Zheng Yuxin, You Tingting, Du Rongwei, Zhang Jiahui, Peng Tingting, Liang Junjie, Zhao Biyi, Ou Haining, Jiang Yongchun, Feng Huiping, Yilifate Anniwaer, Lin Qiang
Department of Rehabilitation Medicine, The Fifth Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.
Department of Rehabilitation Medicine, The Fifth College of Guangzhou Medical University, Guangzhou, China.
Front Hum Neurosci. 2022 Jul 12;16:902757. doi: 10.3389/fnhum.2022.902757. eCollection 2022.
Exercise is one of the effective ways to improve cognition. Different forms of exercises, such as aerobic exercise, resistance exercise, and coordination exercise, have different effects on the improvement of cognitive impairment. In recent years, exergames based on Non-Immersive Virtual Reality (NIVR-Exergames) have been widely used in entertainment and have gradually been applied to clinical rehabilitation. However, the mechanism of NIVR-Exergames on improving motor cognition has not been clarified. Therefore, the aim of this study is to find whether NIVR-Exergames result in a better neural response mechanism to improve the area of the cerebral cortex related to motor cognition under functional near-infrared spectroscopy (fNIRS) dynamic monitoring in comparison with resistance exercise (resistance band stretching).
A cross-over study design was adopted in this study, and 15 healthy young subjects (18-24 years old) were randomly divided into group A ( = 8) and group B ( = 7) according to a computerized digital table method. Task 1 was an NIVR-Exergame task, and Task 2 was resistance band stretching. Group A first performed Task 1, rested for 30 min (i.e., a washout period), and then performed Task 2. Group B had the reverse order. The fNIRS test was synchronized in real time during exercise tasks, and heart rate measurements, blood pressure measurements, and 2-back task synchronization fNIRS tests were performed at baseline, Post-task 1, and Post-task 2. The primary outcomes were beta values from the general linear model (GLM) in different regions of interest (ROIs), and the secondary outcomes were heart rate, blood pressure, reaction time of 2-back, and accuracy rate of 2-back.
The activation differences of Task 1 and Task 2 in the right premotor cortex (PMC) ( = 0.025) and the left PMC ( = 0.011) were statistically significant. There were statistically significant differences in the activation of the right supplementary motor area (SMA) ( = 0.007), left dorsolateral prefrontal cortex (DLPFC) ( = 0.031), left and right PMC ( = 0.005; = 0.002) between baseline and Post-task 1. The differences in systolic pressure (SBP) between the two groups at three time points among women were statistically significant (1 = 0.009, 2 < 0.001, 3 = 0.044).
In this study, we found that NIVR-Exergames combined with motor and challenging cognitive tasks can promote the activation of SMA, PMC and DLPFC in healthy young people compared with resistance exercise alone, providing compelling preliminary evidence of the power for the rehabilitation of motor and cognitive function in patients with central nervous system diseases.
运动是改善认知的有效方法之一。不同形式的运动，如有氧运动、抗阻运动和协调性运动，对改善认知障碍有不同的效果。近年来，基于非沉浸式虚拟现实的运动游戏（NIVR-Exergames）已广泛应用于娱乐领域，并逐渐应用于临床康复。然而，NIVR-Exergames改善运动认知的机制尚未阐明。因此，本研究的目的是通过功能近红外光谱（fNIRS）动态监测，探究与抗阻运动（弹力带拉伸）相比，NIVR-Exergames是否能产生更好的神经反应机制，以改善与运动认知相关的大脑皮层区域。
本研究采用交叉研究设计，15名健康青年受试者（18-24岁）根据计算机数字表法随机分为A组（n = 8）和B组（n = 7）。任务1为NIVR-Exergame任务，任务2为弹力带拉伸。A组先进行任务1，休息30分钟（即洗脱期），然后进行任务2。B组顺序相反。在运动任务期间实时同步进行fNIRS测试，并在基线、任务1后和任务2后进行心率测量、血压测量以及2-back任务同步fNIRS测试。主要结局指标为不同感兴趣区域（ROIs）的一般线性模型（GLM）的β值，次要结局指标为心率、血压、2-back任务的反应时间和2-back任务的准确率。
任务1和任务2在右侧运动前区（PMC）（P = 0.025）和左侧PMC（P = 0.011）的激活差异具有统计学意义。基线与任务1后之间，右侧辅助运动区（SMA）（P = 0.007）、左侧背外侧前额叶皮质（DLPFC）（P = 0.031）、左右PMC（P = 0.005；P = 0.002）的激活存在统计学显著差异。女性在三个时间点两组之间的收缩压（SBP）差异具有统计学意义（1 = 0.009，2 < 0.001，3 = 0.044）。
在本研究中，我们发现与单独的抗阻运动相比，NIVR-Exergames结合运动和具有挑战性的认知任务可促进健康年轻人SMA、PMC和DLPFC的激活，为中枢神经系统疾病患者的运动和认知功能康复能力提供了有力的初步证据。
