Chirles Theresa J, Reiter Katherine, Weiss Lauren R, Alfini Alfonso J, Nielson Kristy A, Smith J Carson
University of Maryland, College Park, MD, USA.
Marquette University, Milwaukee, WI, USA.
J Alzheimers Dis. 2017;57(3):845-856. doi: 10.3233/JAD-161151.
Effective interventions are needed to improve brain function in mild cognitive impairment (MCI), an early stage of Alzheimer's disease (AD). The posterior cingulate cortex (PCC)/precuneus is a hub of the default mode network (DMN) and is preferentially vulnerable to disruption of functional connectivity in MCI and AD.
We investigated whether 12 weeks of aerobic exercise could enhance functional connectivity of the PCC/precuneus in MCI and healthy elders.
Sixteen MCI and 16 healthy elders (age range = 60-88) engaged in a supervised 12-week walking exercise intervention. Functional MRI was acquired at rest; the PCC/precuneus was used as a seed for correlated brain activity maps.
A linear mixed effects model revealed a significant interaction in the right parietal lobe: the MCI group showed increased connectivity while the healthy elders showed decreased connectivity. In addition, both groups showed increased connectivity with the left postcentral gyrus. Comparing pre to post intervention changes within each group, the MCI group showed increased connectivity in 10 regions spanning frontal, parietal, temporal and insular lobes, and the cerebellum. Healthy elders did not demonstrate any significant connectivity changes.
The observed results show increased functional connectivity of the PCC/precuneus in individuals with MCI after 12 weeks of moderate intensity walking exercise training. The protective effects of exercise training on cognition may be realized through the enhancement of neural recruitment mechanisms, which may possibly increase cognitive reserve. Whether these effects of exercise training may delay further cognitive decline in patients diagnosed with MCI remains to be demonstrated.
需要有效的干预措施来改善轻度认知障碍(MCI)这一阿尔茨海默病(AD)早期阶段的脑功能。后扣带回皮质(PCC)/楔前叶是默认模式网络(DMN)的枢纽,在MCI和AD中优先易受功能连接中断的影响。
我们研究了12周有氧运动是否能增强MCI患者和健康老年人PCC/楔前叶的功能连接。
16名MCI患者和16名健康老年人(年龄范围60 - 88岁)参与了一项为期12周的有监督的步行运动干预。静息状态下采集功能磁共振成像;将PCC/楔前叶作为相关脑活动图谱的种子区域。
线性混合效应模型显示右侧顶叶存在显著交互作用:MCI组连接性增加,而健康老年人组连接性降低。此外,两组与左侧中央后回的连接性均增加。比较每组干预前后的变化,MCI组在额叶、顶叶、颞叶、岛叶和小脑的10个区域连接性增加。健康老年人未表现出任何显著的连接性变化。
观察结果表明,经过12周中等强度步行运动训练后,MCI患者PCC/楔前叶的功能连接增加。运动训练对认知的保护作用可能通过增强神经募集机制来实现,这可能会增加认知储备。运动训练的这些效果是否能延缓MCI诊断患者的进一步认知衰退仍有待证实。