Pedrinolla Anna, Schena Federico, Venturelli Massimo
Department of Medicine, University of Verona, P.zza L.A. Scuro, 10. Verona, Italy.
Department of Neuroscience, Biomedicine, and Movement Sciences, University of Verona, P.zza L.A. Scuro, 10. Verona, Italy.
Curr Alzheimer Res. 2017 Apr 3;14(5):546 - 553. doi: 10.2174/1567205014666170111145817.
Although Alzheimer’s disease (AD) is a neurodegenerative pathology characterized by accumulation of β-amyloid plaques and neurofibrillary tangles at cerebral level, recent studies highlighted that AD might be the result of many altered physiological processes occurring at whole-organism level. The ability to adapt to stressors by “bending” but not “breaking” can be considered as “resilience”. Individuals incline to withstand such pathophysiological challenges, can be considered more resilient than those that do not. Noticeably, recent literature provide evidence of several exercise-induced positive effects in AD patients including improved brain plasticity, increased adrenal sensitivity, increased vascular health, ameliorations of nitric oxide bioavailability and mitochondrial function. This review explores what resilience means in the AD milieu and the physiological mechanisms by which physical activity may mediate positive adaptative processes that enhance resilience.
A comprehensive PubMed search was conducted to identify studies about the role of exercise in AD resiliency. The following terminology was applied: Alzheimer resilience, brain resilience, metabolic resilience, cardiovascular resilience, mitochondrial resilience and exercise resilience.
Seventy-three studies were included. Five papers defined Alzheimer’s resilience, 15 papers brain resilience, 5 cardiovascular resilience, 1 metabolic resilience, 11 mitochondrial resilience, and 7 exercise resilience. Other twenty-six paper were identified from reference list of authors’ knowledge.
Knowing that disturbances in brain, neuroendocrine, vascular and mitochondria metabolism are important events in neurodegeneration and dementia development, the ability of exercise to trigger adaptive mechanisms might represent an important non-pharmacological strategy to improve resilience to AD.
尽管阿尔茨海默病（AD）是一种神经退行性病变，其特征是大脑中β-淀粉样蛋白斑块和神经原纤维缠结的积累，但最近的研究强调，AD可能是在整个生物体水平上发生的许多生理过程改变的结果。通过“弯曲”而非“断裂”来适应应激源的能力可被视为“恢复力”。倾向于承受此类病理生理挑战的个体，可被认为比那些不能承受的个体更具恢复力。值得注意的是，最近的文献提供了证据，表明运动对AD患者有多种积极影响，包括改善大脑可塑性、提高肾上腺敏感性、增强血管健康、改善一氧化氮生物利用度和线粒体功能。本综述探讨了在AD环境中恢复力的含义，以及体育活动可能介导增强恢复力的积极适应过程的生理机制。
进行了全面的PubMed搜索，以识别关于运动在AD恢复力中的作用的研究。应用了以下术语：阿尔茨海默病恢复力、大脑恢复力、代谢恢复力、心血管恢复力、线粒体恢复力和运动恢复力。
纳入了73项研究。5篇论文定义了阿尔茨海默病恢复力，15篇定义了大脑恢复力，5篇定义了心血管恢复力，1篇定义了代谢恢复力，11篇定义了线粒体恢复力，7篇定义了运动恢复力。从作者已知的参考文献列表中识别出其他26篇论文。
鉴于大脑、神经内分泌、血管和线粒体代谢紊乱是神经退行性变和痴呆症发展中的重要事件，运动触发适应机制的能力可能是提高对AD恢复力的一种重要非药物策略。
