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ISC 2026 | The effect of exercise on brain health

Ronald M. Lazar, PhD, FAAN, FAHA, University of Alabama, Birmingham, AL, discusses the effects of exercise on brain health. Prof. Lazar highlights that exercise can improve cognition and hippocampal size, as well as the upregulation of certain neurotransmitters. This interview took place at the 2026 International Stroke Congress (ISC), held in New Orleans, LA.

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Transcript

So with regard to exercise, it’s really clear that exercise improves overall health. But exercise is different from activity. Activity is unstructured. It varies from individual to individual, something like walking or gardening. Exercise is a subset of activity, which is highly structured, protocol-driven, often medium to high intensity. And so studies have been done looking at the effect of exercise on brain health...

So with regard to exercise, it’s really clear that exercise improves overall health. But exercise is different from activity. Activity is unstructured. It varies from individual to individual, something like walking or gardening. Exercise is a subset of activity, which is highly structured, protocol-driven, often medium to high intensity. And so studies have been done looking at the effect of exercise on brain health. So there are demonstrations that, in fact, individuals’ cognition does improve with exercise. It is felt related, perhaps, to an increase in the size of the hippocampus that you see with exercise. There’s some suggestion that some of the neurotransmitters in the brain might actually be upregulated, but those data are difficult to interpret because specific growth factors like BDNF, which is really important for hippocampal function and expressed by the hippocampus, increases in the brain, but it does not pass through the blood-brain barrier. So when you measure BDNF systemically, it’s actually produced in the skeletal muscles from exercise. So the evidence for some of the proteins in the brain that might improve brain health are actually indirect at best. But the current recommendations now are 150 minutes per week of moderate exercise and 30-minute sessions, or 75 minutes per week of high-intensity exercise. What is also crucial is that there is an increase in the intensity of your exercise over time, that you don’t keep on doing the same thing week after week, but in fact you try to step it up a little bit. And that seems to be important as well.

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