Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, Dallas, Texas.
Department of Neurology, University of Texas Southwestern Medical Center, Dallas, Texas.
J Appl Physiol (1985). 2021 Jul 1;131(1):119-130. doi: 10.1152/japplphysiol.00158.2021. Epub 2021 May 20.
The purpose of this study was to test the hypothesis that changes in cerebral vasomotor reactivity (CVMR) after 1-yr aerobic exercise training (AET) are associated with cognitive performances in individuals with amnestic mild cognitive impairment (MCI). Seventy sedentary patients with amnestic MCI were randomized to 1-yr moderate-to-vigorous intensity AET or stretching and toning (SAT) interventions. Cerebral blood flow velocity (CBFV) with transcranial Doppler, mean arterial pressure (MAP) with finapres plethysmograph, and EtCO with capnography were measured during hyperventilation (hypocapnia) and a modified rebreathing protocol (hypercapnia) to assess CVMR. Cerebrovascular conductance index (CVCi) was calculated by CBFV/MAP, and CVMR by ΔCBFV/ΔEtCO and ΔCVCi/ΔEtCO. Episodic memory and executive function were assessed using standard neuropsychological tests (CVLT-II and D-KEFS). Cardiorespiratory fitness was assessed by peak oxygen uptake (V̇o). A total of 37 patients (19 in SAT and 18 in AET) completed 1-yr interventions and CVMR assessments. AET improved V̇o, increased hypocapnic CVMR, but decreased hypercapnic CVMR. The effects of AET on cognitive performance were minimal when compared with SAT. Across both groups, there was a negative correlation between changes in hypocapnic and hypercapnic CVMRs in CBFV% and CVCi% ( = -0.741, = -0.725, < 0.001). Attenuated hypercapnic CVMR, but not increased hypocapnic CVMR, was associated with improved cognitive test scores in the AET group. In conclusion, 1-yr AET increased hypocapnic CVMR and attenuated hypercapnic CVMR which is associated cognitive performance in patients with amnestic MCI. One-year moderate-to-vigorous intensity aerobic exercise training (AET) improved cardiorespiratory fitness (V̇o), increased hypocapnic cerebral vasomotor reactivity (CVMR), whereas it decreased hypercapnic CVMR when compared with stretching and toning in patients with amnestic mild cognitive impairment (MCI). Furthermore, changes in hypercapnic CVMR with AET were correlated with improved memory and executive function. These findings indicate that AET has an impact on cerebrovascular function which may benefit cognitive performance in older adults who have high risk of Alzheimer's disease.
这项研究的目的是检验假设，即经过 1 年的有氧运动训练 (AET) 后，脑血管反应性 (CVMR) 的变化与遗忘型轻度认知障碍 (MCI) 个体的认知表现有关。70 名久坐的遗忘型 MCI 患者被随机分配到 1 年的中等至剧烈强度 AET 或拉伸和塑形 (SAT) 干预组。通过经颅多普勒测量脑血流速度 (CBFV)、用 finapres 体积描记法测量平均动脉压 (MAP)、用 capnography 测量 EtCO，以评估 CVMR。在过度通气 (低碳酸血症) 和改良再呼吸方案 (高碳酸血症) 下测量 CBFV/MAP 以计算脑血管传导指数 (CVCi)，通过 ΔCBFV/ΔEtCO 和 ΔCVCi/ΔEtCO 计算 CVMR。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 (V̇o) 评估心肺功能。共有 37 名患者 (SAT 组 19 名，AET 组 18 名) 完成了 1 年的干预和 CVMR 评估。AET 提高了 V̇o，增加了低碳酸血症 CVMR，但降低了高碳酸血症 CVMR。与 SAT 相比，AET 对认知表现的影响很小。在两组中，CBFV%和 CVCi%的低碳酸血症和高碳酸血症 CVMR 的变化呈负相关 ( = -0.741， = -0.725， < 0.001)。AET 组中，高碳酸血症 CVMR 的减弱与认知测试评分的提高有关，而低碳酸血症 CVMR 的增加则无关。总之，1 年的 AET 增加了低碳酸血症 CVMR，并减弱了高碳酸血症 CVMR，这与遗忘型 MCI 患者的认知表现有关。与拉伸和塑形相比，1 年的中等至剧烈强度有氧运动训练 (AET) 可提高心肺功能 (V̇o)，增加低碳酸血症脑血管反应性 (CVMR)，但降低高碳酸血症 CVMR。此外，AET 后高碳酸血症 CVMR 的变化与记忆和执行功能的改善相关。这些发现表明，AET 对脑血管功能有影响，这可能有益于患有阿尔茨海默病风险较高的老年人的认知表现。
