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Hsu CL, Holtzer R, Tam RC, Al Keridy W, Liu-Ambrose T. Physical reserve and its underpinning functional neural networks moderate the relationship between white matter hyperintensity and postural balance in older adults with subcortical ischemic vascular cognitive impairment. Sci Rep 2024; 14:17161. [PMID: 39060551 PMCID: PMC11282073 DOI: 10.1038/s41598-024-68050-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2024] [Accepted: 07/18/2024] [Indexed: 07/28/2024] Open
Abstract
White matter hyperintensities (WMH) are markers of subcortical ischemic vascular cognitive impairment (SIVCI) associated with impaired postural balance. Physical reserve (PR) is a recently established construct that reflects one's capacity to maintain physical function despite brain pathology. This cross-sectional study aims to map functional networks associated with PR, and examining the relationship between PR, WMH, and postural balance. PR was defined in 22 community-dwelling older adults with SIVCI. Functional networks of PR were computed using general linear model. Subsequent analyses examined whether PR and relevant networks moderated the relationship between WMH and postural balance under two conditions-eyes open while standing on foam (EOF) or on floor (EONF). We found that PR and the relevant networks-frontoparietal network (FPN) and default mode network (DMN)-significantly moderated the association between WMH and postural balance. For individuals with high PR, postural balance remained stable regardless of the extent of WMH load; whereas for those with low PR, postural balance worsened as WMH load increased. These results suggest the attenuated effects of WMH on postural stability due to PR may be underpinned by functional neural network reorganization in the FPN and DMN as a part of compensatory processes.
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Affiliation(s)
- Chun Liang Hsu
- The Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong, SAR, China.
| | - Roee Holtzer
- Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, USA
- Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY, USA
| | - Roger C Tam
- Djavad Mowafaghian Centre for Brain Health, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
- Department of Radiology, University of British Columbia, Vancouver, BC, Canada
- School of Biomedical Engineering, University of British Columbia, Vancouver, BC, Canada
- Centre for Aging SMART at Vancouver Coastal Health, Vancouver Coastal Health Research Institute, Vancouver, BC, Canada
| | - Walid Al Keridy
- Djavad Mowafaghian Centre for Brain Health, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
- Division of Neurology, University of British Columbia Hospital, Vancouver, BC, Canada
- Geriatric Division, Department of Medicine, University of British Columbia, Vancouver, BC, Canada
- Department of Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Teresa Liu-Ambrose
- Djavad Mowafaghian Centre for Brain Health, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
- Department of Physical Therapy, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
- Centre for Aging SMART at Vancouver Coastal Health, Vancouver Coastal Health Research Institute, Vancouver, BC, Canada
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You T, Wang Y, Chen S, Dong Q, Yu J, Cui M. Vascular cognitive impairment: Advances in clinical research and management. Chin Med J (Engl) 2024:00029330-990000000-01159. [PMID: 39048312 DOI: 10.1097/cm9.0000000000003220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2023] [Indexed: 07/27/2024] Open
Abstract
ABSTRACT Vascular cognitive impairment (VCI) encompasses a wide spectrum of cognitive disorders, ranging from mild cognitive impairment to vascular dementia. Its diagnosis relies on thorough clinical evaluations and neuroimaging. VCI predominately arises from vascular risk factors (VRFs) and cerebrovascular disease, either independently or in conjunction with neurodegeneration. Growing evidence underscores the prevalence of VRFs, highlighting their potential for early prediction of cognitive impairment and dementia in later life. The precise mechanisms linking vascular pathologies to cognitive deficits remain elusive. Chronic cerebrovascular pathology is the most common neuropathological feature of VCI, often interacting synergistically with neurodegenerative processes. Current research efforts are focused on developing and validating reliable biomarkers to unravel the etiology of vascular brain changes in VCI. The collaborative integration of these biomarkers into clinical practice, alongside routine incorporation into neuropathological assessments, presents a promising strategy for predicting and stratifying VCI. The cornerstone of VCI prevention remains the control of VRFs, which includes multi-domain lifestyle modifications. Identifying appropriate pharmacological approaches is also of paramount importance. In this review, we synthesize recent advancements in the field of VCI, including its definition, determinants of vascular risk, pathophysiology, neuroimaging and fluid-correlated biomarkers, predictive methodologies, and current intervention strategies. Increasingly evident is the notion that more rigorous research for VCI, which arises from a complex interplay of physiological events, is still needed to pave the way for better clinical outcomes and enhanced quality of life for affected individuals.
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Affiliation(s)
- Tongyao You
- Department of Neurology, Huashan Hospital, Fudan University, Shanghai 200040, China
| | - Yingzhe Wang
- Department of Neurology, Huashan Hospital, Fudan University, Shanghai 200040, China
| | - Shufen Chen
- Department of Neurology, Huashan Hospital, Fudan University, Shanghai 200040, China
| | - Qiang Dong
- Department of Neurology, Huashan Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Fudan University, Shanghai 200040, China
- National Center for Neurological Disorders, Huashan Hospital, Fudan University, Shanghai 200040, China
| | - Jintai Yu
- Department of Neurology, Huashan Hospital, Fudan University, Shanghai 200040, China
| | - Mei Cui
- Department of Neurology, Huashan Hospital, Fudan University, Shanghai 200040, China
- Department of Neurology, Huashan Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Fudan University, Shanghai 200040, China
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Björck A, Matérne M, Arvidsson Lindvall M, Jarl G. Investigating cognitive impairment, biopsychosocial barriers, and predictors of return to daily life among older stroke survivors. Front Neurol 2024; 15:1403567. [PMID: 38988607 PMCID: PMC11233709 DOI: 10.3389/fneur.2024.1403567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2024] [Accepted: 06/13/2024] [Indexed: 07/12/2024] Open
Abstract
Purpose The aim was to investigate the associations between cognitive impairment and biopsychosocial factors among older stroke survivors and predictors of poststroke return to daily life. Materials and methods This cross-sectional study involved 117 stroke survivors (61% men) with an average age of 77 years (range 65-91). The participants completed two questionnaires (Riksstroke and Short Form 36 questionnaires). The Montreal Cognitive Assessment (MoCA) was used to assess cognitive abilities. The International Classification of Functioning, Disability, and Health (ICF) framework guided the selection of biopsychosocial variables. We used Spearman's correlation coefficient and multiple logistic regression in the analyses. Results The average MoCA score was 21.7 points (range: 4-30, SD 5.6). The need for assistance from relatives and professionals, need for help with dressing and household chores, reliance on others for mobility, and reading and balance problems were correlated with more severe cognitive impairment (r = 0.20-0.33). Cognitive impairment, fatigue, and balance issues predicted an unfavorable return to daily life (odds ratio: 6.2-6.8). Conclusion The study indicated that cognitive impairment is associated with difficulties in all ICF domains. Cognitive impairment, fatigue, and balance issues are associated with an unsuccessful return to daily life. Prioritizing these factors and screening for cognitive impairment with objective assessment tools may improve rehabilitation outcomes and enhance overall quality of life poststroke.
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Affiliation(s)
- Alexandra Björck
- School of Health Sciences, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - Marie Matérne
- University Health Care Research Center, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
- School of Behavioural, Social and Legal Sciences, Örebro University, Örebro, Sweden
| | - Mialinn Arvidsson Lindvall
- University Health Care Research Center, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
- School of Health, Care and Social Welfare, Mälardalen University, Västerås, Sweden
| | - Gustav Jarl
- University Health Care Research Center, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
- Department of Prosthetics and Orthotics, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
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Boa Sorte Silva NC, Barha CK, Erickson KI, Kramer AF, Liu-Ambrose T. Physical exercise, cognition, and brain health in aging. Trends Neurosci 2024; 47:402-417. [PMID: 38811309 DOI: 10.1016/j.tins.2024.04.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Revised: 03/20/2024] [Accepted: 04/17/2024] [Indexed: 05/31/2024]
Abstract
Exercise training is an important strategy to counteract cognitive and brain health decline during aging. Evidence from systematic reviews and meta-analyses supports the notion of beneficial effects of exercise in cognitively unimpaired and impaired older individuals. However, the effects are often modest, and likely influenced by moderators such as exercise training parameters, sample characteristics, outcome assessments, and control conditions. Here, we discuss evidence on the impact of exercise on cognitive and brain health outcomes in healthy aging and in individuals with or at risk for cognitive impairment and neurodegeneration. We also review neuroplastic adaptations in response to exercise and their potential neurobiological mechanisms. We conclude by highlighting goals for future studies, including addressing unexplored neurobiological mechanisms and the inclusion of under-represented populations.
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Affiliation(s)
- Nárlon C Boa Sorte Silva
- Djavad Mowafaghian Centre for Brain Health, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada; Department of Physical Therapy, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada; Centre for Aging SMART at Vancouver Coastal Health, Vancouver Coastal Health Research Institute, Vancouver, British Columbia, Canada
| | - Cindy K Barha
- Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada; Department of Cell Biology and Anatomy, Hotchkiss Brain Institute, Calgary, Alberta, Canada
| | - Kirk I Erickson
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, USA; AdventHealth Research Institute, Neuroscience, Orlando, FL, USA
| | - Arthur F Kramer
- Center for Cognitive and Brain Health, Northeastern University, Boston, MA, USA; Beckman Institute, University of Illinois Urbana-Champaign, Champaign, IL, USA
| | - Teresa Liu-Ambrose
- Djavad Mowafaghian Centre for Brain Health, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada; Department of Physical Therapy, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada; Centre for Aging SMART at Vancouver Coastal Health, Vancouver Coastal Health Research Institute, Vancouver, British Columbia, Canada.
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Davidy T, Yore I, Cukierman-Yaffe T, Ravona-Springer R, Livny A, Lesman-Segev OH, Azuri Y, Carmichael O, Kapogiannis D, Zetterberg H, Lin H, Sano M, Beeri MS. A feasibility study of the combination of intranasal insulin with oral semaglutide for cognition in older adults with metabolic syndrome at high dementia risk- Study rationale and design. Mech Ageing Dev 2024; 218:111898. [PMID: 38159613 DOI: 10.1016/j.mad.2023.111898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2023] [Accepted: 12/25/2023] [Indexed: 01/03/2024]
Abstract
INTRODUCTION We present the rationale and design of a double-blind placebo-controlled feasibility trial combining intranasal insulin (INI) with semaglutide, a GLP-1 receptor agonist, to improve cognition in older adults with metabolic syndrome (MetS) and mild cognitive impairment (MCI). Since both INI and dulaglutide have beneficial effects on the cerebrovascular disease (CVD), we anticipate that improved CVD will underlie the hypothesized cognitive benefits. METHODS This 12-months trial will include 80 older adults aged > 60 with MetS and MCI, randomized to 4 groups: INI/oral semaglutide, intranasal placebo/oral semaglutide, INI/oral placebo, and intranasal placebo/oral placebo. Feasibility of combining INI with semaglutide will be tested by examining the ease of use of INI (20IU, twice/day) with semaglutide (14 once daily), adherence, and safety profile are the efficacy of combination therapy on global cognition and neurobiological markers: cerebral blood flow, cerebral glucose utilization, white matter hyperintensities, Alzheimer's related blood biomarkers and expression of insulin signaling proteins measured in brain-derived exosomes. Efficacy will be assessed for the intent-to-treat sample. DISCUSSION This feasibility study is anticipated to provide the basis for a multi-center large-scale randomized clinical trial (RCT) of the cognitive benefits of the combination of INI with semaglutide in individuals enriched for CVD and at high dementia risk.
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Affiliation(s)
- Tal Davidy
- The Joseph Sagol Neuroscience, Center Sheba Medical Center, Tel-Hashomer, Ramat-Gan, Israel; Department of Neurology, Sheba Medical Center, Tel-Hashomer, Ramat-Gan, Israel.
| | - Iscka Yore
- The Joseph Sagol Neuroscience, Center Sheba Medical Center, Tel-Hashomer, Ramat-Gan, Israel
| | - Tali Cukierman-Yaffe
- Gertner Institute for Epidemiology and Health Policy Research, Endocrinology Institute Sheba Medical Center, Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel; Department of Medicine and Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, Ontario, Canada
| | - Ramit Ravona-Springer
- The Joseph Sagol Neuroscience, Center Sheba Medical Center, Tel-Hashomer, Ramat-Gan, Israel; Memory Clinic, Sheba Medical Center, Ramat Gan, Israel
| | - Abigail Livny
- The Joseph Sagol Neuroscience, Center Sheba Medical Center, Tel-Hashomer, Ramat-Gan, Israel; Department of Diagnostic Imaging, Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel
| | - Orit H Lesman-Segev
- The Joseph Sagol Neuroscience, Center Sheba Medical Center, Tel-Hashomer, Ramat-Gan, Israel; Department of Diagnostic Imaging, Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel
| | - Yossi Azuri
- Maccabi Healthcare Services, Israel; Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | | | - Dimitrios Kapogiannis
- Laboratory of Clinical Investigation, Intramural Research Program, National Institute on Aging (NIA/NIH), Baltimore, MD, USA
| | - Henrik Zetterberg
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden; Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
| | - HungMo Lin
- Department of Anesthesiology and Yale Center for Analytical Sciences, USA
| | - Mary Sano
- James J. Peters VA Medical Research Center, New York, NY, USA
| | - Michal Schnaider Beeri
- The Krieger Klein Alzheimer's Research Center, Brain Health Institute, Rutgers University, NJ, USA
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Dao E, Barha CK, Zou J, Wei N, Liu-Ambrose T. Prevention of Vascular Contributions to Cognitive Impairment and Dementia: The Role of Physical Activity and Exercise. Stroke 2024; 55:812-821. [PMID: 38410973 DOI: 10.1161/strokeaha.123.044173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Accepted: 01/03/2024] [Indexed: 02/28/2024]
Abstract
Vascular contributions to cognitive impairment and dementia, specifically cerebral small vessel disease (CSVD), are the second most common cause of dementia. Currently, there are no specific pharmacological treatments for CSVD, and the use of conventional antidementia drugs is not recommended. Exercise has the potential to prevent and mitigate CSVD-related brain damage and improve cognitive function. Mechanistic pathways underlying the neurocognitive benefits of exercise include the control of vascular risk factors, improving endothelial function, and upregulating exerkines. Notably, the therapeutic efficacy of exercise may vary by exercise type (ie, aerobic versus resistance training) and biological sex; thus, studies designed specifically to examine these moderating factors within a CSVD context are needed. Furthermore, future research should prioritize resistance training interventions, given their tremendous therapeutic potential. Addressing these knowledge gaps will help us refine exercise recommendations to maximize their therapeutic impact in the prevention and mitigation of CSVD.
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Affiliation(s)
- Elizabeth Dao
- Department of Radiology (E.D.)
- Department of Physical Therapy, Aging, Mobility, and Cognitive Health Laboratory (E.D., J.Z., N.W., T.L.-A.), Faculty of Medicine, The University of British Columbia, Vancouver, Canada
- Djavad Mowafaghian Centre for Brain Health, The University of British Columbia, Vancouver, Canada (E.D., J.Z., N.W., T.L.-A.)
| | - Cindy K Barha
- Faculty of Kinesiology (C.K.B.), University of Calgary, AB, Canada
- Hotchkiss Brain Institute (C.K.B.), University of Calgary, AB, Canada
| | - Jammy Zou
- Department of Physical Therapy (J.Z., N.W., T.L.-A.)
- Department of Physical Therapy, Aging, Mobility, and Cognitive Health Laboratory (E.D., J.Z., N.W., T.L.-A.), Faculty of Medicine, The University of British Columbia, Vancouver, Canada
- Djavad Mowafaghian Centre for Brain Health, The University of British Columbia, Vancouver, Canada (E.D., J.Z., N.W., T.L.-A.)
- Centre for Aging SMART at Vancouver Coastal Health, Vancouver Coastal Health Research Institute, BC, Canada (J.Z., N.W., T.L.-A.)
| | - Nathan Wei
- Department of Physical Therapy (J.Z., N.W., T.L.-A.)
- Department of Physical Therapy, Aging, Mobility, and Cognitive Health Laboratory (E.D., J.Z., N.W., T.L.-A.), Faculty of Medicine, The University of British Columbia, Vancouver, Canada
- Djavad Mowafaghian Centre for Brain Health, The University of British Columbia, Vancouver, Canada (E.D., J.Z., N.W., T.L.-A.)
- Centre for Aging SMART at Vancouver Coastal Health, Vancouver Coastal Health Research Institute, BC, Canada (J.Z., N.W., T.L.-A.)
| | - Teresa Liu-Ambrose
- Department of Physical Therapy (J.Z., N.W., T.L.-A.)
- Department of Physical Therapy, Aging, Mobility, and Cognitive Health Laboratory (E.D., J.Z., N.W., T.L.-A.), Faculty of Medicine, The University of British Columbia, Vancouver, Canada
- Djavad Mowafaghian Centre for Brain Health, The University of British Columbia, Vancouver, Canada (E.D., J.Z., N.W., T.L.-A.)
- Centre for Aging SMART at Vancouver Coastal Health, Vancouver Coastal Health Research Institute, BC, Canada (J.Z., N.W., T.L.-A.)
