Lin Feng V, Tao Ye, Chen Quanjing, Anthony Mia, Zhang Zhengwu, Tadin Duje, Heffner Kathi L
Elaine C. Hubbard Center for Nursing Research on Aging, School of Nursing, University of Rochester Medical Center, USA; Department of Psychiatry, School of Medicine and Dentistry, University of Rochester Medical Center, USA; Department of Brain and Cognitive Sciences, University of Rochester, USA; Department of Neuroscience, School of Medicine and Dentistry, University of Rochester Medical Center, USA; Department of Neurology, School of Medicine and Dentistry, University of Rochester Medical Center, USA.
Department of Electrical and Computational Engineering, University of Rochester, USA.
Neuroimage. 2020 Jun;213:116730. doi: 10.1016/j.neuroimage.2020.116730. Epub 2020 Mar 9.
Adaptation capacity is critical for maintaining cognition, yet it is understudied in groups at risk for dementia. Autonomic nervous system (ANS) is critical for neurovisceral integration and is a key contributor to adaptation capacity. To determine the central nervous system's top-down regulation of ANS, we conducted a mechanistic randomized controlled trial study, using a 6-week processing speed and attention (PS/A)-targeted intervention. Eighty-four older adults with amnestic mild cognitive impairment (aMCI) were randomized to a 6-week PS/A-targeted intervention or an active control without PS/A. Utilizing repeated measures (i.e., PS/A test different from the intervention, resting and cognitive task-based ECG, and resting fMRI) at baseline, immediately post-intervention (post-test), and 6-month follow-up, we aimed to test whether PS/A causally influences vagal control of ANS via their shared central neural pathways in aMCI. We indexed vagal control of ANS using high-frequency heart rate variability (HF-HRV) extracted from ECG data. Functional brain connectivity patterns were extracted from fMRI using advanced statistical tools. Compared to the control group, the intervention group showed significant improvement in PS/A, HF-HRV, salience network (SN), central executive network (CEN), and frontal parietal network (FPN) connectivity at post-test; the effect on SN, CEN, and FPN remained at 6-month follow-up. Changes in PS/A and SN connectivity significantly predicted change in HF-HRV from baseline to post-test and/or 6-month-follow-up. Age, neurodegeneration, nor sex did not affect these relationships. This work provides novel support for top-down regulation of PS/A and associated SN on vagal control of ANS. Intervening PS/A may be a viable approach for promoting adaptation capacity in groups at risk for dementia.
适应能力对于维持认知至关重要，但在有患痴呆症风险的人群中对此研究较少。自主神经系统（ANS）对于神经内脏整合至关重要，并且是适应能力的关键贡献因素。为了确定中枢神经系统对ANS的自上而下调节，我们进行了一项机制性随机对照试验研究，采用为期6周的处理速度和注意力（PS/A）靶向干预。84名患有遗忘型轻度认知障碍（aMCI）的老年人被随机分为接受为期6周的PS/A靶向干预组或无PS/A的积极对照组。在基线、干预后立即（测试后）和6个月随访时采用重复测量（即与干预不同的PS/A测试、静息和基于认知任务的心电图以及静息功能磁共振成像），我们旨在测试PS/A是否通过其在aMCI中共享的中枢神经通路因果性地影响ANS的迷走神经控制。我们使用从心电图数据中提取的高频心率变异性（HF-HRV）来衡量ANS的迷走神经控制。使用先进的统计工具从功能磁共振成像中提取功能性脑连接模式。与对照组相比，干预组在测试后PS/A、HF-HRV、突显网络（SN）、中央执行网络（CEN）和额顶网络（FPN）连接性方面有显著改善；对SN、CEN和FPN的影响在6个月随访时仍然存在。从基线到测试后和/或6个月随访，PS/A和SN连接性的变化显著预测了HF-HRV的变化。年龄、神经退行性变和性别均未影响这些关系。这项工作为PS/A和相关SN对ANS迷走神经控制的自上而下调节提供了新的支持。干预PS/A可能是促进有患痴呆症风险人群适应能力的一种可行方法。
