Wu Han, Zhu Yi, Yang Xi, Li Jiahuan, Meng Fanfan, Qi Ming, Ding Hongyuan, Tian Shui, Wang Tong
Department of Rehabilitation, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing, China.
Rehabilitation Medicine Center, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
Quant Imaging Med Surg. 2025 Mar 3;15(3):2016-2028. doi: 10.21037/qims-24-1212. Epub 2025 Feb 26.
Exercise is an effective non-pharmacological strategy to enhance cognitive function in individuals with mild cognitive impairment (MCI). Our previous studies confirmed that aerobic dance can increase the amplitude of low-frequency fluctuations (LFF) in bilateral fronto-temporal, entorhinal, anterior cingulate, and para-hippocampal cortices. However, its effects on structural connections remain unclear. The present study comprised a secondary analysis of a randomized clinical trial and aimed to examine the impact of a 3-month aerobic dance program on white matter integrity of default mode network (DMN) in older adults with amnestic MCI, as assessed by magnetic resonance imaging (MRI).
A total of 112 patients with memory decline were recruited, 38 of whom completed cognitive assessments and magnetic resonance scans and were randomized to the exercise group (n=19) or the control group (n=19). The exercise group received 3 months of aerobic dance and health education, whereas the control group only received health education. All participants underwent cognitive assessments and MRI scans at baseline and after the 3-month intervention. A series of neuropsychological assessments, including Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), Wechsler Memory Scale-Revised Logical Memory (WMS-RLM), Trail Making Test Part A&B (TMT-A&B), Symbol Digit Modalities Test (SDMT), and Forward and Backward Digit Span Task (DST) Chinese version, were used to assess the participants' global cognitive function, memory function, and executive function. Structural connections of the hippocampus-hub temporal network were analyzed using the network-based statistic.
Finally, 16 participants in each group were included in the statistics and analysis. There was no statistical difference in cognitive functions at 3 months in the control group compared with those at baseline. However, the cognitive functions of the exercise group improved significantly after 3 months of aerobic dance, including MMSE (P=0.006), MoCA (P=0.009), WMS-RLM (P=0.005), TMT-A (P=0.007), and DST (P=0.025). Moreover, the exercise group had significantly improved WMS-RLM (P=0.003) compared to the control group after 3 months of intervention. In addition, they showed significant increases in structural connections within the DMN, including the structural connection between hippocampus and para-hippocampus, hippocampus and fusiform gyrus, hippocampus and middle temporal gyrus, and precuneus and middle temporal gyrus. The structural connection between DMN and supplementary motor area was also significantly increased in the exercise group, correlating positively with MMSE (R=0.31, P=0.04) and negatively with TMT-A (R=-0.40, P=0.011), respectively.
A 3-month aerobic dance program may enhance the structural connections in the hippocampus-hub temporal network and improve episodic memory and global cognition in older adults with amnestic MCI.
运动是一种有效的非药物策略，可增强轻度认知障碍（MCI）个体的认知功能。我们之前的研究证实，有氧舞蹈可增加双侧额颞叶、内嗅皮质、前扣带回和海马旁回皮质的低频波动（LFF）幅度。然而，其对结构连接的影响仍不清楚。本研究包括一项随机临床试验的二次分析，旨在通过磁共振成像（MRI）评估为期3个月的有氧舞蹈计划对遗忘型MCI老年成人默认模式网络（DMN）白质完整性的影响。
共招募了112名记忆力下降的患者，其中38名完成了认知评估和磁共振扫描，并被随机分为运动组（n = 19）或对照组（n = 19）。运动组接受3个月的有氧舞蹈和健康教育，而对照组仅接受健康教育。所有参与者在基线和3个月干预后均接受认知评估和MRI扫描。使用一系列神经心理学评估，包括简易精神状态检查表（MMSE）、蒙特利尔认知评估量表（MoCA）、韦氏记忆量表修订版逻辑记忆测试（WMS-RLM）、连线测验A和B（TMT-A&B）、符号数字模式测验（SDMT）以及中文版顺背和倒背数字广度任务（DST），来评估参与者的整体认知功能、记忆功能和执行功能。使用基于网络的统计方法分析海马-枢纽颞叶网络的结构连接。
最后，每组16名参与者纳入统计分析。与基线时相比，对照组3个月时的认知功能无统计学差异。然而，运动组在进行3个月的有氧舞蹈后，认知功能显著改善，包括MMSE（P = 0.006）、MoCA（P = 0.009）、WMS-RLM（P = 0.005）、TMT-A（P = 0.007）和DST（P = 0.025）。此外，干预3个月后，运动组的WMS-RLM较对照组显著改善（P = 0.003）。此外，他们的DMN内结构连接显著增加，包括海马与海马旁回、海马与梭状回、海马与颞中回以及楔前叶与颞中回之间的结构连接。运动组DMN与辅助运动区之间的结构连接也显著增加，分别与MMSE呈正相关（R = 0.31，P = 0.04），与TMT-A呈负相关（R = -0.40，P = 0.011）。
为期3个月的有氧舞蹈计划可能增强海马-枢纽颞叶网络的结构连接，并改善遗忘型MCI老年成人的情景记忆和整体认知。