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Fan D, Zhao H, Liu H, Niu H, Liu T, Wang Y. Abnormal brain activities of cognitive processes in cerebral small vessel disease: A systematic review of task fMRI studies. J Neuroradiol 2024; 51:155-167. [PMID: 37844660 DOI: 10.1016/j.neurad.2023.10.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Revised: 10/13/2023] [Accepted: 10/13/2023] [Indexed: 10/18/2023]
Abstract
Cerebral small vessel disease (CSVD) is characterized by widespread functional changes in the brain, as evident from abnormal brain activations during cognitive tasks. However, the existing findings in this area are not yet conclusive. We systematically reviewed 25 studies reporting task-related fMRI in five cognitive domains in CSVD, namely executive function, working memory, processing speed, motor, and affective processing. The findings highlighted: (1) CSVD affects cognitive processes in a domain-specific manner; (2) Compensatory and regulatory effects were observed simultaneously in CSVD, which may reflect the interplay between the negative impact of brain lesion and the positive impact of cognitive reserve. Combined with behavioral and functional findings in CSVD, we proposed an integrated model to illustrate the relationship between altered activations and behavioral performance in different stages of CSVD: functional brain changes may precede and be more sensitive than behavioral impairments in the early pre-symptomatic stage; Meanwhile, compensatory and regulatory mechanisms often occur in the early stages of the disease, while dysfunction/decompensation and dysregulation often occur in the late stages. Overall, abnormal hyper-/hypo-activations are crucial for understanding the mechanisms of small vessel lesion-induced behavioral dysfunction, identifying potential neuromarker and developing interventions to mitigate the impact of CSVD on cognitive function.
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Affiliation(s)
- Dongqiong Fan
- Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing, China
| | - Haichao Zhao
- Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing, China; Faculty of Psychology, MOE Key Laboratory of Cognition and Personality, Southwest University, Chongqing, China
| | - Hao Liu
- Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing, China
| | - Haijun Niu
- Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing, China
| | - Tao Liu
- Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing, China.
| | - Yilong Wang
- Department of Neurology, Beijing TianTan Hospital, Capital Medical University, Beijing, China; Chinese Institute for Brain Research, Beijing, China; National Center for Neurological Disorders, Beijing, China.
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Byun K, Hyodo K, Suwabe K, Fukuie T, Ha MS, Damrongthai C, Kuwamizu R, Koizumi H, Yassa MA, Soya H. Mild exercise improves executive function with increasing neural efficiency in the prefrontal cortex of older adults. GeroScience 2024; 46:309-325. [PMID: 37318716 PMCID: PMC10828372 DOI: 10.1007/s11357-023-00816-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Accepted: 04/27/2023] [Indexed: 06/16/2023] Open
Abstract
This study examined whether a 3-month mild-exercise intervention could improve executive function in healthy middle-aged and older adults in a randomized control trial. Ultimately, a total of 81 middle-aged and older adults were randomly assigned to either an exercise group or a control group. The exercise group received 3 months of mild cycle exercise intervention (3 sessions/week, 30-50 min/session). The control group was asked to behave as usual for the intervention period. Before and after the intervention, participants did color-word matching Stroop tasks (CWST), and Stroop interference (SI)-related reaction time (RT) was assessed as an indicator of executive function. During the CWST, prefrontal activation was monitored using functional near-infrared spectroscopy (fNIRS). SI-related oxy-Hb changes and SI-related neural efficiency (NE) scores were assessed to examine the underlying neural mechanism of the exercise intervention. Although the mild-exercise intervention significantly decreased SI-related RT, there were no significant effects of exercise intervention on SI-related oxy-Hb changes or SI-related NE scores in prefrontal subregions. Lastly, changes in the effects of mild exercise on NE with advancing age were examined. The 81 participants were divided into two subgroups (younger-aged subgroup [YA], older-aged subgroup [OA], based on median age [68 years.]). Interestingly, SI-related RT significantly decreased, and SI-related NE scores in all ROIs of the prefrontal cortex significantly increased only in the OA subgroup. These results reveal that a long-term intervention of very light-intensity exercise has a positive effect on executive function especially in older adults, possibly by increasing neural efficiency in the prefrontal cortex.
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Affiliation(s)
- Kyeongho Byun
- Sport Neuroscience Division, Advanced Research Initiative for Human High Performance (ARIHHP), Faculty of Health and Sport Sciences, University of Tsukuba, Tsukuba, Ibaraki, Japan
- Division of Sport Science; Sport Science Institute & Health Promotion Center, College of Arts & Physical Education, Incheon National University, Yeonsu, Incheon, Republic of Korea
| | - Kazuki Hyodo
- Physical Fitness Research Institute, Meiji Yasuda Life Foundation of Health and Welfare, Hachioji, Tokyo, Japan
- Laboratory of Exercise Biochemistry and Neuroendocrinology, Faculty of Health and Sport Sciences, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Kazuya Suwabe
- Sport Neuroscience Division, Advanced Research Initiative for Human High Performance (ARIHHP), Faculty of Health and Sport Sciences, University of Tsukuba, Tsukuba, Ibaraki, Japan
- Faculty of Health and Sport Sciences, Ryutsu Keizai University, Ryugasaki, Ibaraki, Japan
| | - Takemune Fukuie
- Laboratory of Exercise Biochemistry and Neuroendocrinology, Faculty of Health and Sport Sciences, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Min-Seong Ha
- Sport Neuroscience Division, Advanced Research Initiative for Human High Performance (ARIHHP), Faculty of Health and Sport Sciences, University of Tsukuba, Tsukuba, Ibaraki, Japan
- Department of Sports Science, College of the Arts and Sports, University of Seoul, Dongdaemun, Seoul, Republic of Korea
| | - Chorphaka Damrongthai
- Sport Neuroscience Division, Advanced Research Initiative for Human High Performance (ARIHHP), Faculty of Health and Sport Sciences, University of Tsukuba, Tsukuba, Ibaraki, Japan
- Laboratory of Exercise Biochemistry and Neuroendocrinology, Faculty of Health and Sport Sciences, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Ryuta Kuwamizu
- Laboratory of Exercise Biochemistry and Neuroendocrinology, Faculty of Health and Sport Sciences, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Hikaru Koizumi
- Laboratory of Exercise Biochemistry and Neuroendocrinology, Faculty of Health and Sport Sciences, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Michael A Yassa
- Sport Neuroscience Division, Advanced Research Initiative for Human High Performance (ARIHHP), Faculty of Health and Sport Sciences, University of Tsukuba, Tsukuba, Ibaraki, Japan.
- Department of Neurobiology and Behavior, Center for the Neurobiology of Learning and Memory, University of California, Irvine, CA, USA.
| | - Hideaki Soya
- Sport Neuroscience Division, Advanced Research Initiative for Human High Performance (ARIHHP), Faculty of Health and Sport Sciences, University of Tsukuba, Tsukuba, Ibaraki, Japan.
- Laboratory of Exercise Biochemistry and Neuroendocrinology, Faculty of Health and Sport Sciences, University of Tsukuba, Tsukuba, Ibaraki, Japan.
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Gluck MA, Gills JL, Fausto BA, Malin SK, Duberstein PR, Erickson KI, Hu L. Examining the efficacy of a cardio-dance intervention on brain health and the moderating role of ABCA7 in older African Americans: a protocol for a randomized controlled trial. Front Aging Neurosci 2023; 15:1266423. [PMID: 38076534 PMCID: PMC10710152 DOI: 10.3389/fnagi.2023.1266423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Accepted: 11/06/2023] [Indexed: 02/12/2024] Open
Abstract
Introduction African Americans are two to three times more likely to be diagnosed with Alzheimer's disease (AD) compared to White Americans. Exercise is a lifestyle behavior associated with neuroprotection and decreased AD risk, although most African Americans, especially older adults, perform less than the recommended 150 min/week of moderate-to-vigorous intensity exercise. This article describes the protocol for a Phase III randomized controlled trial that will examine the effects of cardio-dance aerobic exercise on novel AD cognitive and neural markers of hippocampal-dependent function (Aims #1 and #2) and whether exercise-induced neuroprotective benefits may be modulated by an AD genetic risk factor, ABCA7 rs3764650 (Aim #3). We will also explore the effects of exercise on blood-based biomarkers for AD. Methods and analysis This 6-month trial will include 280 African Americans (≥ 60 years), who will be randomly assigned to 3 days/week of either: (1) a moderate-to-vigorous cardio-dance fitness condition or (2) a low-intensity strength, flexibility, and balance condition for 60 min/session. Participants will complete health and behavioral surveys, neuropsychological testing, saliva and venipuncture, aerobic fitness, anthropometrics and resting-state structural and functional neuroimaging at study entry and 6 months. Discussion Results from this investigation will inform future exercise trials and the development of prescribed interventions that aim to reduce the risk of AD in African Americans.
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Affiliation(s)
- Mark A. Gluck
- Center for Molecular and Behavioral Neuroscience, Rutgers University-Newark, Newark, NJ, United States
| | - Joshua L. Gills
- Center for Molecular and Behavioral Neuroscience, Rutgers University-Newark, Newark, NJ, United States
| | - Bernadette A. Fausto
- Center for Molecular and Behavioral Neuroscience, Rutgers University-Newark, Newark, NJ, United States
| | - Steven K. Malin
- Department of Kinesiology and Health, Rutgers University, New Brunswick, NJ, United States
| | - Paul R. Duberstein
- Department of Health Behavior, Society and Policy, Rutgers School of Public Health, Piscataway, NJ, United States
| | | | - Liangyuan Hu
- Department of Biostatistics and Epidemiology, School of Public Health, Rutgers School of Public Health, Piscataway, NJ, United States
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Tang C, Huang T, Huang J, Xu N, Lyu H, Wang Y, Cao Y. Effortful and effortless training of executive functions improve brain multiple demand system activities differently: an activation likelihood estimation meta-analysis of functional neuroimaging studies. Front Neurosci 2023; 17:1243409. [PMID: 38033550 PMCID: PMC10682784 DOI: 10.3389/fnins.2023.1243409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Accepted: 10/18/2023] [Indexed: 12/02/2023] Open
Abstract
Both effortful and effortless training have been shown to be effective in enhancing individuals' executive functions. Effortful training improves domain-specific EFs, while effortless training improves domain-general EFs. Furthermore, effortful training has significantly higher training effects on EFs than effortless training. The neural mechanism underlying these different effects remained unclear. The present study conducted meta-analysis on neuroimaging studies to explore the changes of brain activations induced by effortful and effortless training. The results showed that effortful training induced greater activation in superior frontal gyrus, while effortless training induced greater activation in middle frontal gyrus, precuneus and cuneus. The brain regions of MD system enhanced by effortful training were more associated with core cognitive functions underlying EFs, while those enhanced by effortless training were more correlated with language functions. In addition, the significant clusters induced by effortful training had more overlaps with the MD system than effortless training. These results provided us with possibility to discuss the different behavioral results brought by effortful and effortless training.
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Affiliation(s)
- Chan Tang
- School of Psychology, Northeast Normal University, Changchun, China
- School of Psychology, Jilin Provincial Key Laboratory of Cognitive Neuroscience and Brain Development, Northeast Normal University, Changchun, China
- State Key Laboratory for Cognitive Neuroscience and Learning, Faculty of Psychology, Beijing Normal University, Beijing, China
| | - Ting Huang
- School of Psychology, Northeast Normal University, Changchun, China
- School of Humanities and Social Sciences, Beijing Institute of Technology, Beijing, China
| | - Jipeng Huang
- School of Psychology, Northeast Normal University, Changchun, China
- State Key Laboratory for Cognitive Neuroscience and Learning, Faculty of Psychology, Beijing Normal University, Beijing, China
| | - Nuo Xu
- School of Psychology, Northeast Normal University, Changchun, China
| | - Hui Lyu
- School of Psychology, Northeast Normal University, Changchun, China
| | - Yuan Wang
- School of Psychology, Northeast Normal University, Changchun, China
- School of Psychology, Jilin Provincial Key Laboratory of Cognitive Neuroscience and Brain Development, Northeast Normal University, Changchun, China
| | - Yifei Cao
- School of Psychology, Northeast Normal University, Changchun, China
- School of Psychology, Jilin Provincial Key Laboratory of Cognitive Neuroscience and Brain Development, Northeast Normal University, Changchun, China
- State Key Laboratory for Cognitive Neuroscience and Learning, Faculty of Psychology, Beijing Normal University, Beijing, China
- Zurich Center for Neuroscience, University of Zurich and ETH Zurich, Zurich, Switzerland
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11
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Tarasova I, Trubnikova O, Kukhareva I, Syrova I, Sosnina A, Kupriyanova D, Barbarash O. A Comparison of Two Multi-Tasking Approaches to Cognitive Training in Cardiac Surgery Patients. Biomedicines 2023; 11:2823. [PMID: 37893196 PMCID: PMC10604887 DOI: 10.3390/biomedicines11102823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Revised: 10/13/2023] [Accepted: 10/13/2023] [Indexed: 10/29/2023] Open
Abstract
BACKGROUND The multi-tasking approach may be promising for cognitive rehabilitation in cardiac surgery patients due to a significant effect on attentional and executive functions. This study aimed to compare the neuropsychological changes in patients who have undergone two variants of multi-tasking training and a control group in the early postoperative period of coronary artery bypass grafting (CABG). METHODS One hundred and ten CABG patients were divided into three groups: cognitive training (CT) I (a postural balance task with mental arithmetic, verbal fluency, and divergent tasks) (n = 30), CT II (a simple visual-motor reaction with mental arithmetic, verbal fluency, and divergent tasks) (n = 40), and control (n = 40). RESULTS Two or more cognitive indicators improved in 93.3% of CT I patients, in 72.5% of CT II patients, and in 62.5% of control patients; CT I patients differed from CT II and control (p = 0.04 and p = 0.008, respectively). The improving short-term memory and attention was found more frequently in the CT I group as compared to control (56.7% vs. 15%; p = 0.0005). The cognitive improvement of all domains (psychomotor and executive functions, attention, and short-term memory) was also revealed in CT I patients more frequently than CT II (46.7% vs. 20%; p = 0.02) and control (46.7% vs. 5%; p = 0.0005). CONCLUSIONS The CT I multi-tasking training was more effective at improving the cognitive performance in cardiac surgery patients as compared to CT II training and standard post-surgery management. The findings of this study will be helpful for future studies involving multi-tasking training.
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Affiliation(s)
- Irina Tarasova
- Department of Clinical Cardiology, Research Institute for Complex Issues of Cardiovascular Diseases, Sosnovy Blvd., 6, 650002 Kemerovo, Russia; (O.T.); (I.S.)
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12
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Lin JC, Chen IH, Cheng FY. Review articles (Meta-Analyses) effects of walking on cognitive function in individuals with mild cognitive impairment: a systematic review and meta-analysis. BMC Geriatr 2023; 23:500. [PMID: 37605156 PMCID: PMC10441758 DOI: 10.1186/s12877-023-04235-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Accepted: 08/14/2023] [Indexed: 08/23/2023] Open
Abstract
BACKGROUND Mild cognitive impairment (MCI) is the stage between the expected cognitive decline of normal aging and the more serious decline of dementia. Previous studies have shown that regular exercise can improve cognition and physical performance in older adults. Walking is a low-technology and low-cost exercise that has been proven to improve cognition and mobility in healthy elderly individuals. However, no systematic review or meta-analysis has explored whether walking can improve cognitive function in older adults with MCI. This study aimed to explore the effects of walking interventions on cognitive functions in individuals with MCI. METHODS In accordance with the PRISMA guidelines, MEDLINE, PubMed, SPORTDiscus, Cochrane Central Register of Controlled Trials, CINAHL, Web of Science, Airiti Library, and the National Digital Library of Theses and Dissertations in Taiwan were searched from inception to July 2023. Independent reviewers selected randomized clinical trials (RCT) that compared the effects of walking with no intervention or other exercises in individuals with MCI. The primary outcomes were cognitive functions, and the secondary outcome was walking endurance. Three reviewers independently conducted data extraction. The risk of bias was assessed using the Revised Cochrane Risk of Bias assessment tool. RESULTS Fourteen RCTs were included in this review. The quality of evidence in these studies was rated as good to excellent. The results of the meta-analysis showed that the individuals with MCI had no significant improvement in cognitive function but had significant improvement in the 6-min walk test (Mean Difference=23.70, p=0.008) after walking interventions compared to no intervention or other exercises. CONCLUSION Walking intervention has no significant improvement on cognitive functions in older adults with MCI. However, walking induces beneficial effects on aerobic capacity. TRIAL REGISTRATION This systematic review has the registration number CRD42021283753 on PROSPERO.
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Affiliation(s)
- Jia-Chi Lin
- MacKay Medical College, Institute of Long-Term Care, No.46, Sec. 3, Zhongzheng Rd, Sanzhi Dist, New Taipei City, 252, Taiwan
| | - I-Hsuan Chen
- Department of Physical Therapy, Fooyin University, Kaohsiung City, Taiwan
| | - Fang-Yu Cheng
- MacKay Medical College, Institute of Long-Term Care, No.46, Sec. 3, Zhongzheng Rd, Sanzhi Dist, New Taipei City, 252, Taiwan.
