早期阿尔茨海默病中的心肺适能与脑萎缩
Cardiorespiratory fitness and brain atrophy in early Alzheimer disease.
作者信息
Burns J M, Cronk B B, Anderson H S, Donnelly J E, Thomas G P, Harsha A, Brooks W M, Swerdlow R H
机构信息
Department of Neurology, Hoglund Brain Imaging Center, University of Kansas School of Medicine, 3599 Rainbow Blvd, MSN 2012, Kansas City, KS 66160, USA.
出版信息
Neurology. 2008 Jul 15;71(3):210-6. doi: 10.1212/01.wnl.0000317094.86209.cb.
OBJECTIVE
To examine the correlation of cardiorespiratory fitness with brain atrophy and cognition in early-stage Alzheimer disease (AD).
BACKGROUND
In normal aging physical fitness appears to mitigate functional and structural age-related brain changes. Whether this is observed in AD is not known.
METHODS
Subjects without dementia (n = 64) and subjects with early-stage AD (n = 57) had MRI and standard clinical and psychometric evaluations. Peak oxygen consumption (VO(2)(peak)), the standard measure of cardiorespiratory fitness, was assessed during a graded treadmill test. Normalized whole brain volume, a brain atrophy estimate, was determined by MRI. Pearson correlation and linear regression were used to assess fitness in relation to brain volume and cognitive performance.
RESULTS
Cardiorespiratory fitness (VO(2)(peak)) was modestly reduced in subjects with AD (34.7 [5.0] mL/kg/min) vs subjects without dementia (38.1 [6.3] mL/kg/min, p = 0.002). In early AD, VO(2)(peak) was associated with whole brain volume (beta = 0.35, p = 0.02) and white matter volume (beta = 0.35, p = 0.04) after controlling for age. Controlling for additional covariates of sex, dementia severity, physical activity, and physical frailty did not attenuate the relationships. VO(2)(peak) was associated with performance on delayed memory and digit symbol in early AD but not after controlling for age. In participants with no dementia, there was no relationship between fitness and brain atrophy. Fitness in participants with no dementia was associated with better global cognitive performance (r = 0.30, p = 0.02) and performance on Trailmaking A and B, Stroop, and delayed logical memory but not after controlling for age.
CONCLUSIONS
Increased cardiorespiratory fitness is associated with reduced brain atrophy in Alzheimer disease (AD). Cardiorespiratory fitness may moderate AD-related brain atrophy or a common underlying AD-related process may impact both brain atrophy and cardiorespiratory fitness.
目的
研究早期阿尔茨海默病（AD）患者心肺适能与脑萎缩及认知功能之间的相关性。
背景
在正常衰老过程中，体能似乎可减轻与年龄相关的脑功能和结构变化。AD患者中是否存在这种情况尚不清楚。
方法
对无痴呆受试者（n = 64）和早期AD患者（n = 57）进行MRI检查以及标准的临床和心理测量评估。在分级跑步机测试中评估心肺适能的标准指标——峰值耗氧量（VO₂(peak)）。通过MRI确定归一化全脑体积，作为脑萎缩的评估指标。采用Pearson相关性分析和线性回归分析评估适能与脑体积及认知表现的关系。
结果
AD患者的心肺适能（VO₂(peak)）（34.7 [5.0] mL/kg/min）较无痴呆受试者（38.1 [6.3] mL/kg/min，p = 0.002）略有降低。在早期AD患者中，校正年龄后，VO₂(peak)与全脑体积（β = 0.35，p = 0.02）和白质体积（β = 0.35，p = 0.04）相关。校正性别、痴呆严重程度、体力活动和身体虚弱等其他协变量后，上述关系并未减弱。在早期AD患者中，VO₂(peak)与延迟记忆和数字符号测试表现相关，但校正年龄后则无相关性。在无痴呆参与者中，适能与脑萎缩无关。无痴呆参与者的适能与更好的整体认知表现（r = 0.30，p = 0.02）以及连线测验A和B、Stroop测验和延迟逻辑记忆表现相关，但校正年龄后则无相关性。
结论
心肺适能增加与阿尔茨海默病（AD）患者脑萎缩减少相关。心肺适能可能会减轻AD相关的脑萎缩，或者一个共同的潜在AD相关过程可能同时影响脑萎缩和心肺适能。
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