Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, Dallas, TX, USA.
Department of Neurology, University of Texas Southwestern Medical Center, Dallas, TX, USA.
J Alzheimers Dis. 2021;80(2):841-853. doi: 10.3233/JAD-201456.
Central arterial stiffness and brain hypoperfusion are emerging risk factors of Alzheimer's disease (AD). Aerobic exercise training (AET) may improve central arterial stiffness and brain perfusion.
To investigate the effects of AET on central arterial stiffness and cerebral blood flow (CBF) in patients with amnestic mild cognitive impairment (MCI), a prodromal stage of AD.
This is a proof-of-concept, randomized controlled trial that assigned 70 amnestic MCI patients into a 12-month program of moderate-to-vigorous AET or stretching-and-toning (SAT) intervention. Carotid β-stiffness index and CBF were measured by color-coded duplex ultrasonography and applanation tonometry. Total CBF was measured as the sum of CBF from both the internal carotid and vertebral arteries, and divided by total brain tissue mass assessed with MRI to obtain normalized CBF (nCBF). Episodic memory and executive function were assessed using standard neuropsychological tests (CVLT-II and D-KEFS). Changes in cardiorespiratory fitness were measured by peak oxygen uptake (VO2peak).
Total 48 patients (29 in SAT and 19 in AET) were completed one-year training. AET improved VO2peak, decreased carotid β-stiffness index and CBF pulsatility, and increased nCBF. Changes in VO2peak were associated positively with changes in nCBF (r = 0.388, p = 0.034) and negatively with carotid β-stiffness index (r = -0.418, p = 0.007) and CBF pulsatility (r = -0.400, p = 0.014). Decreases in carotid β-stiffness were associated with increases in cerebral perfusion (r = -0.494, p = 0.003). AET effects on cognitive performance were minimal compared with SAT.
AET reduced central arterial stiffness and increased CBF which may precede its effects on neurocognitive function in patients with MCI.
中心动脉僵硬度和脑灌注不足是阿尔茨海默病（AD）的新兴危险因素。有氧运动训练（AET）可能改善中心动脉僵硬度和脑灌注。
研究有氧运动训练对 AD 前期遗忘型轻度认知障碍（MCI）患者中心动脉僵硬度和脑血流（CBF）的影响。
这是一项概念验证、随机对照试验，将 70 名遗忘型 MCI 患者分为 12 个月的中等至剧烈有氧运动训练或拉伸和塑形（SAT）干预组。通过彩色双功能超声和平面张力测量颈动脉 β-僵硬度指数和 CBF。总 CBF 测量为颈内动脉和椎动脉 CBF 的总和，除以 MRI 评估的总脑组织质量以获得归一化 CBF（nCBF）。使用标准神经心理学测试（CVLT-II 和 D-KEFS）评估情景记忆和执行功能。通过峰值摄氧量（VO2peak）测量心肺适能的变化。
共有 48 名患者（SAT 组 29 名，AET 组 19 名）完成了一年的训练。AET 提高了 VO2peak，降低了颈动脉 β-僵硬度指数和 CBF 搏动，增加了 nCBF。VO2peak 的变化与 nCBF 的变化呈正相关（r=0.388，p=0.034），与颈动脉 β-僵硬度指数（r=-0.418，p=0.007）和 CBF 搏动（r=-0.400，p=0.014）呈负相关。颈动脉 β-僵硬度的降低与脑灌注的增加有关（r=-0.494，p=0.003）。与 SAT 相比，AET 对认知表现的影响较小。
AET 降低了中心动脉僵硬度并增加了 CBF，这可能先于其对 MCI 患者神经认知功能的影响。
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