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13
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Davidy T, Yore I, Cukierman-Yaffe T, Ravona-Springer R, Livny A, Lesman-Segev OH, Azuri Y, Carmichael O, Kapogiannis D, Zetterberg H, Lin H, Sano M, Beeri MS. A feasibility study of the combination of intranasal insulin with dulaglutide for cognition in older adults with metabolic syndrome at high dementia risk - Study rationale and design. Mech Ageing Dev 2023; 213:111825. [PMID: 37245533 DOI: 10.1016/j.mad.2023.111825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2023] [Revised: 05/10/2023] [Accepted: 05/24/2023] [Indexed: 05/30/2023]
Abstract
INTRODUCTION We present the rationale and design of a double-blind placebo-controlled feasibility trial combining intranasal insulin (INI) with dulaglutide, a GLP-1 receptor agonist, to improve cognition in older adults with metabolic syndrome (MetS) and mild cognitive impairment (MCI). Since both INI and dulaglutide have beneficial effects on the cerebrovascular disease (CVD), we anticipate that improved CVD will underlie the hypothesized cognitive benefits. METHODS This 12-months trial will include 80 older adults aged > 60 with MetS and MCI, randomized to 4 groups: INI/dulaglutide injection, intranasal placebo/dulaglutide injection, INI/placebo injection, and intranasal placebo/placebo injection. Feasibility of combining INI with dulaglutide will be tested by examining the ease of use of INI (20IU, twice/day) with dulaglutide (1.5 mg/week), adherence, and safety profile are the efficacy of combination therapy on global cognition and neurobiological markers: cerebral blood flow, cerebral glucose utilization, white matter hyperintensities, Alzheimer's related blood biomarkers and expression of insulin signaling proteins measured in brain-derived exosomes. Efficacy will be assessed for the intent-to-treat sample. DISCUSSION This feasibility study is anticipated to provide the basis for a multi-center large-scale randomized clinical trial of the cognitive benefits of the combination of INI with dulaglutide in individuals enriched for CVD and at high dementia risk.
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Affiliation(s)
- Tal Davidy
- The Joseph Sagol Neuroscience Center, Sheba Medical Center, Tel-Hashomer, Ramat-Gan, Israel; Department of Neurology, Sheba Medical Center, Tel-Hashomer, Ramat-Gan, Israel.
| | - Iscka Yore
- The Joseph Sagol Neuroscience Center, Sheba Medical Center, Tel-Hashomer, Ramat-Gan, Israel
| | - Tali Cukierman-Yaffe
- Gertner Institute for Epidemiology and Health Policy Research, Endocrinology Institute Sheba Medical Center, Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel; Department of Medicine and Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, Ontario, Canada
| | - Ramit Ravona-Springer
- The Joseph Sagol Neuroscience Center, Sheba Medical Center, Tel-Hashomer, Ramat-Gan, Israel; Memory Clinic, Sheba Medical Center, Ramat Gan, Israel
| | - Abigail Livny
- The Joseph Sagol Neuroscience Center, Sheba Medical Center, Tel-Hashomer, Ramat-Gan, Israel; Department of Diagnostic Imaging, Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel
| | - Orit H Lesman-Segev
- The Joseph Sagol Neuroscience Center, Sheba Medical Center, Tel-Hashomer, Ramat-Gan, Israel; Department of Diagnostic Imaging, Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel
| | - Yossi Azuri
- Maccabi Healthcare Services, Israel; Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | | | - Dimitrios Kapogiannis
- Laboratory of Clinical Investigation, Intramural Research Program, National Institute on Aging (NIA/NIH), Baltimore, MD, USA
| | - Henrik Zetterberg
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden; Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
| | - HungMo Lin
- Department of anesthesiology and Yale Center for Analytical Sciences, USA
| | - Mary Sano
- James J. Peters VA Medical Research Center, New York, NY, USA
| | - Michal Schnaider Beeri
- The Joseph Sagol Neuroscience Center, Sheba Medical Center, Tel-Hashomer, Ramat-Gan, Israel; Icahn School of Medicine at Mount Sinai, Department of Psychiatry, New York, NY 10029, USA
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14
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Karamacoska D, Butt A, Leung IHK, Childs RL, Metri NJ, Uruthiran V, Tan T, Sabag A, Steiner-Lim GZ. Brain function effects of exercise interventions for cognitive decline: a systematic review and meta-analysis. Front Neurosci 2023; 17:1127065. [PMID: 37260849 PMCID: PMC10228832 DOI: 10.3389/fnins.2023.1127065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Accepted: 04/21/2023] [Indexed: 06/02/2023] Open
Abstract
Introduction Exercise is recognized as a modifiable lifestyle factor that can mitigate cognitive decline and dementia risk. While the benefits of exercise on cognitive aging have been reported on extensively, neuronal effects in adults experiencing cognitive decline have not been systematically synthesized. The aim of this systematic review was to assess the effects of exercise on cognition and brain function in people with cognitive decline associated with dementia risk. Method A systematic search was conducted for randomized controlled trials of ≥ 4 weeks exercise (aerobic, resistance, or mind-body) that assessed cognition and brain function using neuroimaging and neurophysiological measures in people with subjective or objective cognitive decline. Study characteristics and brain function effects were narratively synthesized, while domain-specific cognitive performance was subjected to meta-analysis. Study quality was also assessed. Results 5,204 records were identified and 12 unique trials met the eligibility criteria, representing 646 adults classified with cognitive frailty, mild or vascular cognitive impairment. Most interventions involved 40-minute sessions conducted 3 times/week. Exercise improved global cognition (g = -0.417, 95% CI, -0.694 to -0.140, p = 0.003, I2 = 43.56%), executive function (g = -0.391, 95% CI, -0.651 to -0.131, p = 0.003, I2 = 13.28%), but not processing speed or general short-term memory (both p >0.05). Across fMRI and ERP studies, significant neuronal adaptations were found with exercise cf. control throughout the brain and were linked with improved global cognition, memory, and executive function. Cerebral blood flow was also found to improve with 24 weeks of exercise, but was not linked with cognitive changes. Discussion The cognitive improvements associated with exercise are likely driven by increased metabolic activity, cerebrovascular mechanisms, and neuroplasticity throughout the brain. Our paper shows the promise in, and need for, high-quality trials integrating cognitive and brain function measures to elucidate the functional relationship between exercise and brain health in populations with a high risk of dementia. Systematic review registration PROSPERO, identifier: CRD42022291843.
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Affiliation(s)
- Diana Karamacoska
- NICM Health Research Institute, Western Sydney University, Penrith, NSW, Australia
- Translational Health Research Institute (THRI), Western Sydney University, Penrith, NSW, Australia
| | - Ali Butt
- NICM Health Research Institute, Western Sydney University, Penrith, NSW, Australia
| | - Isabella H. K. Leung
- NICM Health Research Institute, Western Sydney University, Penrith, NSW, Australia
- School of Health Sciences, Western Sydney University, Campbelltown, NSW, Australia
| | - Ryan L. Childs
- NICM Health Research Institute, Western Sydney University, Penrith, NSW, Australia
| | - Najwa-Joelle Metri
- NICM Health Research Institute, Western Sydney University, Penrith, NSW, Australia
| | - Vithya Uruthiran
- School of Health Sciences, Western Sydney University, Campbelltown, NSW, Australia
| | - Tiffany Tan
- School of Medicine, Western Sydney University, Penrith, NSW, Australia
| | - Angelo Sabag
- NICM Health Research Institute, Western Sydney University, Penrith, NSW, Australia
- Discipline of Exercise and Sport Science, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Genevieve Z. Steiner-Lim
- NICM Health Research Institute, Western Sydney University, Penrith, NSW, Australia
- Translational Health Research Institute (THRI), Western Sydney University, Penrith, NSW, Australia
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15
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Barha CK, Starkey SY, Hsiung GYR, Tam R, Liu-Ambrose T. Aerobic exercise improves executive functions in females, but not males, without the BDNF Val66Met polymorphism. Biol Sex Differ 2023; 14:16. [PMID: 37013586 PMCID: PMC10069071 DOI: 10.1186/s13293-023-00499-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Accepted: 03/10/2023] [Indexed: 04/05/2023] Open
Abstract
BACKGROUND Aerobic exercise promotes cognitive function in older adults; however, variability exists in the degree of benefit. The brain-derived neurotropic factor (BDNF) Val66Met polymorphism and biological sex are biological factors that have been proposed as important modifiers of exercise efficacy. Therefore, we assessed whether the effect of aerobic exercise on executive functions was dependent on the BDNFval66met genotype and biological sex. METHODS We used data from a single-blind randomized controlled trial in older adults with subcortical ischemic vascular cognitive impairment (NCT01027858). Fifty-eight older adults were randomly assigned to either the 6 months, three times per week progressive aerobic training (AT) group or the usual care plus education control (CON) group. The secondary aim of the parent study included executive functions which were assessed with the Trail Making Test (B-A) and the Digit Symbol Substitution Test at baseline and trial completion at 6 months. RESULTS Analysis of covariance, controlling for baseline global cognition and baseline executive functions performance (Trail Making Test or Digit Symbol Substitution Test), tested the three-way interaction between experimental group (AT, CON), BDNFval66met genotype (Val/Val carrier, Met carrier), and biological sex (female, male). Significant three-way interactions were found for the Trail Making Test (F(1,48) = 4.412, p < 0.04) and Digit Symbol Substitution Test (F(1,47) = 10.833, p < 0.002). Posthoc analyses showed female Val/Val carriers benefited the most from 6 months of AT compared with CON for Trail Making Test and Digit Symbol Substitution Test performance. Compared with CON, AT did not improve Trail Making Test performance in male Val/Val carriers or Digit Symbol Substitution Test performance in female Met carriers. CONCLUSIONS These results suggest that future randomized controlled trials should take into consideration BDNF genotype and biological sex to better understand the beneficial effects of AT on cognitive function in vascular cognitive impairment to maximize the beneficial effects of exercise and help establish exercise as medicine for cognitive health.
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Affiliation(s)
- Cindy K Barha
- Aging, Mobility, and Cognitive Neuroscience Lab, Department of Physical Therapy, University of British Columbia, Vancouver, Canada
- Djavad Mowafaghian Centre for Brain Health C/O Liu-Ambrose Lab, 2215 Wesbrook Mall, Vancouver, BC, V6T 2B5, Canada
- Centre for Hip Health and Mobility, Vancouver, Canada
- Faculty of Kinesiology, University of Calgary, Calgary, AB, Canada
| | - Samantha Y Starkey
- Aging, Mobility, and Cognitive Neuroscience Lab, Department of Physical Therapy, University of British Columbia, Vancouver, Canada
- Centre for Hip Health and Mobility, Vancouver, Canada
- Faculty of Medicine, University of British Columbia, Vancouver, Canada
| | - G Y Robin Hsiung
- Djavad Mowafaghian Centre for Brain Health C/O Liu-Ambrose Lab, 2215 Wesbrook Mall, Vancouver, BC, V6T 2B5, Canada
- Division of Neurology, University of British Columbia, Vancouver, Canada
- Vancouver Coastal Health Research Institute and University of British Columbia Hospital Clinic for Alzheimer Disease and Related Disorders, Vancouver, Canada
| | - Roger Tam
- Djavad Mowafaghian Centre for Brain Health C/O Liu-Ambrose Lab, 2215 Wesbrook Mall, Vancouver, BC, V6T 2B5, Canada
- School of Biomedical Engineering, University of British Columbia, Vancouver, Canada
| | - Teresa Liu-Ambrose
- Aging, Mobility, and Cognitive Neuroscience Lab, Department of Physical Therapy, University of British Columbia, Vancouver, Canada.
- Djavad Mowafaghian Centre for Brain Health C/O Liu-Ambrose Lab, 2215 Wesbrook Mall, Vancouver, BC, V6T 2B5, Canada.
- Centre for Hip Health and Mobility, Vancouver, Canada.
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16
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The role of inhibitory control in sport performance: Systematic review and meta-analysis in stop-signal paradigm. Neurosci Biobehav Rev 2023; 147:105108. [PMID: 36828162 DOI: 10.1016/j.neubiorev.2023.105108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 02/14/2023] [Accepted: 02/18/2023] [Indexed: 02/25/2023]
Abstract
Inhibitory control is an executive function that is closely and bidirectionally related to sports practice. The objective of this systematic review and meta-analysis was to study the effect of this relationship when response suppression is assessed within the Stop-Signal Paradigm. Twenty-four articles met the inclusion criteria and were selected for qualitative analysis, of which 11 studies were further analyzed through meta-analytic techniques. The standardized mean difference (SMD) was estimated for the stop-signal reaction time, and the influence of moderator variables was assessed. Athletes showed shorter stop-signal reaction time than non-athlete controls (SMD=0.44; 95% CI=0.14, 0.73), and this effect was mediated by age (SMD=-0.56; 95% CI=-1.11, -0.01). Athletes' superior stop-signal reaction time may be a result of extensive practice in cognitively demanding competitive environments. Young athletes can benefit the most from sports practice. In addition, engaging individuals in more cognitively demanding activities may obtain better response suppression enhancements, although the evidence in the stop-signal task is limited. Finally, some stop-signal task methodological aspects should be considered in future research.
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17
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Wu S, Ji H, Won J, Jo EA, Kim YS, Park JJ. The Effects of Exergaming on Executive and Physical Functions in Older Adults With Dementia: Randomized Controlled Trial. J Med Internet Res 2023; 25:e39993. [PMID: 36881445 PMCID: PMC10031442 DOI: 10.2196/39993] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 08/19/2022] [Accepted: 10/25/2022] [Indexed: 03/08/2023] Open
Abstract
BACKGROUND Despite increasing interest in the effects of exergaming on cognitive function, little is known about its effects on older adults with dementia. OBJECTIVE The purpose of this is to investigate the effects of exergaming on executive and physical functions in older adults with dementia compared to regular aerobic exercise. METHODS In total, 24 older adults with moderate dementia participated in the study. Participants were randomized into either the exergame group (EXG, n=13, 54%) or the aerobic exercise group (AEG, n=11, 46%). For 12 weeks, EXG engaged in a running-based exergame and AEG performed a cycling exercise. At baseline and postintervention, participants underwent the Ericksen flanker test (accuracy % and response time [RT]) while recording event-related potentials (ERPs) that included the N2 and P3b potentials. Participants also underwent the senior fitness test (SFT) and the body composition test pre- and postintervention. Repeated-measures ANOVA was performed to assess the effects of time (pre- vs postintervention), group (EXG vs AEG), and group×time interactions. RESULTS Compared to AEG, EXG demonstrated greater improvements in the SFT (F1.22=7.434, P=.01), reduction in body fat (F1.22=6.476, P=.02), and increase in skeletal mass (F1.22=4.525, P=.05), fat-free mass (F1.22=6.103, P=.02), and muscle mass (F1.22=6.636, P=.02). Although there was a significantly shorter RT in EXG postintervention (congruent P=.03, 95% CI 13.581-260.419, incongruent P=.04, 95% CI 14.621-408.917), no changes occurred in AEG. EXG also yielded a shorter N2 latency for central (Cz) cortices during both congruent conditions compared to AEG (F1.22=4.281, P=.05). Lastly, EXG presented a significantly increased P3b amplitude compared to AEG during the Ericksen flanker test (congruent: frontal [Fz] F1.22=6.546, P=.02; Cz F1.22=5.963, P=.23; parietal [Pz] F1.22=4.302, P=.05; incongruent: Fz F1.22=8.302, P=.01; Cz F1.22=15.199, P=.001; Pz F1.22=13.774, P=.001). CONCLUSIONS Our results suggest that exergaming may be associated with greater improvements in brain neuronal activity and enhanced executive function task performance than regular aerobic exercise. Exergaming characterized by both aerobic exercise and cognitive stimulation can be used as an effective intervention to improve cognitive and physical functions in older adults with dementia. TRIAL REGISTRATION Clinical Research Information Service KCT0008238; https://cris.nih.go.kr/cris/search/detailSearch.do/24170.
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Affiliation(s)
- Shanshan Wu
- School of Physical Education & Health, Wenzhou University, Wenzhou, China
- Division of Sport Science, Pusan National University, Busan, Republic of Korea
| | - Hongqing Ji
- School of Physical Education & Health, Wenzhou University, Wenzhou, China
- Division of Sport Science, Pusan National University, Busan, Republic of Korea
| | - Junyeon Won
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital, Dallas, TX, United States
| | - Eun-Ah Jo
- Department of Internal Medicine, Kosin University College of Medicine, Busan, Republic of Korea
| | - Yun-Sik Kim
- Division of Sport Science, Pusan National University, Busan, Republic of Korea
| | - Jung-Jun Park
- Division of Sport Science, Pusan National University, Busan, Republic of Korea
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18
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McGrath AB, Weinstock J, Cloutier R, Christensen M, Taylor DJ, Henderson CE. Examination of college student health behaviors and self-reported executive functions. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2023; 71:639-649. [PMID: 33830875 DOI: 10.1080/07448481.2021.1904951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 01/24/2021] [Accepted: 03/14/2021] [Indexed: 06/12/2023]
Abstract
UNLABELLED Objective: Emerging adulthood is characterized by maturation of executive functions (EF) and changes in health behaviors (HB). Interestingly, EF are bi-directionally related to many specific HB; yet how EF performs in relation to overall patterns of HB engagement is unclear. Groupings of HB and the relationship between these HB groupings and EF were examined. PARTICIPANTS Full-time college students were recruited from three large Mid- and Southwest universities (N = 1,387). METHODS Online self-report questionnaires assessing demographics, HB, and EF were completed. RESULTS Latent class analysis of HB revealed three classes: (1) High Substance Use, (2) Moderately Healthy, (3) Healthy. In general, the Healthy class had significantly greater EF compared to no significant differences between the other two classes. CONCLUSIONS Collective engagement in HB is associated with EF. Interventions targeting both HB and EF simultaneously may be most efficacious.
