Hess David C, Khan Mohammad B, Hoda Nasrul, Morgan John C
Department of Neurology Medical College of Georgia, Georgia Regent's University, Augusta, GA USA.
Department of Medical Laboratory, Imaging, and Radiologic Sciences, College of Allied Health Sciences, Georgia Regent's University, Augusta, GA USA.
Brain Circ. 2015 Jul-Dec;1(2):133-139. doi: 10.4103/2394-8108.172885. Epub 2015 Dec 31.
There is a strong link between hypoperfusion and white matter (WM) damage in patients with leukoaraiosis and vascular cognitive impairment (VCI). Other than management of vascular risk factors, there is no treatment for WM damage and VCI that delays progression of the disease process to dementia. Observational studies suggest that exercise may prevent or slow down the progression of Alzheimer's disease (AD) and VCI. However, getting patients to exercise is challenging especially with advancing age and disability. Remote ischemic conditioning, an "exercise equivalent", allows exercise to be given with a "device" in the home for long periods of time. Since RIC increases CBF in pre-clinical studies and in humans, RIC may be an ideal therapy to treat VCI and WM disease and perhaps even sporadic AD. By using MRI imaging of WM progression, a sample size in the range of about 100 subjects per group could determine if RIC has activity in WM disease and VCI.
在患有脑白质疏松症和血管性认知障碍（VCI）的患者中，低灌注与白质（WM）损伤之间存在紧密联系。除了控制血管危险因素外，尚无针对WM损伤和VCI的治疗方法能够延缓疾病进程发展为痴呆症。观察性研究表明，运动可能预防或减缓阿尔茨海默病（AD）和VCI的进展。然而，让患者进行运动具有挑战性，尤其是随着年龄增长和出现残疾时。远程缺血预处理作为一种“等效运动”，能让患者在家中通过“设备”长时间进行“运动”。由于在临床前研究和人体研究中，远程缺血预处理可增加脑血流量，因此它可能是治疗VCI和WM疾病甚至散发性AD的理想疗法。通过使用WM进展的MRI成像，每组约100名受试者的样本量可以确定远程缺血预处理在WM疾病和VCI中是否具有活性。
