Wong Adrian, Lam Bonnie Yin Ka, Mak Margaret Kit Yi, Lam Linda Chiu Wa, Au Lisa Wing Chi, Yiu Brian Ka Fung, Wong Chun, Tong Hor Yee, Yeung Sin Ki, Chu Winnie Chiu Wing, Shi Lin, Leung Thomas Wai Hong, Soo Yannie Oi Yan, Lau Alexander Yuk Lun, Ip Bonaventure Yiu Ming, Kwok Timothy Chi Yui, Ko Ho, Mok Vincent Chung Tong
Division of Neurology Department of Medicine and Therapeutics Faculty of Medicine The Chinese University of Hong Kong Hong Kong SAR China.
Margaret K.L. Cheung Research Centre for Management of Parkinsonism Therese Pei Fong Chow Research Centre for Prevention of Dementia Lui Che Woo Institute of Innovative Medicine Gerald Choa Neuroscience Centre The Chinese University of Hong Kong Hong Kong SAR China.
Alzheimers Dement (N Y). 2021 Dec 31;7(1):e12224. doi: 10.1002/trc2.12224. eCollection 2021.
The benefit and risk of aerobic exercise among older people harboring advanced cerebral small vessel disease (CSVD) upon cognition, mood, and motor functions are unknown.
This rater-blind randomized trial examined effects of a 24-week aerobic exercise training (60 min/session, twice/week) upon clinical (cognition, mood, motor functions) and hemodynamic (pulse pressure [PP], blood pressure [BP], pulsatility index) measures in older people harboring moderate to severe CSVD, as evidenced by confluent white matter hyperintensity and/or ≥2 lacunes on magnetic resonance imaging. We further investigated interactions between treatment conditions and hemodynamics measures.
Fifty-three and 54 subjects were randomized into the active and control group, respectively. There was no between-group difference in any of the clinical outcomes. The active group had a greater between-group reduction in systolic BP and PP than the control group. Within-group comparison showed that global cognition of the active group remained similar at end of the study compared to baseline, whereas it declined significantly in the control group. We observed "diverging" interaction effects in that greater reduction in systolic BP/PP was associated with greater improvement in memory functions and global cognition but worsening in processing speed in the active group. Side effects were comparable between the two groups.
Future study should investigate the mechanisms of the diverging impacts of aerobic exercise upon different cognitive domains so that the benefit-risk ratio of aerobic exercise in older people harboring more advanced CSVD can be better defined.
对于患有晚期脑小血管疾病（CSVD）的老年人，有氧运动对认知、情绪和运动功能的益处及风险尚不清楚。
这项评估者盲法随机试验研究了为期24周的有氧运动训练（每次60分钟，每周两次）对患有中度至重度CSVD的老年人临床（认知、情绪、运动功能）和血流动力学（脉压[PP]、血压[BP]、搏动指数）指标的影响，磁共振成像显示有融合性白质高信号和/或≥2个腔隙可证明这一点。我们进一步研究了治疗条件与血流动力学指标之间的相互作用。
分别有53名和54名受试者被随机分为运动组和对照组。任何临床结局在两组之间均无差异。运动组收缩压和脉压的组间降低幅度大于对照组。组内比较显示，运动组在研究结束时的整体认知与基线相比保持相似，而对照组则显著下降。我们观察到“发散性”相互作用效应，即收缩压/脉压降低幅度越大，运动组的记忆功能和整体认知改善越大，但处理速度恶化。两组的副作用相当。
未来的研究应调查有氧运动对不同认知领域产生不同影响的机制，以便更好地确定有氧运动对患有更晚期CSVD的老年人的利弊比。