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Affiliation(s)
- Andrew B McGrath
- Department of Psychology, Saint Louis University, St. Louis, MO, USA
| | | | - Renee Cloutier
- Department of Psychology, University of North Texas, Denton, TX, USA
- Methodology Center, Pennsylvania State University, University Park, PA, USA
| | | | - Daniel J Taylor
- Department of Psychology, University of North Texas, Denton, TX, USA
- Department of Psychology, University of Arizona, Tucson, AZ, USA
| | - Craig E Henderson
- Department of Psychology, Sam Houston State University, Huntsville, TX, USA
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19
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Son M, Jung J, Hwang D, Beck D, Park W. The effect of backpack weight on the performance of basic short-term/working memory tasks while walking along a pre-determined route. ERGONOMICS 2023; 66:227-245. [PMID: 35532033 DOI: 10.1080/00140139.2022.2075941] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Accepted: 05/02/2022] [Indexed: 06/14/2023]
Abstract
This study investigated possible backpack weight effects on the performance of three basic short-term/working memory (STM/WM) tasks conducted concurrently with the physical task of route walking. The STM/WM tasks were the Corsi block-tapping, digit span, and 3-back tasks, and, were employed to examine the visuo-spatial sketchpad, phonological loop and central executive components of the WM system. Four backpack weight levels (0%, 15%, 25% and 40% of body mass) were considered. Thirty participants conducted the three experimental tasks requiring physical-cognitive multitasking. Data analyses revealed that: (1) increased backpack weight resulted in decreases in the performance of the Corsi block-tapping and the 3-back task, but (2) backpack weight did not significantly affect the digit span task performance. The study results suggest that reducing backpack weight could benefit the performance of various cognitive tasks during route walking. The study findings may be useful for the ergonomics design of body-worn equipment and human-system interfaces.Practitioner summary: This study examined the backpack weight effects on the performance of three basic short-term/working memory tasks conducted concurrently with the physical task of route walking. The study revealed that reducing backpack weight could benefit various cognitive tasks during physical-cognitive multitasking, especially cognitive tasks that require visuospatial processing and executive control.
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Affiliation(s)
- Minseok Son
- Digital Appliances Business, Samsung Electronics Co. Ltd, Seoul, South Korea
| | - Jaemoon Jung
- Department of Industrial Engineering, Seoul National University, Seoul, South Korea
| | - Dongwook Hwang
- School of Media and Communication, Kwangwoon University, Seoul, South Korea
| | - Donghyun Beck
- Department of Safety Engineering, Incheon National University, Incheon, South Korea
| | - Woojin Park
- Department of Industrial Engineering, Seoul National University, Seoul, South Korea
- Department of Industrial Engineering and Institute for Industrial Systems Innovation, Seoul National University, Seoul, South Korea
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Rao RV, Subramaniam KG, Gregory J, Bredesen AL, Coward C, Okada S, Kelly L, Bredesen DE. Rationale for a Multi-Factorial Approach for the Reversal of Cognitive Decline in Alzheimer's Disease and MCI: A Review. Int J Mol Sci 2023; 24:ijms24021659. [PMID: 36675177 PMCID: PMC9865291 DOI: 10.3390/ijms24021659] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 01/03/2023] [Accepted: 01/09/2023] [Indexed: 01/18/2023] Open
Abstract
Alzheimer's disease (AD) is a multifactorial, progressive, neurodegenerative disease typically characterized by memory loss, personality changes, and a decline in overall cognitive function. Usually manifesting in individuals over the age of 60, this is the most prevalent type of dementia and remains the fifth leading cause of death among Americans aged 65 and older. While the development of effective treatment and prevention for AD is a major healthcare goal, unfortunately, therapeutic approaches to date have yet to find a treatment plan that produces long-term cognitive improvement. Drugs that may be able to slow down the progression rate of AD are being introduced to the market; however, there has been no previous solution for preventing or reversing the disease-associated cognitive decline. Recent studies have identified several factors that contribute to the progression and severity of the disease: diet, lifestyle, stress, sleep, nutrient deficiencies, mental health, socialization, and toxins. Thus, increasing evidence supports dietary and other lifestyle changes as potentially effective ways to prevent, slow, or reverse AD progression. Studies also have demonstrated that a personalized, multi-therapeutic approach is needed to improve metabolic abnormalities and AD-associated cognitive decline. These studies suggest the effects of abnormalities, such as insulin resistance, chronic inflammation, hypovitaminosis D, hormonal deficiencies, and hyperhomocysteinemia, in the AD process. Therefore a personalized, multi-therapeutic program based on an individual's genetics and biochemistry may be preferable over a single-drug/mono-therapeutic approach. This article reviews these multi-therapeutic strategies that identify and attenuate all the risk factors specific to each affected individual. This article systematically reviews studies that have incorporated multiple strategies that target numerous factors simultaneously to reverse or treat cognitive decline. We included high-quality clinical trials and observational studies that focused on the cognitive effects of programs comprising lifestyle, physical, and mental activity, as well as nutritional aspects. Articles from PubMed Central, Scopus, and Google Scholar databases were collected, and abstracts were reviewed for relevance to the subject matter. Epidemiological, pathological, toxicological, genetic, and biochemical studies have all concluded that AD represents a complex network insufficiency. The research studies explored in this manuscript confirm the need for a multifactorial approach to target the various risk factors of AD. A single-drug approach may delay the progression of memory loss but, to date, has not prevented or reversed it. Diet, physical activity, sleep, stress, and environment all contribute to the progression of the disease, and, therefore, a multi-factorial optimization of network support and function offers a rational therapeutic strategy. Thus, a multi-therapeutic program that simultaneously targets multiple factors underlying the AD network may be more effective than a mono-therapeutic approach.
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Affiliation(s)
- Rammohan V. Rao
- Apollo Health, Burlingame, CA 94011, USA
- Correspondence: (R.V.R.); (D.E.B.)
| | | | | | | | | | - Sho Okada
- Apollo Health, Burlingame, CA 94011, USA
| | | | - Dale E. Bredesen
- Apollo Health, Burlingame, CA 94011, USA
- Department of Molecular and Medical Pharmacology, University of California, Los Angeles, CA 90024, USA
- Correspondence: (R.V.R.); (D.E.B.)
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Galle SA, Liu J, Bonnechère B, Amin N, Milders MM, Deijen JB, Scherder EJA, Drent ML, Voortman T, Ikram MA, van Duijn CM. The long-term relation between physical activity and executive function in the Rotterdam Study. Eur J Epidemiol 2023; 38:71-81. [PMID: 36166135 DOI: 10.1007/s10654-022-00902-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Accepted: 07/24/2022] [Indexed: 01/27/2023]
Abstract
BACKGROUND Research on the association between physical inactivity and cognitive decline and dementia is dominated by studies with short-term follow-up, that might be biased by reverse causality. OBJECTIVE Investigate the long-term association between physical activity, cognition, and the rate of age-associated cognitive decline. METHODS We investigated the association between late-life physical activity and executive functioning and rate of decline of executive abilities during follow-up of up to 16 years, in 3553 participants of the prospective Rotterdam Study cohort. Measurement took place in 1997-1999, 2002-2004, 2009-2011, and 2014-2015. RESULTS At baseline (age ± 72 years), higher levels of physical activity were associated with higher levels of executive functioning (adjusted mean difference = 0.03, 95% CI: 0.00 ; 0.06, p = 0.03). This difference remained intact up to 16 years of follow-up. The level of physical activity at baseline was unrelated to the rate of decline of executive abilities over time, in the whole group (adjusted mean difference in changetime*physical activity = 0.00, 95% CI: -0.00 ; 0.01, p = 0.31). However, stratification by APOE genotype showed that the accelerated decline of executive abilities observed in those with the ApoE-ε4 allele might be attenuated by higher levels of physical activity in late adulthood (ApoE-ε4 carriers: Btime*physical activity = 0.01, 95% CI: 0.00 ; 0.01, p = 0.03). CONCLUSION Higher levels of physical activity in late adulthood are related to higher levels of executive functioning, up to 16 years of follow-up. Accelerated decline of executive abilities observed in those with the ApoE-ε4 allele might be mitigated by higher levels of physical activity.
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Affiliation(s)
- Sara A Galle
- Department of Clinical, Neuro- and Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
- Department of Epidemiology, Erasmus MC, University Medical Centre, Rotterdam, The Netherlands.
| | - Jun Liu
- Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Bruno Bonnechère
- REVAL Rehabilitation Research Centre, Faculty of Rehabilitation Sciences, Hasselt University, Hasselt, Belgium
- Technology-Supported and Data-Driven Rehabilitation, Data Sciences Institute, Hasselt University, Diepenbeek, Belgium
| | - Najaf Amin
- Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Maarten M Milders
- Department of Clinical, Neuro- and Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Jan Berend Deijen
- Department of Clinical, Neuro- and Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Hersencentrum Mental Health Institute, Amsterdam, The Netherlands
| | - Erik J A Scherder
- Department of Clinical, Neuro- and Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Madeleine L Drent
- Department of Clinical, Neuro- and Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Department of Internal Medicine, Endocrinology Section, Amsterdam University Medical Centre, Amsterdam, The Netherlands
| | - Trudy Voortman
- Department of Epidemiology, Erasmus MC, University Medical Centre, Rotterdam, The Netherlands
| | - M Arfan Ikram
- Department of Epidemiology, Erasmus MC, University Medical Centre, Rotterdam, The Netherlands
| | - Cornelia M van Duijn
- Department of Epidemiology, Erasmus MC, University Medical Centre, Rotterdam, The Netherlands
- Nuffield Department of Population Health, University of Oxford, Oxford, UK
- Li Ka Shing Centre for Health Information and Discovery, Big Data Institute, Oxford, UK
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The effects of aerobic exercise and transcranial direct current stimulation on cognitive function in older adults with and without cognitive impairment: A systematic review and meta-analysis. Ageing Res Rev 2022; 81:101738. [PMID: 36162707 DOI: 10.1016/j.arr.2022.101738] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2022] [Revised: 09/21/2022] [Accepted: 09/21/2022] [Indexed: 01/31/2023]
Abstract
BACKGROUND Aerobic exercise (AE) may slow age-related cognitive decline. However, such cognition-sparing effects are not uniform across cognitive domains and studies. Transcranial direct current stimulation (tDCS) is a form of non-invasive brain stimulation and is also emerging as a potential alternative to pharmaceutical therapies. Like AE, the effectiveness of tDCS is also inconsistent for reducing cognitive impairment in ageing. The unexplored possibility exists that pairing AE and tDCS could produce synergistic effects and reciprocally augment cognition-improving effects in older individuals with and without cognitive impairments. Previous research found such synergistic effects on cognition when cognitive training is paired with tDCS in older individuals with and without mild cognitive impairment (MCI) or dementia. AIM The purpose of this systematic review with meta-analysis was to explore if pairing AE with tDCS could augment singular effects of AE and tDCS on global cognition (GC), working memory (WM) and executive function (EF) in older individuals with or without MCI and dementia. METHODS Using a PRISMA-based systematic review, we compiled studies that examined the effects of AE alone, tDCS alone, and AE and tDCS combined on cognitive function in older individuals with and without mild cognitive impairment (MCI) or dementia. Using a PICOS approach, we systematically searched PubMed, Scopus and Web of Science searches up to December 2021, we focused on 'MoCA', 'MMSE', 'Mini-Cog' (measures) and 'cognition', 'cognitive function', 'cognitive', 'cognitive performance', 'executive function', 'executive process', 'attention', 'memory', 'memory performance' (outcome terms). We included only randomized controlled trials (RTC) in humans if available in English full text over the past 20 years, with participants' age over 60. We assessed the methodological quality of the included studies (RTC) by the Physiotherapy Evidence Database (PEDro) scale. RESULTS Overall, 68 studies were included in the meta-analyses. AE (ES = 0.56 [95% CI: 0.28-0.83], p = 0.01) and tDCS (ES = 0.69 [95% CI: 0.12-1.26], p = 0.02) improved GC in all three groups of older adults combined (healthy, MCI, demented). In healthy population, AE improved GC (ES = 0.46 [95% CI: 0.22-0.69], p = 0.01) and EF (ES = 0.27 [95% CI: 0.05-0.49], p = 0.02). AE improved GC in older adults with MCI (ES = 0.76 [95% CI: 0.21-1.32], p = 0.01). tDCS improved GC (ES = 0.69 [90% CI: 0.12-1.26], p = 0.02), all three cognitive function (GC, WM and EF) combined in older adults with dementia (ES = 1.12 [95% CI: 0.04-2.19], p = 0.04) and improved cognitive function in older adults overall (ES = 0.69 [95% CI: 0.20-1,18], p = 0.01). CONCLUSION Our systematic review with meta-analysis provided evidence that beyond the cardiovascular and fitness benefits of AE, pairing AE with tDCS may have the potential to slow symptom progression of cognitive decline in MCI and dementia. Future studies will examine the hypothesis of this present review that a potentiating effect would incrementally improve cognition with increasing severity of cognitive impairment.
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Sun R, Li X, Zhu Z, Li T, Zhao M, Mo L, Li W, Xi X, Huang P, Gong W. Effects of dual-task training in patients with post-stroke cognitive impairment: A randomized controlled trial. Front Neurol 2022; 13:1027104. [PMID: 36353135 PMCID: PMC9639668 DOI: 10.3389/fneur.2022.1027104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Accepted: 10/10/2022] [Indexed: 11/30/2022] Open
Abstract
Background Evidence for the efficacy of cognitive-motor dual-task (CMDT) training in patients with post-stroke cognitive impairment (PSCI) and no dementia is still lacking. More importantly, although some studies on the cognitive effect of CMDT training show an improvement in cognitive performance, the results are still controversial, and the intervention mechanism of CMDT training on cognitive function improvement is not clear. The main purpose of this study was to analyze the effects of CMDT training on cognitive function, neuron electrophysiology, and frontal lobe hemodynamics in patients with PSCI. Methods Here we tested the effects of CMDT training on cognitive function in PSCI patients. Forty subjects who met the criteria of PSCI were randomly assigned to control and experimental groups. CMDT training or cognitive task (CT) training was administered to each patient in the experimental and control groups, respectively. All subjects performed Mini-mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) scale before and after the intervention, and the event-related potentials (ERP) and functional near-infrared spectroscopy (fNIRS) were used to evaluate the changes in neuron electrophysiology and hemodynamics. Results Forty patients were randomized across Beijing Rehabilitation Hospital Capital Medical University in Beijing. At the end of the intervention, 33 subjects completed the experimental process. The CMDT group showed significant improvement in the MMSE (P = 0.01) and MoCA (P = 0.024) relative to the CT group. The results of ERP and fNIRS showed that CMDT training could shorten the latency of P300 (P = 0.001) and the peak time of oxygenated hemoglobin (P = 0.004). The results showed that CMDT training shortened the response time of central neurons and significantly increased the rate of oxygen supply to the frontal lobe. Conclusion CMDT training in patients with PSCI improved global cognitive function, which was supported by the improved neural efficiency of associated brain areas. Clinical trial registration http://www.chictr.org.cn, identifier ChiCTR2000034862.
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Affiliation(s)
- Ruifeng Sun
- Beijing Rehabilitation Medicine Academy, Capital Medical University, Beijing, China
| | - Xiaoling Li
- Beijing Rehabilitation Medicine Academy, Capital Medical University, Beijing, China
| | - Ziman Zhu
- Beijing Rehabilitation Medicine Academy, Capital Medical University, Beijing, China
| | - Tiancong Li
- Beijing Rehabilitation Medicine Academy, Capital Medical University, Beijing, China
| | - Man Zhao
- Department of Neurological Rehabilitation, Beijing Rehabilitation Hospital, Capital Medical University, Beijing, China
| | - Linhong Mo
- Department of Neurological Rehabilitation, Beijing Rehabilitation Hospital, Capital Medical University, Beijing, China
| | - Wenshan Li
- Beijing Rehabilitation Medicine Academy, Capital Medical University, Beijing, China
| | - Xiaoshuang Xi
- Beijing Rehabilitation Medicine Academy, Capital Medical University, Beijing, China
| | - Peiling Huang
- Department of Neurological Rehabilitation, Beijing Rehabilitation Hospital, Capital Medical University, Beijing, China
| | - Weijun Gong
- Beijing Rehabilitation Medicine Academy, Capital Medical University, Beijing, China
- Department of Neurological Rehabilitation, Beijing Rehabilitation Hospital, Capital Medical University, Beijing, China
- *Correspondence: Weijun Gong
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Yuan J, Bai X, Driscoll B, Liu M, Huang H, Feng J. Standing and Walking Attention Visual Field (SWAVF) task: A new method to assess visuospatial attention during walking. APPLIED ERGONOMICS 2022; 104:103804. [PMID: 35635940 DOI: 10.1016/j.apergo.2022.103804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 05/13/2022] [Accepted: 05/14/2022] [Indexed: 06/15/2023]
Abstract
Visuospatial attention during walking has been associated with pedestrian safety and fall risks. However, visuospatial attention measures during walking remained under-explored. Current studies introduced a newly-developed Standing and Walking Visual Attention Field (SWAVF) task to assess visuospatial attention during walking and examined its reliability, validity, and stability. Thirty young adults completed a traditional computerized Attention Visual Field (AVF) task while sitting, and the SWAVF task under walking and standing settings. Nine participants also performed the SWAVF task under additional distraction conditions. Results showed good split-half reliability during standing (r = 0.70) and walking (r = 0.69), moderate concurrent validity with the sitting AVF task (r = 0.42), moderate convergent validity between the standing and walking settings (r = 0.69), good construct validity, and moderate rank-order stability (r = 0.53). Overall, the SWAVF task showed good psychometric properties. Potential applications to the evaluation of prosthetic and other exoskeleton devices, smart glasses, and ground-level traffic lights or signs were discussed.
