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遗忘型轻度认知障碍的运动训练:一项为期一年的随机对照试验。

Exercise Training in Amnestic Mild Cognitive Impairment: A One-Year Randomized Controlled Trial.

机构信息

Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, Dallas, TX, USA.

Departments of Neurology and Neurotherapeutics, University of Texas Southwestern Medical Center, Dallas, TX, USA.

出版信息

J Alzheimers Dis. 2019;71(2):421-433. doi: 10.3233/JAD-181175.

Abstract

BACKGROUND

The current evidence is inconclusive to support the benefits of aerobic exercise training (AET) for preventing neurocognitive decline in patients with amnestic mild cognitive impairment (aMCI).

OBJECTIVE

To examine the effect of a progressive, moderate-to-high intensity AET program on memory and executive function, brain volume, and cortical amyloid-β (Aβ) plaque deposition in aMCI patients.

METHODS

This is a proof-of-concept trial that randomized 70 aMCI patients to 12 months of AET or stretching and toning (SAT, active control) interventions. Primary neuropsychological outcomes were assessed by using the California Verbal Learning Test-second edition (CVLT-II) and the Delis-Kaplan Executive Function System (D-KEFS). Secondary outcomes were the global and hippocampal brain volumes and the mean cortical and precuneus Aβ deposition.

RESULTS

Baseline cognitive scores were similar between the groups. Memory and executive function performance improved over time but did not differ between the AET and SAT groups. Brain volume decreased and precuneus Aβ plaque deposition increased over time but did not differ between the groups. Cardiorespiratory fitness was significantly improved in the AET compared with SAT group. In amyloid positive patients, AET was associated with reduced hippocampal atrophy when compared with the SAT group.

CONCLUSION

The AET and SAT groups both showed evidence of slightly improved neuropsychological scores in previously sedentary aMCI patients. However, these interventions did not prevent brain atrophy or increases in cortical Aβ deposition over 12 months. In amyloid positive patients, AET reduced hippocampal atrophy when compared with the SAT group.

摘要

背景

目前的证据尚不能支持有氧运动训练(AET)对预防遗忘型轻度认知障碍(aMCI)患者神经认知下降的益处。

目的

研究渐进式、中高强度 AET 方案对 aMCI 患者记忆和执行功能、脑容量和皮质淀粉样蛋白-β(Aβ)斑块沉积的影响。

方法

这是一项概念验证试验,将 70 名 aMCI 患者随机分为 12 个月的 AET 或拉伸和塑形(SAT,主动对照)干预组。主要神经心理学结局通过加利福尼亚语言学习测试第二版(CVLT-II)和德利斯-卡普兰执行功能系统(D-KEFS)进行评估。次要结局是全脑和海马脑容量以及皮质和楔前叶 Aβ沉积的平均值。

结果

两组基线认知评分相似。记忆和执行功能表现随时间改善,但 AET 和 SAT 组之间无差异。脑容量随时间减少,楔前叶 Aβ斑块沉积随时间增加,但两组之间无差异。与 SAT 组相比,AET 组的心肺适能显著提高。在淀粉样蛋白阳性患者中,与 SAT 组相比,AET 与海马萎缩减少相关。

结论

AET 和 SAT 组均显示出先前久坐不动的 aMCI 患者神经心理学评分略有改善的证据。然而,这些干预措施未能在 12 个月内预防脑萎缩或皮质 Aβ沉积增加。在淀粉样蛋白阳性患者中,与 SAT 组相比,AET 减少了海马萎缩。

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