Eggermont Laura, Swaab Dick, Luiten Paul, Scherder Erik
Department of Clinical Neuropsychology, Vrije Universiteit, Van der Boechorststraat 1, 1081 BT Amsterdam, The Netherlands.
Neurosci Biobehav Rev. 2006;30(4):562-75. doi: 10.1016/j.neubiorev.2005.10.004. Epub 2005 Dec 13.
Regional hypoperfusion, associated with a reduction in cerebral metabolism, is a hallmark of Alzheimer's disease (AD) and contributes to cognitive decline. Cerebral perfusion and hence cognition can be enhanced by exercise. The present review describes first how the effects of exercise on cerebral perfusion in AD are mediated by nitric oxide (NO) and tissue-type plasminogen activator, the release of which is regulated by NO. A conclusion of clinical relevance is that exercise may not be beneficial for the cognitive functioning of all people with dementia if cardiovascular risk factors are present. The extent to which cardiovascular risk factors play a role in the selection of older people with dementia in clinical studies will be addressed in the second part of the review in which the effects of exercise on cognition are presented. Only eight relevant studies were found in the literature, emphasizing the paucity of studies in this field. Positive effects of exercise on cognition were reported in seven studies, including two that excluded and two that included patients with cardiovascular risk factors. These findings suggest that cardiovascular risk factors do not necessarily undo the beneficial effects of exercise on cognition in cognitively impaired people. Further research is called for, in view of the limitations of the clinical studies reviewed here.
局部灌注不足与脑代谢降低相关，是阿尔茨海默病（AD）的一个标志，并导致认知功能下降。运动可增强脑灌注，进而改善认知。本综述首先描述运动对AD脑灌注的影响如何通过一氧化氮（NO）和组织型纤溶酶原激活物介导，而它们的释放受NO调节。一个具有临床相关性的结论是，如果存在心血管危险因素，运动可能对所有痴呆患者的认知功能都无益处。心血管危险因素在临床研究中对老年痴呆患者选择的影响程度将在综述的第二部分讨论，该部分将阐述运动对认知的影响。文献中仅发现八项相关研究，凸显了该领域研究的匮乏。七项研究报告了运动对认知的积极影响，其中两项研究排除了心血管危险因素患者，两项研究纳入了此类患者。这些发现表明，心血管危险因素不一定会消除运动对认知功能受损者认知的有益影响。鉴于本文所综述临床研究的局限性，需要进一步开展研究。