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Affiliation(s)
- Jing Yuan
- Department of Psychology, North Carolina State University, NC, USA.
| | - Xiaolu Bai
- Department of Psychology, North Carolina State University, NC, USA.
| | - Brendan Driscoll
- Joint Department of Biomedical Engineering, North Carolina State University, University of North Carolina - Chapel Hill, NC, USA.
| | - Ming Liu
- Joint Department of Biomedical Engineering, North Carolina State University, University of North Carolina - Chapel Hill, NC, USA.
| | - He Huang
- Joint Department of Biomedical Engineering, North Carolina State University, University of North Carolina - Chapel Hill, NC, USA.
| | - Jing Feng
- Department of Psychology, North Carolina State University, NC, USA.
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Ankle-Brachial Index and Arterial Stiffness, Modulate the Exertional Capacity of High-Frequency Training Athletes. J Cardiovasc Dev Dis 2022; 9:jcdd9090312. [PMID: 36135457 PMCID: PMC9506274 DOI: 10.3390/jcdd9090312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 09/02/2022] [Accepted: 09/15/2022] [Indexed: 11/16/2022] Open
Abstract
Ankle-brachial index and arterial stiffness are associated with leg function in the elderly and in patients with peripheral arterial disease. Little is known about the meaning of these parameters in young and trained subjects and how they are related to physical performance. The main objective was to evaluate the mediating role of arterial stiffness and ankle-brachial index in physical performance. In a cross-sectional, case-control study, 240 male athletes were consecutively enrolled from the Laboratory of Cardiology and Sports Medicine, “G. d’Annunzio” University (Italy). All the subjects underwent the examination protocol for the annual medical evaluation for sport participation. Soccer (football) players compared to runners showed a lower level of ankle-brachial index, higher arterial stiffness, and lower systolic and diastolic blood pressure. In the treadmill stress test, soccer players compared to runners showed a greater maximal aerobic capacity. Differences in cardiovascular performance between soccer players and runners were mediated by better arterial stiffness and low level of ankle-brachial index; the estimated effect was 0.11 ± 0.05 and 0.24 ± 0.06, respectively. Vigorous strength training drops blood pressure and increases arterial stiffness. Taken together, our findings would seem to suggest that ABI and CAVI could be used as markers for athletes’ performance.
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Abstract
PURPOSE OF REVIEW We review recent work on applications of non-pharmacologic strategies to promote cognitive health in older adulthood and discuss potential network mechanisms, limitations, and considerations for improving intervention uptake and efficacy. RECENT FINDINGS In healthy older adults and patients with mild cognitive impairment, cognitive training produces global and domain-specific cognitive gains, though effect sizes tend to be modest and transfer is variable. Non-invasive brain stimulation has shown moderate success in enhancing cognitive function, though the optimum approach, parameters, and cortical targets require further investigation. Physical activity improves cognitive functions in late life, with emerging trials highlighting key intervention components that may maximize treatment outcomes. Multimodal interventions may be superior to single-component interventions in conferring cognitive gains, although interpretation is limited by modest sample sizes and variability in training components and parameters. Across modalities, individual differences in patient characteristics predict therapeutic response. These interventions may advance cognitive health by modulating functional networks that support core cognitive abilities including the default mode, executive control, and salience networks. Effectiveness of cognitive enhancement strategies may be increased with clinician-led coaching, booster sessions, gamification, integration of multiple intervention modalities, and concrete applications to everyday functioning. Future trials involving rigorous comparisons of training components, parameters, and delivery formats will be essential in establishing the precise approaches needed to maximize cognitive outcomes. Novel studies using patient-level clinical and neuroimaging features to predict individual differences in training gains may inform the development of personalized intervention prescriptions to optimize cognitive health in late life.
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Zhou Q, Han C, Xia Y, Wan F, Yin S, Li Y, Kou L, Chi X, Hu J, Sun Y, Wu J, Zou W, Huang J, Wang T. Efficacy and safety of 3-n-butylphthalide for the treatment of cognitive impairment: A systematic review and meta-analysis. CNS Neurosci Ther 2022; 28:1706-1717. [PMID: 36047338 PMCID: PMC9532910 DOI: 10.1111/cns.13952] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 07/28/2022] [Accepted: 07/30/2022] [Indexed: 11/30/2022] Open
Abstract
Background Current evidence for the efficacy of pharmacological treatment in improving cognitive function is absent. Recent studies have reported that 3‐n‐butylphthalide (NBP) has a positive effect on improving cognitive impairment; however, its clinical efficacy and safety is unclear. Therefore, we conducted a meta‐analysis to assess its efficacy and safety for cognitive impairment. Methods We systematically searched the PubMed, EMBASE, Cochrane Library, Web of Science, and Scopus databases, and two reviewers independently screened and extracted the data from included studies. We synthesized the data using the Review Manager Software version 5.3. Results We included six randomized clinical trials (RCTs), encompassing 851 patients with cognitive impairment. The results showed that NBP improved cognitive impairment. Specifically, the clinical efficacy was better than that in the control group, with better performance in improving the Mini‐Mental State Examination and the Montreal Cognitive Assessment scores, while decreasing the Alzheimer's Disease Assessment Scale‐Cognitive subscale and the Clinician's Interview‐Based Impression of Change plus caregiver input scores. There was no significant difference in the incidence of adverse events between both groups. Conclusion The NBP is effective and safe in improving cognitive impairment; however, more high‐quality RCTs are needed to confirm these findings.
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Affiliation(s)
- Qiulu Zhou
- Department of Neurology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Chao Han
- Department of Neurology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China
| | - Yun Xia
- Department of Neurology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Fang Wan
- Department of Neurology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Sijia Yin
- Department of Neurology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Yunna Li
- Department of Neurology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Liang Kou
- Department of Neurology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Xiaosa Chi
- Department of Neurology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Junjie Hu
- Department of Neurology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Yadi Sun
- Department of Neurology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Jiawei Wu
- Department of Neurology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Wenkai Zou
- Department of Neurology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Jinsha Huang
- Department of Neurology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Tao Wang
- Department of Neurology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
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Xia MH, Li A, Gao RX, Li XL, Zhang Q, Tong X, Zhao WW, Cao DN, Wei ZY, Yue J. Research hotspots and trends of multimodality MRI on vascular cognitive impairment in recent 12 years: A bibliometric analysis. Medicine (Baltimore) 2022; 101:e30172. [PMID: 36042608 PMCID: PMC9410608 DOI: 10.1097/md.0000000000030172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Multimodality magnetic resonance imaging (MRI) is widely used to detect vascular cognitive impairment (VCI). However, a bibliometric analysis of this issue remains unknown. Therefore, this study aimed to explore the research hotspots and trends of multimodality MRI on VCI over the past 12 years based on the Web of Science core collection using CiteSpace Software (6.1R2). METHODS Literature related to multimodality MRI for VCI from 2010 to 2021 was identified and analyzed from the Web of Science core collection database. We analyzed the countries, institutions, authors, cited journals, references, keyword bursts, and clusters using CiteSpace. RESULTS In total, 587 peer-reviewed documents were retrieved, and the annual number of publications showed an exponential growth trend over the past 12 years. The most productive country was the USA, with 182 articles, followed by China with 134 papers. The top 3 active academic institutions were Capital Medical University, Radboud UNIV Nijmegen, and UNIV Toronto. The most productive journal was the Journal of Alzheimer's Disease (33 articles). The most co-cited journal was Neurology, with the highest citations (492) and the highest intermediary centrality (0.14). The top-ranked publishing author was De Leeuw FE (17 articles) with the highest intermediary centrality of 0.04. Ward Law JM was the most cited author (123 citations) and Salat Dh was the most centrally cited author (0.24). The research hotspots of multimodal MRI for VCI include Alzheimer disease, vascular cognitive impairment, white matter intensity, cerebrovascular disease, dementia, mild cognitive impairment, neurovascular coupling, acute ischemic stroke, depression, and cerebral ischemic stroke. The main frontiers in the keywords are fMRI, vascular coupling, and cerebral ischemic stroke, and current research trends include impact, decline, and classification. CONCLUSIONS The findings from this bibliometric study provide research hotspots and trends for multimodality MRI for VCI over the past 12 years, which may help researchers identify hotspots and explore cutting-edge trends in this field.
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Affiliation(s)
- Mei-Hui Xia
- Department of Endocrinology and Geriatrics, Second Affiliated Hospital of Heilongjiang University of Chinese Medicine, Harbin, China
| | - Ang Li
- Sanofi-Aventis China Investment Co., Ltd, Beijing, China
| | - Rui-Xue Gao
- Graduate School of Heilongjiang University of Chinese Medicine, Harbin, China
| | - Xiao-Ling Li
- Division of CT and MRI, First Affiliated Hospital of Heilongjiang University of Chinese Medicine, Harbin, China
| | - Qinhong Zhang
- Department of Tuina, Acupuncture and Moxibustion, Shenzhen Jiuwei Chinese Medicine Clinic, Shenzhen, China
| | - Xin Tong
- Graduate School of Heilongjiang University of Chinese Medicine, Harbin, China
| | | | - Dan-Na Cao
- Division of CT and MRI, First Affiliated Hospital of Heilongjiang University of Chinese Medicine, Harbin, China
| | - Ze-Yi Wei
- Graduate School of Heilongjiang University of Chinese Medicine, Harbin, China
| | - Jinhuan Yue
- Department of Tuina, Acupuncture and Moxibustion, Shenzhen Jiuwei Chinese Medicine Clinic, Shenzhen, China
- *Correspondence: Jinhuan Yue, Department of Tuina, Acupuncture and Moxibustion, Shenzhen Jiuwei Chinese Medicine Clinic, Shenzhen 518000, China (e-mail: )
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Trubnikova OA, Tarasova IV, Kukhareva IN, Temnikova TB, Sosnina AS, Syrova ID, Kupriyanova DS, Barbarash OI. Effectiveness of dual-task computerized cognitive training in the prevention of postoperative cognitive dysfunction in coronary bypass surgery. КАРДИОВАСКУЛЯРНАЯ ТЕРАПИЯ И ПРОФИЛАКТИКА 2022. [DOI: 10.15829/1728-8800-2022-3320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Aim. To evaluate the effectiveness of dual-task computerized cognitive training (CCT) in the prevention of postoperative cognitive dysfunction in patients after on-pump coronary artery bypass grafting (CABG).Material and methods. This cohort prospective study included 68 patients (median age, 64 years [54; 69]) admitted for elective on-pump CABG. In addition to the standard preoperative examination, all patients underwent advanced neuropsychological and neurophysiological examination. Starting from 3-4 days of the postoperative period, all patients underwent dual-task CCT.Results. After 8-10 days, early postoperative cognitive dysfunction was observed in 37 (54,4%) patients from CCT group, while in patients without training in 69,3% of cases (n=79). The best results of cognitive functioning were achieved in neurodynamics and short-term memory. In addition, in patients who completed the training course, a postoperative increase in the frontooccipital gradient of theta rhythm was observed.Conclusion. Neuropsychological and neurophysiological assessment have demonstrated the limited effectiveness of a short-term dual task CCT using in the prevention of early postoperative cognitive dysfunction in patients after on-pump CABG. The dual task method can be an additional preventive intervention in the development of a personalized approach to cognitive rehabilitation therapy in cardiac surgery patients.
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Affiliation(s)
- O. A. Trubnikova
- Research Institute for Complex Issues of Cardiovascular Diseases
| | - I. V. Tarasova
- Research Institute for Complex Issues of Cardiovascular Diseases
| | - I. N. Kukhareva
- Research Institute for Complex Issues of Cardiovascular Diseases
| | - T. B. Temnikova
- Research Institute for Complex Issues of Cardiovascular Diseases
| | - A. S. Sosnina
- Research Institute for Complex Issues of Cardiovascular Diseases
| | - I. D. Syrova
- Research Institute for Complex Issues of Cardiovascular Diseases
| | | | - O. I. Barbarash
- Research Institute for Complex Issues of Cardiovascular Diseases
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Wu J, Xiao W, Yip J, Peng L, Zheng K, Takyi Bentil O, Ren Z. Effects of Exercise on Neural Changes in Inhibitory Control: An ALE Meta-Analysis of fMRI Studies. Front Hum Neurosci 2022; 16:891095. [PMID: 35814955 PMCID: PMC9265250 DOI: 10.3389/fnhum.2022.891095] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Accepted: 06/08/2022] [Indexed: 11/13/2022] Open
Abstract
It is widely known that exercise improves inhibitory control; however, the mechanisms behind the cognitive improvement remain unclear. This study analyzes the extant literature on the neuronal effects of exercise on inhibitory control functions. We searched four online databases (Pubmed, Scopus, PsycINFO, and Web of Science) for relevant peer-reviewed studies to identify eligible studies published before September 1, 2021. Among the 4,090 candidate studies identified, 14 meet the inclusion criteria, and the results of 397 participants in these 14 studies are subsequently analyzed. We quantify the neural effects on the entire brain by using GingerALE software and identify 10 clusters of exercise-induced neuronal with either increases/decreases in the superior temporal gyrus (BA 22), precuneus (BA 7), superior frontal gyrus (BA 10), cuneus (BA 19), precuneus (BA 19), caudate, posterior cingulate (BA 19), middle temporal gyrus (B 37), parahippocampal gyrus (BA 30), precentral gyrus (BA 6). Meta-analytic coactivation map (MACM) showed that multiple functional networks overlap with brain regions with activation likelihood estimation (ALE) results. We propose the effect of exercise on neural activity is related to inhibitory control in the extended frontoparietal, default mode network (DMN), visual network, and other pathways. These results provide preliminary evidence of the neural effects of exercise on inhibitory control.
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Affiliation(s)
- Jinlong Wu
- School of Physical Education, Shenzhen University, Shenzhen, China
- Institute of Textiles and Clothing, The Hong Kong Polytechnic University, Hong Kong, China
| | - Wen Xiao
- School of Physical Education, Shenzhen University, Shenzhen, China
| | - Joanne Yip
- Institute of Textiles and Clothing, The Hong Kong Polytechnic University, Hong Kong, China
| | - Li Peng
- College of Physical Education, Southwest University, Chongqing, China
| | - Kangyong Zheng
- Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, China
| | - Obed Takyi Bentil
- Civil and Environmental Engineering Department, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China
| | - Zhanbing Ren
- School of Physical Education, Shenzhen University, Shenzhen, China
- *Correspondence: Zhanbing Ren
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The effect of creative expression program in neurocognitive networks performance measured by task and resting-state functional MRI. Int Psychogeriatr 2022:1-10. [PMID: 35575053 DOI: 10.1017/s1041610222000382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND The current study examined the effects of a 16-week creative expression program on brain activity during a story creating task and resting-state functional network connectivity in mild cognitive impairment (MCI) adults. METHOD Thirty-six MCI adults were allocated to either the creative expression program (CrExp, n = 18) or control group (CG,n = 18). Before and after intervention, all participants were scanned with functional magnetic resonance imaging (fMRI) during story creating task performance and a resting state. The two-group comparison was calculated between the blood oxygenation level-dependent (BOLD) signal changes for each cluster to investigate the differences in fMRI activation and functional connectivity (FC) between two groups. RESULTS Task activation analyses showed an increase in the right anterior cingulate gyrus (ACG), right medial frontal gyrus (MFG), right lentiform nucleus (LN), left hippocampus (HIP), left middle occipital gyrus (MOG), and left cerebellum posterior lobe (CPL) (p < 0.05). Story creating performance improvements were associated with greater activation in the left HIP region. Resting-state functional connectivity (FC) between left HIP and certain other brain areas shown a significant interaction of creative expression group versus control group. Moreover, connectivity between the right angular gyrus (ANG), right inferior temporal gyrus (ITG), right superior occipital gyrus (SOG), left ANG, and left MFG were related to improved cognitive performance (p < 0.05). CONCLUSION These data extend current knowledge by indicating that the creative expression program can improve cognitive activation in MCI, and these enhancements may be related to the neurocognitive network plasticity changes induced by creative expression training.
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Balbim GM, Falck RS, Barha CK, Starkey SY, Bullock A, Davis JC, Liu-Ambrose T. Effects of exercise training on the cognitive function of older adults with different types of dementia: a systematic review and meta-analysis. Br J Sports Med 2022; 56:bjsports-2021-104955. [PMID: 35577539 DOI: 10.1136/bjsports-2021-104955] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/21/2022] [Indexed: 11/04/2022]
Abstract
OBJECTIVES To assess the effect of exercise training on the cognitive function of older adults living with different types of dementia, as well as potential moderators of exercise efficacy. DESIGN Systematic review and meta-analysis. DATA SOURCES Cochrane Central, PsycINFO, Embase, Medline and CINAHL. ELIGIBILITY CRITERIA Peer-reviewed, randomised controlled trials, in English (1990-present), which examined the effects of exercise training on the cognitive function of older adults living with dementia. STUDY APPRAISAL AND SYNTHESIS Risk of bias and study quality were assessed (Cochrane Risk of Bias Tool 2.0 and Physiotherapy Evidence Database Scale). We performed random-effects models using robust variance estimation and tested moderators using the approximate Hotelling-Zhang test. RESULTS Twenty-eight studies (n=2158) were included in the qualitative review and 25 in the meta-analysis. For all-cause dementia, a small effect of exercise training on cognitive function was observed (g=0.19; 95% CI 0.05 to 0.33; p=0.009). Type of dementia and exercise training characteristics did not moderate the effects of exercise training on cognitive function (p>0.05). Adherence to the intervention moderated the cognitive outcome effect size such that greater mean adherence was associated with greater cognitive outcome effect sizes (b=0.02; SE=0.01; p=0.005). CONCLUSION Exercise training showed small benefits for the cognitive function of older adults living with all-cause dementia. More research and standardised reporting of exercise training characteristics can strengthen the evidence for what works best for which types of dementia. PROSPERO REGISTRATION NUMBER CRD42020198716.
