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运动训练可降低阻塞性睡眠呼吸暂停患者的交感神经活性,并改善其执行功能。

Exercise training reduces sympathetic nerve activity and improves executive performance in individuals with obstructive sleep apnea.

机构信息

Intituto do Coracao (InCor), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, BR.

Escola de Artes Ciencias e Humanidades, Universidade de Sao Paulo, Sao Paulo, SP, BR.

出版信息

Clinics (Sao Paulo). 2021 Sep 3;76:e2786. doi: 10.6061/clinics/2021/e2786. eCollection 2021.

Abstract

OBJECTIVE

To investigate the effects of exercise training (ET) on muscle sympathetic nerve activity (MSNA) and executive performance during Stroop Color Word Test (SCWT) also referred to as mental stress test.

METHODS

Forty-four individuals with obstructive sleep apnea (OSA) and no significant co-morbidities were randomized into 2 groups; 15 individuals completed the control period, and 18 individuals completed the ET. Mini-mental state of examination and intelligence quotient were also assessed. MSNA assessed by microneurography, heart rate by electrocardiography, blood pressure (automated oscillometric device) were measured at baseline and during 3 min of the SCWT. Peak oxygen uptake (VO2 peak) was evaluated using cardiopulmonary exercise testing. Executive performance was assessed by the total correct responses during 3 min of the SCWT. ET consisted of 3 weekly sessions of aerobic exercise, resistance exercises, and flexibility (72 sessions, achieved in 40±3.9 weeks).

RESULTS

Baseline parameters were similar between groups. Heart rate, blood pressure, and MSNA responses during SCWT were similar between groups (p>0.05). The comparisons between groups showed that the changes in VO2 (4.7±0.8 vs -1.2±0.4) and apnea-hypopnea index (-7.4±3.1 vs 5.5±3.3) in the exercise-trained group were significantly greater than those observed in the control group respectively (p<0.05) after intervention. ET reduced MSNA responses (p<0.05) and significantly increased the number of correct answers (12.4%) during SCWT. The number of correct answers was unchanged in the control group (p>0.05).

CONCLUSIONS

ET improves sympathetic response and executive performance during SCWT, suggesting a prominent positive impact of ET on prefrontal functioning in individuals with OSA. ClinicalTrials.gov: NCT002289625.

摘要

目的

探讨运动训练(ET)对阻塞性睡眠呼吸暂停(OSA)患者肌肉交感神经活动(MSNA)和斯特鲁普色词测验(SCWT)期间执行功能的影响,也称为心理应激测试。

方法

将 44 名无明显合并症的 OSA 患者随机分为 2 组;15 名患者完成对照期,18 名患者完成 ET。还评估了简易精神状态检查和智商。通过微神经记录法评估 MSNA,通过心电图评估心率,通过自动血压计评估血压,在基线和 SCWT 的 3 分钟内进行测量。通过心肺运动测试评估峰值摄氧量(VO2 峰值)。通过 SCWT 的 3 分钟内的总正确反应评估执行功能。ET 包括每周 3 次有氧运动、阻力运动和柔韧性训练(72 次,在 40±3.9 周内完成)。

结果

组间基线参数相似。SCWT 期间的心率、血压和 MSNA 反应在组间相似(p>0.05)。组间比较显示,运动训练组的 VO2 变化(4.7±0.8 对-1.2±0.4)和呼吸暂停-低通气指数(-7.4±3.1 对 5.5±3.3)明显大于对照组(p<0.05)干预后。ET 降低了 MSNA 反应(p<0.05),并显著增加了 SCWT 期间的正确答案数(12.4%)。对照组的正确答案数没有变化(p>0.05)。

结论

ET 改善了 SCWT 期间的交感神经反应和执行功能,表明 ET 对 OSA 患者前额叶功能有显著的积极影响。ClinicalTrials.gov:NCT002289625。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0420/8382151/a1e1bb631163/cln-76-e2786-g001.jpg

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