Herholz Sibylle C, Herholz Regina S, Herholz Karl
1German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany.
Expert Rev Neurother. 2013 Nov;13(11):1235-45. doi: 10.1586/14737175.2013.845086. Epub 2013 Oct 17.
Non-pharmacological interventions have the potential to reduce cognitive decline and to improve psychosocial aspects in mild cognitive impairment and Alzheimer's dementia, and the absence of side effects makes them a favorable option also for preventive strategies. We provide an overview on recent studies involving cognitive training and reminiscence, stimulating and challenging experiences such as visual art and music, physical activities, and electromagnetic stimulation. We review findings on neuroplasticity in the aging brain and their relevance for cognitive improvement in patients with neurodegenerative diseases. We discuss cognitive reserve and possible mechanisms that drive neuroplasticity and new learning. Finally, we identify promising avenues for future intervention strategies and research, such as combinations of cognitive and pharmaceutical interventions, and individual strategies adapted to the disease stage and tailored to the needs, predispositions and preferences of patients.
非药物干预有可能减少轻度认知障碍和阿尔茨海默病性痴呆患者的认知衰退,并改善其心理社会状况,而且无副作用使其成为预防性策略的一个有利选择。我们概述了近期涉及认知训练和回忆疗法、视觉艺术和音乐等刺激性及挑战性体验、体育活动以及电磁刺激的研究。我们回顾了衰老大脑中神经可塑性的研究结果及其与神经退行性疾病患者认知改善的相关性。我们讨论了认知储备以及驱动神经可塑性和新学习的可能机制。最后,我们确定了未来干预策略和研究的有前景的途径,例如认知与药物干预的联合,以及根据疾病阶段并针对患者的需求、易感性和偏好量身定制的个体化策略。