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Affiliation(s)
- Guilherme Moraes Balbim
- Department of Physical Therapy, The University of British Columbia, Faculty of Medicine, Vancouver, British Columbia, Canada
- Djavad Mowafaghian Centre for Brain Health, The University of British Columbia, Vancouver, British Columbia, Canada
- Centre for Hip Health and Mobility, Vancouver Coastal Research Institute, Vancouver, British Columbia, Canada
| | - Ryan S Falck
- Department of Physical Therapy, The University of British Columbia, Faculty of Medicine, Vancouver, British Columbia, Canada
- Djavad Mowafaghian Centre for Brain Health, The University of British Columbia, Vancouver, British Columbia, Canada
- Centre for Hip Health and Mobility, Vancouver Coastal Research Institute, Vancouver, British Columbia, Canada
- School of Biomedical Engineering, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Cindy K Barha
- Department of Physical Therapy, The University of British Columbia, Faculty of Medicine, Vancouver, British Columbia, Canada
- Djavad Mowafaghian Centre for Brain Health, The University of British Columbia, Vancouver, British Columbia, Canada
- Centre for Hip Health and Mobility, Vancouver Coastal Research Institute, Vancouver, British Columbia, Canada
- Department of Physical Therapy, University of British Columbia, Vancouver, British Columbia, Canada
| | - Samantha Y Starkey
- Faculty of Medicine, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Alexis Bullock
- Department of Physical Therapy, The University of British Columbia, Faculty of Medicine, Vancouver, British Columbia, Canada
- Djavad Mowafaghian Centre for Brain Health, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Jennifer C Davis
- Centre for Hip Health and Mobility, Vancouver Coastal Research Institute, Vancouver, British Columbia, Canada
- Faculty of Management, The University of British Columbia Okanagan, Kelowna, British Columbia, Canada
| | - Teresa Liu-Ambrose
- Department of Physical Therapy, The University of British Columbia, Faculty of Medicine, Vancouver, British Columbia, Canada
- Djavad Mowafaghian Centre for Brain Health, The University of British Columbia, Vancouver, British Columbia, Canada
- Centre for Hip Health and Mobility, Vancouver Coastal Research Institute, Vancouver, British Columbia, Canada
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Kanegusuku H, Correia MA, Longano P, Ritti-Dias RM, Wolosker N, Cucato GG. Effects of arm-crank exercise on cardiovascular function, functional capacity, cognition and quality of life in patients with peripheral artery disease: Study protocol for a randomized controlled trial. PLoS One 2022; 17:e0267849. [PMID: 35511887 PMCID: PMC9070866 DOI: 10.1371/journal.pone.0267849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Accepted: 04/13/2022] [Indexed: 12/24/2022] Open
Abstract
Background Arm-crank exercise training (ACT) is an alternative exercise strategy for patients with symptomatic peripheral artery disease (PAD) due to the attenuation of pain symptoms during the exercise, as well as the benefits to functional capacity. Purpose The aim of this study is to describe the study protocol to analyze the effects of ACT exercise on cardiovascular function, functional capacity, cognition and quality of life in patients with symptomatic PAD. Methods This is a three-armed randomized, prospective, single-blind data collection, single-center, controlled study enrolling 45 patients with symptomatic PAD who will be randomized into 3 intervention groups: walking training (WT), ACT and control group. The WT and ACT will perform 2 sessions/week, 15 to 10 sets of 2 to 5 minutes at values of 13 to 15 on the Borg scale. Before and after 12 weeks of intervention, cardiovascular function (ambulatory blood pressure, office blood pressure, central blood pressure, heart rate variability, arterial stiffness and vascular function), functional capacity (six-minute walk test, 2 minute step test, handgrip test, Walking impairment questionnaire, Walking estimated limitation calculated by history, Baltimore activity scale for intermittent claudication, and short physical performance battery), cognition (executive function and memory), and quality of life (vascular quality of life questionnaire and World Health Organization Quality of Life) will be assessed. Results This is the first trial to evaluate the effects of ACT on regulatory mechanisms of the cardiovascular system in PAD patients. If the results are as expected, they will provide evidence the ability of ACT to promote cardiovascular benefits in the symptomatic PAD population.
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Affiliation(s)
| | | | - Paulo Longano
- Graduated Program in Rehabilitation Sciences, Universidade Nove de Julho, São Paulo, Brazil
| | | | | | - Gabriel Grizzo Cucato
- Department of Sport, Exercise and Rehabilitation, Northumbria University, Newcastle upon Tyne, United Kingdom
- * E-mail:
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Gibson E, Koh CL, Eames S, Bennett S, Scott AM, Hoffmann TC. Occupational therapy for cognitive impairment in stroke patients. Cochrane Database Syst Rev 2022; 3:CD006430. [PMID: 35349186 PMCID: PMC8962963 DOI: 10.1002/14651858.cd006430.pub3] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
BACKGROUND Cognitive impairment is a frequent consequence of stroke and can impact on a person's ability to perform everyday activities. Occupational therapists use a range of interventions when working with people who have cognitive impairment poststroke. This is an update of a Cochrane Review published in 2010. OBJECTIVES To assess the impact of occupational therapy on activities of daily living (ADL), both basic and instrumental, global cognitive function, and specific cognitive abilities in people who have cognitive impairment following a stroke. SEARCH METHODS We searched the Cochrane Stroke Group Trials Register, CENTRAL, MEDLINE, Embase, four other databases (all last searched September 2020), trial registries, and reference lists. SELECTION CRITERIA We included randomised and quasi-randomised controlled trials that evaluated an intervention for adults with clinically defined stroke and confirmed cognitive impairment. The intervention needed either to be provided by an occupational therapist or considered within the scope of occupational therapy practice as defined in the review. We excluded studies focusing on apraxia or perceptual impairments or virtual reality interventions as these are covered by other Cochrane Reviews. The primary outcome was basic activities of daily living (BADL) such as dressing, feeding, and bathing. Secondary outcomes were instrumental ADL (IADL) (e.g. shopping and meal preparation), community integration and participation, global cognitive function and specific cognitive abilities (including attention, memory, executive function, or a combination of these), and subdomains of these abilities. We included both observed and self-reported outcome measures. DATA COLLECTION AND ANALYSIS Two review authors independently selected studies that met the inclusion criteria, extracted data, and assessed the certainty of the evidence. A third review author moderated disagreements if consensus was not reached. We contacted trial authors for additional information and data, where available. We assessed the certainty of key outcomes using GRADE. MAIN RESULTS: We included 24 trials from 11 countries involving 1142 (analysed) participants (two weeks to eight years since stroke onset). This update includes 23 new trials in addition to the one study included in the previous version. Most were parallel randomised controlled trials except for one cross-over trial and one with a two-by-two factorial design. Most studies had sample sizes under 50 participants. Twenty studies involved a remediation approach to cognitive rehabilitation, particularly using computer-based interventions. The other four involved a compensatory and adaptive approach. The length of interventions ranged from 10 days to 18 weeks, with a mean total length of 19 hours. Control groups mostly received usual rehabilitation or occupational therapy care, with a few receiving an attention control that was comparable to usual care; two had no intervention (i.e. a waiting list). Apart from high risk of performance bias for all but one of the studies, the risk of bias for other aspects was mostly low or unclear. For the primary outcome of BADL, meta-analysis found a small effect on completion of the intervention with a mean difference (MD) of 2.26 on the Functional Independence Measure (FIM) (95% confidence interval (CI) 0.17 to 4.22; P = 0.03, I2 = 0%; 6 studies, 336 participants; low-certainty evidence). Therefore, on average, BADL improved by 2.26 points on the FIM that ranges from 18 (total assist) to 126 (complete independence). On follow-up, there was insufficient evidence of an effect at three months (MD 10.00, 95% CI -0.54 to 20.55; P = 0.06, I2 = 53%; 2 studies, 73 participants; low-certainty evidence), but evidence of an effect at six months (MD 11.38, 95% CI 1.62 to 21.14, I2 = 12%; 2 studies, 73 participants; low-certainty evidence). These differences are below 22 points which is the established minimal clinically important difference (MCID) for the FIM for people with stroke. For IADL, the evidence is very uncertain about an effect (standardised mean difference (SMD) 0.94, 95% CI 0.41 to 1.47; P = 0.0005, I2 = 98%; 2 studies, 88 participants). For community integration, we found insufficient evidence of an effect (SMD 0.09, 95% CI -0.35 to 0.54; P = 0.68, I2 = 0%; 2 studies, 78 participants). There was an improvement of clinical importance in global cognitive functional performance after the intervention (SMD 0.35, 95% CI 0.16 to 0.54; P = 0.0004, I2 = 0%; 9 studies, 432 participants; low-certainty evidence), equating to 1.63 points on the Montreal Cognitive Assessment (MoCA) (95% CI 0.75 to 2.52), which exceeds the anchor-based MCID of the MoCA for stroke rehabilitation patients of 1.22. We found some effect for attention overall (SMD -0.31, 95% CI -0.47 to -0.15; P = 0.0002, I2 = 20%; 13 studies, 620 participants; low-certainty evidence), equating to a difference of 17.31 seconds (95% CI 8.38 to 26.24), and for executive functional performance overall (SMD 0.49, 95% CI 0.31 to 0.66; P < 0.00001, I2 = 74%; 11 studies, 550 participants; very low-certainty evidence), equating to 1.41 points on the Frontal Assessment Battery (range: 0-18). Of the cognitive subdomains, we found evidence of effect of possible clinical importance, immediately after intervention, for sustained visual attention (moderate certainty) equating to 15.63 seconds, for working memory (low certainty) equating to 59.9 seconds, and thinking flexibly (low certainty), compared to control. AUTHORS' CONCLUSIONS The effectiveness of occupational therapy for cognitive impairment poststroke remains unclear. Occupational therapy may result in little to no clinical difference in BADL immediately after intervention and at three and six months' follow-up. Occupational therapy may slightly improve global cognitive performance of a clinically important difference immediately after intervention, likely improves sustained visual attention slightly, and may slightly increase working memory and flexible thinking after intervention. There is evidence of low or very low certainty or insufficient evidence for effect on other cognitive domains, IADL, and community integration and participation. Given the low certainty of much of the evidence in our review, more research is needed to support or refute the effectiveness of occupational therapy for cognitive impairment after stroke. Future trials need improved methodology to address issues including risk of bias and to better report the outcome measures and interventions used.
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Affiliation(s)
- Elizabeth Gibson
- Institute for Evidence-Based Healthcare, Bond University, Gold Coast, Australia
| | - Chia-Lin Koh
- Department of Occupational Therapy, College of Medicine, National Cheng Kung University, Tainan City, Taiwan
| | - Sally Eames
- Community and Oral Health Innovation and Research Centre, Metro North Hospital and Health Service, Brisbane, Australia
| | - Sally Bennett
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Anna Mae Scott
- Institute for Evidence-Based Healthcare, Bond University, Gold Coast, Australia
| | - Tammy C Hoffmann
- Institute for Evidence-Based Healthcare, Bond University, Gold Coast, Australia
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Verdelho A, Correia M, Ferro JM, Madureira S, Vilela P, Rodrigues M, Borges M, Oliveira V, Santos AC, Gonçalves-Pereira M, Santa-Clara H. Physical Activity Self-Report Is Not Reliable Among Subjects with Mild Vascular Cognitive Impairment: The AFIVASC Study. J Alzheimers Dis 2022; 87:405-414. [PMID: 35275531 DOI: 10.3233/jad-215381] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND The World Health Organization (WHO) recommends a minimum of 150 minutes of moderate physical activity per week. Adherence to these recommendations is difficult to assess. OBJECTIVE We aimed to evaluate the validity of self-reported physical activity in mild vascular cognitive impairment (mVCI) and whether physical activity was associated with cognitive status, by using baseline data from a randomized controlled trial. METHODS A hundred and four subjects with mVCI were included (mean age 72 years; 51% women). Subjects underwent neurological, physical, and comprehensive neuropsychological assessments. Adherence to WHO physical activity recommendations was evaluated using both self-reported information and objective measures (accelerometry). RESULTS There was poor agreement (kappa = 0.106) between self-report of following WHO recommendations and actually fulfilling them according to accelerometry. Only 16.6% of participants reported following WHO recommendations and displayed compatible values according to the accelerometer. Participants whose accelerometry values confirmed adherence to WHO recommendations had better performance in a global measure of cognition, attention, and mental speed processing. In multiple regression analyses, education and accelerometry values in accordance with WHO recommendations were independently associated with the global measure of cognition, attention, and processing speed, controlling for sex, age, and depressive symptoms. Accelerometry results were not associated with memory and executive functions. CONCLUSION In this sample of mVCI subjects, self-reported physical activity displayed poor agreement with accelerometry values, suggesting that objective measures of physical activity are preferable. Physical activity (performed, at least, according to WHO recommendations) was associated with better cognitive performance overall.
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Affiliation(s)
- Ana Verdelho
- Department of Neurosciences and Mental Health, CHLN-Hospital de Santa Maria, Lisbon, Portugal.,Instituto de Medicina Molecular João Lobo Antunes - IMM, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal.,Instituto de Saúde Ambiental - ISAMB, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
| | - Manuel Correia
- Neurology Service, Hospital de Santo António, Centro Hospitalar do Porto and Instituto de Ciências Biomédicas Abel Salazar (ICBAS), University of Porto, Portugal
| | - José Manuel Ferro
- Department of Neurosciences and Mental Health, CHLN-Hospital de Santa Maria, Lisbon, Portugal.,Instituto de Medicina Molecular João Lobo Antunes - IMM, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
| | - Sofia Madureira
- Instituto de Medicina Molecular João Lobo Antunes - IMM, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
| | - Pedro Vilela
- Neuroradiology Department, Hospital da Luz, Lisboa, Portugal
| | - Mário Rodrigues
- Instituto de Medicina Molecular João Lobo Antunes - IMM, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
| | - Mariana Borges
- Instituto de Medicina Molecular João Lobo Antunes - IMM, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
| | - Vanessa Oliveira
- Neurology Service, Hospital de Santo António, Centro Hospitalar do Porto and Instituto de Ciências Biomédicas Abel Salazar (ICBAS), University of Porto, Portugal
| | - Ana Catarina Santos
- Instituto de Medicina Molecular João Lobo Antunes - IMM, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
| | - Manuel Gonçalves-Pereira
- Comprehensive Health Research Centre (CHRC), CEDOC, NOVA Medical School/Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisbon, Portugal
| | - Helena Santa-Clara
- Exercise and Health Laboratory, Faculdade de Motricidade Humana, Centro Interdisciplinar de Estudo da Performance Humana -CIPER, Universidade de Lisboa, Lisboa, Portugal
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Zhu Y, Gao Y, Guo C, Qi M, Xiao M, Wu H, Ma J, Zhong Q, Ding H, Zhou Q, Ali N, Zhou L, Zhang Q, Wu T, Wang W, Sun C, Thabane L, Zhang L, Wang T. Effect of 3-Month Aerobic Dance on Hippocampal Volume and Cognition in Elderly People With Amnestic Mild Cognitive Impairment: A Randomized Controlled Trial. Front Aging Neurosci 2022; 14:771413. [PMID: 35360212 PMCID: PMC8961023 DOI: 10.3389/fnagi.2022.771413] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Accepted: 01/31/2022] [Indexed: 01/06/2023] Open
Abstract
As an intermediate state between normal aging and dementia, mild cognitive impairment (MCI), especially amnestic MCI (aMCI), is a key stage in the prevention and intervention of Alzheimer’s disease (AD). Whether dancing could increase the hippocampal volume of seniors with aMCI remains debatable. The aim of this study was to investigate the influence of aerobic dance on hippocampal volume and cognition after 3 months of aerobic dance in older adults with aMCI. In this randomized controlled trial, 68 elderly people with aMCI were randomized to either the aerobic dance group or the control group using a 1:1 allocation ratio. Ultimately, 62 of 68 participants completed this study, and the MRI data of 54 participants were included. A specially designed aerobic dance routine was performed by the dance group three times per week for 3 months, and all participants received monthly healthcare education after inclusion. MRI with a 3.0T MRI scanner and cognitive assessments were performed before and after intervention. High-resolution three-dimensional (3D) T1-weighted anatomical images were acquired for the analysis of hippocampal volume. A total of 35 participants (mean age: 71.51 ± 6.62 years) were randomized into the aerobic dance group and 33 participants (mean age: 69.82 ± 7.74 years) into the control group. A multiple linear regression model was used to detect the association between intervention and the difference of hippocampal volumes as well as the change of cognitive scores at baseline and after 3 months. The intervention group showed greater right hippocampal volume (β [95% CI]: 0.379 [0.117, 0.488], p = 0.002) and total hippocampal volume (β [95% CI]: 0.344 [0.082, 0.446], p = 0.005) compared to the control group. No significant association of age or gender was found with unilateral or global hippocampal volume. There was a correlation between episodic memory and intervention, as the intervention group showed a higher Wechsler Memory Scale-Revised Logical Memory (WMS-RLM) score (β [95% CI]: 0.326 [1.005, 6.773], p = 0.009). Furthermore, an increase in age may cause a decrease in the Mini-Mental State Examination (MMSE) score (β [95% CI]: −0.366 [−0.151, −0.034], p = 0.002). In conclusion, 3 months of aerobic dance could increase the right and total hippocampal volumes and improve episodic memory in elderly persons with aMCI. Clinical Trial Registration: This study was registered on the Chinese Clinical Trial Registry [www.chictr.org.cn], identifier [ChiCTR-INR-15007420].
