lower incidence of epilepsy in Vasaloppet participants was seen regardless of gender, education and occupation level compared to controls. The participants included both elite and recreational skiers, and in a previous survey, they have reported a higher exercise rate than the general Swedish population. Sub-analyses revealed a significantly lower incidence of epilepsy in participants with a faster compared to slower finishing time. Dividing participants according to specified epilepsy diagnoses revealed 40–50% decrease in focal and unspecified epilepsy, respectively, but no differences in generalized epilepsy. Voluntary exercise in seizure-prone SynIIKO mice for 1 month before predicted epilepsy development decreased seizure manifestation from > 70 to 40%. Brain tissue analyses following 1 month of exercise showed increased hippocampal neurogenesis (DCX-positive cells), while microglial (Iba1) and astrocytic activation (GFAP), neuronal Map2, brain-derived neurotrophic factor and its receptor tyrosine receptor kinase B intensity were unaltered. Continued exercise for additionally 2 months after predicted seizure onset in SynIIKO mice resulted in a 5-fold reduction in seizure manifestation (from 90 to 20%), while 2 months of exercise initiated at the time of predicted seizure development gave no seizure relief, suggesting exercise-induced anti-epileptogenic rather than anti-convulsive effect. Conclusion: The clinical study and the experimental findings in mice indicate that physical activity may prevent or delay the development of epilepsy.

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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Epilepsy, Epilepsy incidence, Epileptogenesis, Exercise, Physical activity, Seizures
in
Sports Medicine - Open
volume
5
issue
1
article number
52
external identifiers
  • pmid:31844999
  • scopus:85076469256
ISSN
2199-1170
DOI
10.1186/s40798-019-0226-8
language
English
LU publication?
yes
id
cdd14d95-f7ea-47b2-a66f-02f9392291ad
date added to LUP
2020-01-07 14:21:30
date last changed
2020-01-08 08:58:42
@article{cdd14d95-f7ea-47b2-a66f-02f9392291ad,
  abstract     = {<p>Background: Epilepsy patients commonly exercise less than the general population. Animal studies indicate beneficial effects of physical activity in established epilepsy, while its effect on the development is currently less known. Methods: Here, we investigated the incidence of epilepsy during 20 years in a cohort of participants from the long-distance Swedish cross-country ski race Vasaloppet (n = 197,685) and compared it to the incidence of non-participating-matched controls included in the Swedish population register (n = 197,684). Individuals diagnosed with diseases such as stroke and epilepsy before entering the race were excluded from both groups. Experimentally, we also determined how physical activity could affect the development of epilepsy in epilepsy-prone synapsin II knockout mice (SynIIKO), with and without free access to a running wheel. Results: We identified up to 40–50% lower incidence of epilepsy in the Vasaloppet participants of all ages before retirement. A lower incidence of epilepsy in Vasaloppet participants was seen regardless of gender, education and occupation level compared to controls. The participants included both elite and recreational skiers, and in a previous survey, they have reported a higher exercise rate than the general Swedish population. Sub-analyses revealed a significantly lower incidence of epilepsy in participants with a faster compared to slower finishing time. Dividing participants according to specified epilepsy diagnoses revealed 40–50% decrease in focal and unspecified epilepsy, respectively, but no differences in generalized epilepsy. Voluntary exercise in seizure-prone SynIIKO mice for 1 month before predicted epilepsy development decreased seizure manifestation from &gt; 70 to 40%. Brain tissue analyses following 1 month of exercise showed increased hippocampal neurogenesis (DCX-positive cells), while microglial (Iba1) and astrocytic activation (GFAP), neuronal Map2, brain-derived neurotrophic factor and its receptor tyrosine receptor kinase B intensity were unaltered. Continued exercise for additionally 2 months after predicted seizure onset in SynIIKO mice resulted in a 5-fold reduction in seizure manifestation (from 90 to 20%), while 2 months of exercise initiated at the time of predicted seizure development gave no seizure relief, suggesting exercise-induced anti-epileptogenic rather than anti-convulsive effect. Conclusion: The clinical study and the experimental findings in mice indicate that physical activity may prevent or delay the development of epilepsy.</p>},
  author       = {Ahl, Matilda and Avdic, Una and Strandberg, Maria Compagno and Chugh, Deepti and Andersson, Emelie and Hållmarker, Ulf and James, Stefan and Deierborg, Tomas and Ekdahl, Christine T.},
  issn         = {2199-1170},
  language     = {eng},
  number       = {1},
  series       = {Sports Medicine - Open},
  title        = {Physical Activity Reduces Epilepsy Incidence : a Retrospective Cohort Study in Swedish Cross-Country Skiers and an Experimental Study in Seizure-Prone Synapsin II Knockout Mice},
  url          = {http://dx.doi.org/10.1186/s40798-019-0226-8},
  doi          = {10.1186/s40798-019-0226-8},
  volume       = {5},
  year         = {2019},
}