Department of Neurology, University Hospital Würzburg, Würzburg 97080, Germany.
Aging (Albany NY). 2024 Mar 18;16(6):5772-5791. doi: 10.18632/aging.205667.
The remarkable increase in human life expectancy over the past century has been achieved at the expense of the risk of age-related impairment and disease. Neurodegeneration, be it part of normal aging or due to neurodegenerative disorders, is characterized by loss of specific neuronal populations, leading to increasing clinical impairment. The individual course may be described as balance between aging- or disease-related pathology and intrinsic mechanisms of adaptation. There is plenty of evidence that the human brain is provided with exhaustible resources to maintain function in the face of adverse conditions. While a reserve concept has mainly been coined in cognitive neuroscience, emerging evidence suggests similar mechanisms to underlie individual differences of adaptive capacity within the motor system. In this narrative review, we summarize what has been proposed to date about a motor reserve (mR) framework. We present current evidence from research in aging subjects and people with neurological conditions, followed by a description of what is known about potential neuronal substrates of mR so far. As there is no gold standard of mR quantification, we outline current approaches which describe various indicators of mR. We conclude by sketching out potential future directions of research. Expediting our understanding of differences in individual motor resilience towards aging and disease will eventually contribute to new, individually tailored therapeutic strategies. Provided early diagnosis, enhancing the individual mR may be suited to postpone disease onset by years and may be an efficacious contribution towards healthy aging, with an increased quality of life for the elderly.
在过去的一个世纪中，人类的预期寿命显著增加，但这是以增加与年龄相关的损伤和疾病风险为代价的。神经退行性变，无论是正常衰老的一部分还是由于神经退行性疾病引起的，其特征是特定神经元群体的丧失，导致临床损伤逐渐增加。个体的病程可以描述为衰老或疾病相关病理与内在适应机制之间的平衡。有大量证据表明，人类大脑拥有有限的资源，可以在面对不利条件时维持功能。虽然储备概念主要是在认知神经科学中提出的，但新出现的证据表明，在运动系统中，类似的机制可以解释个体适应能力的差异。在这篇叙述性综述中，我们总结了迄今为止关于运动储备（mR）框架的研究。我们介绍了当前关于衰老受试者和神经疾病患者的研究证据，然后描述了迄今为止关于 mR 潜在神经元基础的已知内容。由于目前还没有 mR 量化的金标准，我们概述了目前描述 mR 各种指标的方法。最后，我们勾勒出潜在的未来研究方向。加速我们对个体运动弹性在衰老和疾病方面差异的理解，最终将有助于制定新的、个体化的治疗策略。通过早期诊断，增强个体的 mR 可能适合将疾病的发病时间推迟数年，并可能通过提高老年人的生活质量，对健康老龄化做出有效的贡献。