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Affiliation(s)
- Yi Zhu
- Rehabilitation Medicine Center, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Yaxin Gao
- Rehabilitation Medicine Center, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Gusu School, Nanjing Medical University, Suzhou, China
| | - Chuan Guo
- Rehabilitation Medicine Center, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Ming Qi
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Ming Xiao
- Jiangsu Key Laboratory of Neurodegeneration, Center for Global Health, Nanjing Medical University, Nanjing, China
- Brain Institute, the Affiliated Nanjing Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Han Wu
- Rehabilitation Department, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China
| | - Jinhui Ma
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada
| | - Qian Zhong
- Rehabilitation Department, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China
| | - Hongyuan Ding
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Qiumin Zhou
- Rehabilitation Medicine Center, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Nawab Ali
- First School of Clinical Medicine, Nanjing Medical University, Nanjing, China
- Swat Institute of Rehabilitation and Medical Sciences, Swat, Pakistan
| | - Li Zhou
- Rehabilitation Medicine Center, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Qin Zhang
- Rehabilitation Medicine Center, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Ting Wu
- Department of Neurology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Wei Wang
- Department of Neurology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Cuiyun Sun
- Rehabilitation Department, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China
| | - Lehana Thabane
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada
- Biostatistics Unit, St Joseph’s Healthcare, Hamilton, ON, Canada
| | - Ling Zhang
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
- *Correspondence: Ling Zhang,
| | - Tong Wang
- Rehabilitation Medicine Center, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
- Tong Wang,
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Lee E, Kostensalo J, Willeit P, Kunutsor SK, Laukkanen T, Zaccardi F, Khan H, Laukkanen JA. Standalone sauna vs exercise followed by sauna on cardiovascular function in non-naïve sauna users: A comparison of acute effects. Health Sci Rep 2021; 4:e393. [PMID: 34622026 PMCID: PMC8485612 DOI: 10.1002/hsr2.393] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 09/03/2021] [Accepted: 09/06/2021] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND AND AIMS Sauna bathing and aerobic exercise have each been shown to affect cardiovascular function. However, direct comparisons between standalone sauna bathing and a combination of exercise and sauna on vascular indices remain limited. Therefore, we conducted a cross-over study using matched durations to explore the hemodynamic changes of sauna exposure when compared to a combination of aerobic exercise and sauna exposure. METHODS Participants (N = 72) with at least one cardiovascular risk factor underwent, on two separate occasions: (a) a 30-minute sauna at 75°C (SAUNA) and (b) the combination of a 15-minute cycling exercise at 75% maximum heart rate followed by 15-minute sauna exposure (EX+SAUNA). Relative changes to arterial stiffness (PWV), augmentation index (Alx), brachial systolic and diastolic blood pressure (SBP and DBP), central SBP (cSBP), mean arterial pressure (MAP), and heart rate (HR) were compared PRE-POST and pre- to 30-minutes post-intervention (PRE-POST30). RESULTS Baseline SBP and DBP were 143 (SD 18) mmHg and 86 (SD 10) mmHg, respectively. From PRE-POST, SAUNA had lower DBP (mean difference [95% CI] 2.5 [1.0, 4.1], P = .002) and MAP (2.5 [0.6, 4.3], P = .01). However, EX+SAUNA had lower SBP (-2.7 [-4.8, -0.5], P = .02), DBP (-1.8 [-3.3, -0.4], P = .01), and MAP (-2.0 [-3.5, -0.5], P = .009) PRE-POST30. There were no statistically significant differences between SAUNA and EX+SAUNA for other measured parameters. CONCLUSION This study demonstrated that when matched for duration, EX+SAUNA and SAUNA elicit comparable acute hemodynamic alterations in middle-aged participants with cardiovascular risk factors. The sauna is a suitable option for acute blood pressure reductions in those who are unable to perform aerobic exercise, and may be a viable lifestyle treatment option to improve blood pressure control.
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Affiliation(s)
- Earric Lee
- Faculty of Sport and Health Sciences University of Jyväskylä Jyväskylä Finland
| | - Joel Kostensalo
- Faculty of Mathematics and Science University of Jyväskylä Jyväskylä Finland
| | - Peter Willeit
- Department of Neurology Medical University of Innsbruck Innsbruck Austria
- Department of Public Health and Primary Care University of Cambridge Cambridge UK
| | - Setor K Kunutsor
- National Institute for Health Research Bristol Biomedical Research Centre University Hospitals Bristol and Weston NHS Foundation Trust and the University of Bristol Bristol UK
- Translational Health Sciences, Bristol Medical School University of Bristol, Learning & Research Building (Level 1), Southmead Hospital Bristol UK
| | - Tanjaniina Laukkanen
- Institute of Public Health and Clinical Nutrition University of Eastern Finland Kuopio Finland
| | | | - Hassan Khan
- Division of Cardiology, Department of Medicine Emory University Atlanta Georgia USA
| | - Jari A Laukkanen
- Faculty of Sport and Health Sciences University of Jyväskylä Jyväskylä Finland
- Department of Internal Medicine Central Finland Health Care District Jyväskylä Finland
- Institute of Clinical Medicine University of Eastern Finland Kuopio Finland
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38
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Smith DL, Haworth JL, Brooks EK, Cousins JM. Postural Control, Dual Task Performance and Executive Function Following an Ultramarathon. Percept Mot Skills 2021; 128:2767-2786. [PMID: 34474623 DOI: 10.1177/00315125211044351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
As research into the postural and cognitive effects of ultramarathon running is sparse and still needed, we investigated the effect of ultramarathon running on runners' postural control, dual task postural control and a measure of executive function-the flanker test, expecting fatigue-related deterioration on each measure. We used a pre- and post-test research design with 14 runners who completed (a) postural assessment with eyes open and closed, on a flat surface and on foam during (b) a two-choice reaction time dual task postural assessment, and (c) an executive function modified flanker task. With regard to postural stability, we observed, after running, increased anterior-posterior (AP) path length and AP root mean square (RMS) and reductions in both mediolateral (ML) RMS and ML median frequency. Dual task analysis showed reduced ML RMS prior to the race, whereas the effect was absent afterwards. Reaction times were not significantly altered between pre-post or surface conditions assessments. There were no statistically significant differences in mean modified flanker scores before and after the race. These data demonstrated that, following an endurance run, there were plane specific movement adaptations in postural sway that may have resulted from neuroprotective changes under extreme fatigue.
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Affiliation(s)
- Dean L Smith
- Department of Kinesiology and Health, Miami University, Oxford, Ohio, United States.,Essence of Wellness Chiropractic Center, Eaton, Ohio, United States
| | - Joshua L Haworth
- Department of Human Movement Science, 6918Oakland University, Oakland University, Rochester, Michigan, United States
| | - Eric K Brooks
- Department of Kinesiology and Health, Miami University, Oxford, Ohio, United States
| | - Julie M Cousins
- Department of Kinesiology, 1098Albion College, Albion College, Albion, Michigan, United States
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The Association between the Binding Processes of Working Memory and Vascular Risk Profile in Adults. Brain Sci 2021; 11:brainsci11091140. [PMID: 34573162 PMCID: PMC8467480 DOI: 10.3390/brainsci11091140] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2021] [Revised: 08/23/2021] [Accepted: 08/26/2021] [Indexed: 12/17/2022] Open
Abstract
Episodic buffer (EB), a key component of working memory, seems to have a rather complicated function as part of binding processes. Recent papers on the field claim that binding processes of working memory (WM) are assisted by attention and executive functions. On the same page, vascular pathology is gaining more ground as the main underlying cause for many brain pathologies. Hypercholesterolemia, hypertension, obesity, diabetes, lack of exercise and smoking are the most common risk factors that people of all ages suffer from and constitute the main vascular risk factors responsible for a possible decline in executive functions and attention. Thus, this research is an attempt to examine the relation between the binding functions of WM and the existence of vascular risk factors via a computerized test focusing on feature binding. The study comprised adults (n = 229) with and without vascular risk factors. The main tools used were a biomarker questionnaire and a feature binding test (FBT). The results showed that participants who report suffering from one or more vascular risk factors had significantly lower performance on specific subtasks of the FBT in comparison to the participants who were healthy. This allows us to assume that there might be a positive association between feature binding and a vascular risk profile in adults, and such a test could be a useful diagnostic tool for early cognitive impairment due to incipient vascular pathology.
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40
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Chen Y, Wang X, Guan L, Wang Y. Role of White Matter Hyperintensities and Related Risk Factors in Vascular Cognitive Impairment: A Review. Biomolecules 2021; 11:biom11081102. [PMID: 34439769 PMCID: PMC8391787 DOI: 10.3390/biom11081102] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Revised: 07/24/2021] [Accepted: 07/25/2021] [Indexed: 02/06/2023] Open
Abstract
White matter hyperintensities (WMHs) of presumed vascular origin are one of the imaging markers of cerebral small-vessel disease, which is prevalent in older individuals and closely associated with the occurrence and development of cognitive impairment. The heterogeneous nature of the imaging manifestations of WMHs creates difficulties for early detection and diagnosis of vascular cognitive impairment (VCI) associated with WMHs. Because the underlying pathological processes and biomarkers of WMHs and their development in cognitive impairment remain uncertain, progress in prevention and treatment is lagging. For this reason, this paper reviews the status of research on the features of WMHs related to VCI, as well as mediators associated with both WMHs and VCI, and summarizes potential treatment strategies for the prevention and intervention in WMHs associated with VCI.
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Affiliation(s)
- Yiyi Chen
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China; (Y.C.); (X.W.)
- China National Clinical Research Center for Neurological Diseases, Beijing 100070, China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing 100070, China
- Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing 100070, China
| | - Xing Wang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China; (Y.C.); (X.W.)
- China National Clinical Research Center for Neurological Diseases, Beijing 100070, China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing 100070, China
- Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing 100070, China
- Department of Neurology, Chongqing University Central Hospital, Chongqing Emergency Medical Center, Chongqing 400000, China
| | - Ling Guan
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China; (Y.C.); (X.W.)
- China National Clinical Research Center for Neurological Diseases, Beijing 100070, China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing 100070, China
- Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing 100070, China
- Correspondence: (L.G.); (Y.W.)
| | - Yilong Wang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China; (Y.C.); (X.W.)
- China National Clinical Research Center for Neurological Diseases, Beijing 100070, China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing 100070, China
- Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing 100070, China
- Correspondence: (L.G.); (Y.W.)
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41
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Benefits of VR Physical Exercise on Cognition in Older Adults with and without Mild Cognitive Decline: A Systematic Review of Randomized Controlled Trials. Healthcare (Basel) 2021; 9:healthcare9070883. [PMID: 34356259 PMCID: PMC8306887 DOI: 10.3390/healthcare9070883] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 06/25/2021] [Accepted: 07/09/2021] [Indexed: 11/17/2022] Open
Abstract
It is well known that physical exercise has beneficial effects on cognitive function in older adults. Recently, several physical exercise programs with virtual reality (VR) have been proposed to support physical exercise benefits. However, it is still unclear whether VR physical exercise (VR-PE) has positive effects on cognitive function in older adults. The purpose of this study was to conduct a systematic review (SR) of the effects of VR-PE on cognitive function in older adults with and without cognitive decline. We used academic databases to search for research papers. The criteria were intervention study using any VR-PE, participants were older adults with and without mild cognitive decline (not dementia), and cognitive functions were assessed. We found that 6 of 11 eligible studies reported the significant benefits of the VR-PE on a wide range of cognitive functions in aging populations. The SR revealed that VR-PE has beneficial effects on the inhibition of executive functions in older adults with and without mild cognitive decline. Moreover, VR-PE selectively leads to improvements in shifting and general cognitive performance in healthy older adults. The SR suggests that VR-PE could be a successful approach to improve cognitive function in older adults with and without cognitive decline.
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42
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A Randomized Controlled Trial Protocol to Test the Efficacy of a Dual-Task Multicomponent Exercise Program vs. a Simple Program on Cognitive and Fitness Performance in Elderly People. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18126507. [PMID: 34208766 PMCID: PMC8296364 DOI: 10.3390/ijerph18126507] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Revised: 06/09/2021] [Accepted: 06/11/2021] [Indexed: 11/17/2022]
Abstract
BACKGROUND The necessity of improve the life quality in elderly people is well-known. The aim of this study was to determine the effects of physical and cognitive training programs, as well as their combination on the cognitive functions and physical capacities in women over 80 years old. METHODS Forty-three women took part in this study (80.86 ± 5.03 years). They were divided into four groups (three experimental groups and one control group). Experimental group 1 performed cognitive training. Experimental group 2 did physical-cognitive training, and Experimental Group 3 accomplished physical training. All of training programs had duration of eight weeks (five sessions of 60 min per week). We measured cognitive variables with the Stroop test, D2 test, and Trail Making test. Physical variables were measured with handgrip strength, Minute Step Test, and visual-acoustic reaction time. RESULTS Control group reduces his physical and cognitive capacities, while the three experimental groups increase these capacities. We found a strong correlation between the increase of physical and cognitive capacities. CONCLUSION Eight weeks of training physical, cognitive or mixed, increased physical and cognitive functions of elderly people which may reduce the negative effects of the aging process.
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43
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Wardlaw JM, Debette S, Jokinen H, De Leeuw FE, Pantoni L, Chabriat H, Staals J, Doubal F, Rudilosso S, Eppinger S, Schilling S, Ornello R, Enzinger C, Cordonnier C, Taylor-Rowan M, Lindgren AG. ESO Guideline on covert cerebral small vessel disease. Eur Stroke J 2021; 6:CXI-CLXII. [PMID: 34414301 PMCID: PMC8370079 DOI: 10.1177/23969873211012132] [Citation(s) in RCA: 68] [Impact Index Per Article: 22.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Accepted: 04/02/2021] [Indexed: 12/11/2022] Open
Abstract
'Covert' cerebral small vessel disease (ccSVD) is common on neuroimaging in persons without overt neurological manifestations, and increases the risk of future stroke, cognitive impairment, dependency, and death. These European Stroke Organisation (ESO) guidelines provide evidence-based recommendations to assist with clinical decisions about management of ccSVD, specifically white matter hyperintensities and lacunes, to prevent adverse clinical outcomes. The guidelines were developed according to ESO standard operating procedures and Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) methodology. We prioritised the clinical outcomes of stroke, cognitive decline or dementia, dependency, death, mobility and mood disorders, and interventions of blood pressure lowering, antiplatelet drugs, lipid lowering, lifestyle modifications, glucose lowering and conventional treatments for dementia. We systematically reviewed the literature, assessed the evidence, formulated evidence-based recommendations where feasible, and expert consensus statements. We found little direct evidence, mostly of low quality. We recommend patients with ccSVD and hypertension to have their blood pressure well controlled; lower blood pressure targets may reduce ccSVD progression. We do not recommend antiplatelet drugs such as aspirin in ccSVD. We found little evidence on lipid lowering in ccSVD. Smoking cessation is a health priority. We recommend regular exercise which may benefit cognition, and a healthy diet, good sleep habits, avoiding obesity and stress for general health reasons. In ccSVD, we found no evidence for glucose control in the absence of diabetes or for conventional Alzheimer dementia treatments. Randomised controlled trials with clinical endpoints are a priority for ccSVD.
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Affiliation(s)
- Joanna M Wardlaw
- Centre for Clinical Brain Sciences, UK Dementia Research Institute, University of Edinburgh, Edinburgh, UK
| | - Stephanie Debette
- Bordeaux Population Health Center, University of Bordeaux, INSERM, UM1219, Team VINTAGE
- Department of Neurology, Institute for Neurodegenerative Disease, Bordeaux University Hospital, Bordeaux, France
| | - Hanna Jokinen
- HUS Neurocenter, Division of Neuropsychology, Helsinki University Hospital, University of Helsinki and Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Finland
| | - Frank-Erik De Leeuw
- Radboud University Medical Center, Department of Neurology; Donders Center for Medical Neuroscience, Nijmegen, The Netherlands
| | - Leonardo Pantoni
- Stroke and Dementia Lab, 'Luigi Sacco' Department of Biomedical and Clinical Sciences, University of Milan, Milano, Italy
| | - Hugues Chabriat
- Department of Neurology, Hopital Lariboisiere, APHP, INSERM U 1161, FHU NeuroVasc, University of Paris, Paris, France
| | - Julie Staals
- Department of Neurology, School for Cardiovascular Diseases (CARIM), Maastricht UMC+, AZ Maastricht, the Netherlands
| | - Fergus Doubal
- Centre for Clinical Brain Sciences, UK Dementia Research Institute, University of Edinburgh, Edinburgh, UK
- Dept of Medicine for the Elderly, University of Edinburgh, Edinburgh, UK
| | - Salvatore Rudilosso
- Comprehensive Stroke Center, Department of Neuroscience, Hospital Clínic, Barcelona, Spain
| | - Sebastian Eppinger
- University Clinic of Neurology, Medical University of Graz, Graz, Austria
| | - Sabrina Schilling
- Bordeaux Population Health Center, University of Bordeaux, INSERM, UM1219, Team VINTAGE
| | - Raffaele Ornello
- Department of Applied Clinical Sciences and Biotechnology, University of L’Aquila, L’Aquila, Italy
| | - Christian Enzinger
- University Clinic of Neurology, Medical University of Graz, Graz, Austria
| | - Charlotte Cordonnier
- Univ. Lille, INSERM, CHU Lille, U1172, LilNCog – Lille Neuroscience & Cognition, Lille, France
| | - Martin Taylor-Rowan
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
| | - Arne G Lindgren
- Department of Clinical Sciences Lund, Neurology, Lund University; Section of Neurology, Skåne University Hospital, Lund, Sweden
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44
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Gu N, Li H, Cao X, Li T, Jiang L, Zhang H, Zhao B, Luo C, Li C. Different Modulatory Effects of Cognitive Training and Aerobic Exercise on Resting State Functional Connectivity of Entorhinal Cortex in Community-Dwelling Older Adults. Front Aging Neurosci 2021; 13:655245. [PMID: 34135749 PMCID: PMC8200543 DOI: 10.3389/fnagi.2021.655245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Accepted: 05/03/2021] [Indexed: 11/16/2022] Open
Abstract
The entorhinal cortex (EC) plays an essential role in age-related cognitive decline. However, the effect of functional connectivity (FC) changes between EC and other cerebral cortices on cognitive function remains unclear. The aim of this study was to explore the modulation of two interventions (cognitive training and aerobic exercise) on EC-FC in community-dwelling older adults. In total, 94 healthy older adults aged between 65 and 75 years were assigned to either the cognitive training or aerobic exercise group to receive 24 sessions over 12 weeks, or to a control group. Resting-state functional magnetic resonance imaging was performed at both baseline and 12-month follow-up. Compared to the cognitive training group, the aerobic exercise group showed greater EC-FC in the bilateral middle temporal gyrus, right supramarginal gyrus, left angular gyrus, and right postcentral gyrus. Compared to the control group, the cognitive training group had a decreased EC-FC in the right hippocampus, right middle temporal gyrus, left angular gyrus, and right postcentral gyrus and an increased EC-FC in the bilateral pallidum, while the aerobic exercise group showed increased EC-FC between the right medial prefrontal cortex(mPFC), bilateral pallidum, and right precuneus. Baseline EC-FC in the mPFC was positively correlated with the visuospatial/constructional index score of the Repeatable Battery for the Assessment of Neuropsychological Status. In the cognitive training group, EC-FC value changes in the right hippocampus were negatively correlated with changes in the RBANS delayed memory index score, while in the aerobic exercise group, EC-FC value changes in the left angular gyrus were positively correlated with changes in the RBANS attention index score. These findings support the hypothesis that both cognitive training and aerobic exercise can modulate EC-FC in aging populations but through different neural pathways.
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Affiliation(s)
- NanNan Gu
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Hechun Li
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, Center for Information in Medicine, School of Life Sciences and Technology, University of Electronic Science and Technology of China, Chengdu, China
| | - Xinyi Cao
- Clinical Neurocognitive Research Center, Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Ting Li
- Department of Geriatric Psychiatry, Shanghai Changning Mental Health Center, Shanghai, China
| | - Lijuan Jiang
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Han Zhang
- Institute of Brain-Intelligence Technology, Zhangjiang Lab, Shanghai, China
| | - Binglei Zhao
- Institute of Psychology and Behavioral Science, Shanghai Jiao Tong University, Shanghai, China
| | - Cheng Luo
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, Center for Information in Medicine, School of Life Sciences and Technology, University of Electronic Science and Technology of China, Chengdu, China
| | - Chunbo Li
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Institute of Psychology and Behavioral Science, Shanghai Jiao Tong University, Shanghai, China.,Center for Excellence in Brain Science and Intelligence Technology (CEBSIT), Chinese Academy of Sciences, Shanghai, China.,Brain Science and Technology Research Center, Shanghai Jiao Tong University, Shanghai, China
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45
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Ishihara T, Miyazaki A, Tanaka H, Fujii T, Takahashi M, Nishina K, Kanari K, Takagishi H, Matsuda T. Childhood exercise predicts response inhibition in later life via changes in brain connectivity and structure. Neuroimage 2021; 237:118196. [PMID: 34029739 DOI: 10.1016/j.neuroimage.2021.118196] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Revised: 05/19/2021] [Accepted: 05/19/2021] [Indexed: 10/21/2022] Open
Abstract
Participation in exercise during early life (i.e., childhood through adolescence) enhances response inhibition; however, it is unclear whether participation in exercise during early life positively predicts response inhibition in later life. This historical cohort study was designed to clarify whether participation in exercise (e.g., structured sports participation) during early life predicts response inhibition in adulthood and if so, to reveal the brain connectivity and cortical structures contributing to this association. We analyzed data derived from 214 participants (women = 104, men = 110; age: 26‒69 years). Results indicated that participation in exercise during childhood (before entering junior high school; ≤ 12 years old) significantly predicted better response inhibition. No such association was found if exercise participation took place in early adolescence or later (junior high school or high school; ≥ 12 years old). The positive association of exercise participation during childhood with response inhibition was moderated by decreased structural and functional connectivity in the frontoparietal (FPN), cingulo-opercular (CON), and default mode networks (DMN), and increased inter-hemispheric structural networks. Greater cortical thickness and lower levels of dendritic arborization and density in the FPN, CON, and DMN also moderated this positive association. Our results suggest that participation in exercise during childhood positively predicts response inhibition later in life and that this association can be moderated by changes in neuronal circuitry, such as increased cortical thickness and efficiency, and strengthened inter-hemispheric connectivity.
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Affiliation(s)
- Toru Ishihara
- Graduate School of Human Development and Environment, Kobe University, 3-11 Tsurukabuto, Nada-ku, Kobe 657-8501, Japan; Tamagawa University Brain Science Institute, 6-1-1 Tamagawagakuen, Machida, Tokyo 194-8610, Japan
| | - Atsushi Miyazaki
- Tamagawa University Brain Science Institute, 6-1-1 Tamagawagakuen, Machida, Tokyo 194-8610, Japan
| | - Hiroki Tanaka
- Tamagawa University Brain Science Institute, 6-1-1 Tamagawagakuen, Machida, Tokyo 194-8610, Japan; Japan Society for the Promotion of Science, 5-3-1 Kojimachi, Chiyoda-ku, Tokyo 102-0083, Japan
| | - Takayuki Fujii
- Tamagawa University Brain Science Institute, 6-1-1 Tamagawagakuen, Machida, Tokyo 194-8610, Japan
| | - Muneyoshi Takahashi
- Tamagawa University Brain Science Institute, 6-1-1 Tamagawagakuen, Machida, Tokyo 194-8610, Japan
| | - Kuniyuki Nishina
- Tamagawa University Brain Science Institute, 6-1-1 Tamagawagakuen, Machida, Tokyo 194-8610, Japan
| | - Kei Kanari
- Tamagawa University Brain Science Institute, 6-1-1 Tamagawagakuen, Machida, Tokyo 194-8610, Japan
| | - Haruto Takagishi
- Tamagawa University Brain Science Institute, 6-1-1 Tamagawagakuen, Machida, Tokyo 194-8610, Japan
| | - Tetsuya Matsuda
- Tamagawa University Brain Science Institute, 6-1-1 Tamagawagakuen, Machida, Tokyo 194-8610, Japan.
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Crockett RA, Falck RS, Dao E, Hsu CL, Tam R, Alkeridy W, Liu-Ambrose T. Sweat the Fall Stuff: Physical Activity Moderates the Association of White Matter Hyperintensities With Falls Risk in Older Adults. Front Hum Neurosci 2021; 15:671464. [PMID: 34093153 PMCID: PMC8175638 DOI: 10.3389/fnhum.2021.671464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Accepted: 04/29/2021] [Indexed: 11/26/2022] Open
Abstract
Background: Falls in older adults are a major public health problem. White matter hyperintensities (WMHs) are highly prevalent in older adults and are a risk factor for falls. In the absence of a cure for WMHs, identifying potential strategies to counteract the risk of WMHs on falls are of great importance. Physical activity (PA) is a promising countermeasure to reduce both WMHs and falls risk. However, no study has yet investigated whether PA attenuates the association of WMHs with falls risk. We hypothesized that PA moderates the association between WMHs and falls risk. Methods: Seventy-six community-dwelling older adults aged 70–80 years old were included in this cross-sectional study. We indexed PA using the Physical Activity Score for the Elderly (PASE) Questionnaire. Falls risk was assessed using the Physiological Profile Assessment (PPA), and WMH volume (mm3) was determined by an experienced radiologist on T2-weighted and PD-weighted MRI scans. We first examined the independent associations of WMH volume and PASE score with PPA. Subsequently, we examined whether PASE moderated the relationship between WMH volume and PPA. We plotted simple slopes to interpret the interaction effects. Age, sex, and Montreal Cognitive Assessment (MoCA) score were included as covariates in all models. Results: Participants had a mean age of 74 years (SD = 3 years) and 54 (74%) were female. Forty-nine participants (66%) had a Fazekas score of 1, 19 (26%) had a score of 2, and 6 (8%) a score of 3. Both PASE (β = −0.26 ± 0.11; p = 0.022) and WMH volume (β = 0.23 ± 0.11; p = 0.043) were each independently associated with PPA score. The interaction model indicated that PASE score moderated the association between WMH volume and PPA (β = −0.27 ± 0.12; p = 0.030), whereby higher PASE score attenuated the association between WMHs and falls risk. Conclusion: PA is an important moderator of falls risk. Importantly, older adults with WMH can reduce their risk of falls by increasing their PA.
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Affiliation(s)
- Rachel A Crockett
- Aging, Mobility, and Cognitive Neuroscience Laboratory, The University of British Columbia, Vancouver, BC, Canada.,Djavad Mowafaghian Centre for Brain Health, The University of British Columbia, Vancouver, BC, Canada.,Centre for Hip Health and Mobility, Vancouver Coastal Health Research Institute, Vancouver, BC, Canada
| | - Ryan S Falck
- Aging, Mobility, and Cognitive Neuroscience Laboratory, The University of British Columbia, Vancouver, BC, Canada.,Djavad Mowafaghian Centre for Brain Health, The University of British Columbia, Vancouver, BC, Canada.,Centre for Hip Health and Mobility, Vancouver Coastal Health Research Institute, Vancouver, BC, Canada
| | - Elizabeth Dao
- Aging, Mobility, and Cognitive Neuroscience Laboratory, The University of British Columbia, Vancouver, BC, Canada.,Djavad Mowafaghian Centre for Brain Health, The University of British Columbia, Vancouver, BC, Canada.,Centre for Hip Health and Mobility, Vancouver Coastal Health Research Institute, Vancouver, BC, Canada.,Department of Radiology, The University of British Columbia, Vancouver, BC, Canada
| | - Chun Liang Hsu
- Hinda and Arthur Marcus Institute for Aging Research, Hebrew SeniorLife, Boston, MA, United States.,Harvard Medical School, Harvard University, Boston, MA, United States
| | - Roger Tam
- Department of Radiology, The University of British Columbia, Vancouver, BC, Canada.,School of Biomedical Engineering, The University of British Columbia, Vancouver, BC, Canada
| | - Walid Alkeridy
- Djavad Mowafaghian Centre for Brain Health, The University of British Columbia, Vancouver, BC, Canada.,Centre for Hip Health and Mobility, Vancouver Coastal Health Research Institute, Vancouver, BC, Canada.,Division of Geriatrics, Department of Medicine, The University of British Columbia, Vancouver, BC, Canada.,College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Teresa Liu-Ambrose
- Aging, Mobility, and Cognitive Neuroscience Laboratory, The University of British Columbia, Vancouver, BC, Canada.,Djavad Mowafaghian Centre for Brain Health, The University of British Columbia, Vancouver, BC, Canada.,Centre for Hip Health and Mobility, Vancouver Coastal Health Research Institute, Vancouver, BC, Canada
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47
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Uijen IL, Aaronson JA, Karssemeijer EGA, Olde Rikkert MGM, Kessels RPC. Individual Differences in the Effects of Physical Activity on Cognitive Function in People with Mild to Moderate Dementia. J Alzheimers Dis 2021; 74:435-439. [PMID: 32039840 PMCID: PMC7175929 DOI: 10.3233/jad-190606] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
The aim of this study was to investigate whether the effect of physical activity on cognitive function in persons with dementia is moderated by patient characteristics as Apolipoprotein E and dementia type. We included 101 individuals with dementia and calculated the reliable change index to determine the change in global cognition, executive function, episodic memory, working memory, and processing speed before and after a 12-week exercise training. We found a higher treatment-related benefit in episodic memory in persons with non-Alzheimer’s disease compared to persons with Alzheimer’s disease, and in executive function in individuals with better baseline cognitive function.
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Affiliation(s)
- Iris L Uijen
- Department of Geriatric Medicine & Radboudumc Alzheimer Center, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Justine A Aaronson
- OLVG Hospital, Amsterdam, The Netherlands.,Department of Medical Psychology & Radboudumc Alzheimer Center, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Esther G A Karssemeijer
- Department of Geriatric Medicine & Radboudumc Alzheimer Center, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Marcel G M Olde Rikkert
- Department of Geriatric Medicine & Radboudumc Alzheimer Center, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Roy P C Kessels
- Department of Medical Psychology & Radboudumc Alzheimer Center, Radboud University Medical Center, Nijmegen, The Netherlands.,Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, The Netherlands.,Vincent van Gogh Institute for Psychiatry, Venray, The Netherlands
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48
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Yogev-Seligmann G, Eisenstein T, Ash E, Giladi N, Sharon H, Nachman S, Bregman N, Kodesh E, Hendler T, Lerner Y. Neurocognitive Plasticity Is Associated with Cardiorespiratory Fitness Following Physical Exercise in Older Adults with Amnestic Mild Cognitive Impairment. J Alzheimers Dis 2021; 81:91-112. [PMID: 33720893 DOI: 10.3233/jad-201429] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Aerobic training has been shown to promote structural and functional neurocognitive plasticity in cognitively intact older adults. However, little is known about the neuroplastic potential of aerobic exercise in individuals at risk of Alzheimer's disease (AD) and dementia. OBJECTIVE We aimed to explore the effect of aerobic exercise intervention and cardiorespiratory fitness improvement on brain and cognitive functions in older adults with amnestic mild cognitive impairment (aMCI). METHODS 27 participants with aMCI were randomized to either aerobic training (n = 13) or balance and toning (BAT) control group (n = 14) for a 16-week intervention. Pre- and post-assessments included functional MRI experiments of brain activation during associative memory encoding and neural synchronization during complex information processing, cognitive evaluation using neuropsychological tests, and cardiorespiratory fitness assessment. RESULTS The aerobic group demonstrated increased frontal activity during memory encoding and increased neural synchronization in higher-order cognitive regions such as the frontal cortex and temporo-parietal junction (TPJ) following the intervention. In contrast, the BAT control group demonstrated decreased brain activity during memory encoding, primarily in occipital, temporal, and parietal areas. Increases in cardiorespiratory fitness were associated with increases in brain activationin both the left inferior frontal and precentral gyri. Furthermore, changes in cardiorespiratory fitness were also correlated with changes in performance on several neuropsychological tests. CONCLUSION Aerobic exercise training may result in functional plasticity of high-order cognitive areas, especially, frontal regions, among older adults at risk of AD and dementia. Furthermore, cardiorespiratory fitness may be an important mediating factor of the observed changes in neurocognitive functions.
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Affiliation(s)
- Galit Yogev-Seligmann
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Sagol Brain Institute, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Tamir Eisenstein
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Sagol Brain Institute, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Elissa Ash
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Department of Neurology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Nir Giladi
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Department of Neurology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.,Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
| | - Haggai Sharon
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Sagol Brain Institute, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.,Pain Management & Neuromodulation Centre, Guy's & St Thomas' NHS Foundation Trust, London, UK.,Institute of Pain Medicine, Department of Anesthesiology and Critical Care Medicine, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Shikma Nachman
- Sagol Brain Institute, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Noa Bregman
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Department of Neurology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Einat Kodesh
- Department of Physical Therapy Faculty of Social Welfare & Health Sciences, University of Haifa, Haifa, Israel
| | - Talma Hendler
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Sagol Brain Institute, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.,Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel.,School of Psychological Sciences, Tel Aviv University, Tel Aviv, Israel
| | - Yulia Lerner
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Sagol Brain Institute, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.,Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
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49
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Bray NW, Pieruccini-Faria F, Bartha R, Doherty TJ, Nagamatsu LS, Montero-Odasso M. The effect of physical exercise on functional brain network connectivity in older adults with and without cognitive impairment. A systematic review. Mech Ageing Dev 2021; 196:111493. [PMID: 33887281 DOI: 10.1016/j.mad.2021.111493] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Revised: 04/09/2021] [Accepted: 04/13/2021] [Indexed: 12/14/2022]
Abstract
INTRODUCTION Neurodegeneration is a biproduct of aging that results in concomitant cognitive decline. Physical exercise is an emerging intervention to improve brain health. The underlying neural mechanisms linking exercise to neurodegeneration, however, are unclear. Functional brain network connectivity (FBNC) refers to neural regions that are anatomically separate but temporally synched in functional signalling. FBNC can be measured using functional Magnetic Resonance Imaging (fMRI) and is affected by neurodegeneration. METHODS We conducted a systematic review using PubMed and EMBASE to assess the effect of physical exercise on FBNC in older adults with and without cognitive impairment. RESULTS Our search yielded 1474 articles; after exclusion, 13 were included in the final review, 8 of which focused on cognitively healthy older adults. 10 studies demonstrated an increase in FBNC post-exercise intervention, while 11 studies showed improvements in secondary outcomes (cognitive and/or physical performance). One study showed significant correlations between FBNC and cognitive performance measures that significantly improved post-intervention. DISCUSSION We found evidence that physical exercise increases FBNC. When assessing the association between FBNC with physical and cognitive functioning, careful consideration must be given to variability in exercise parameters, neural regions of interest and networks examined, and heterogeneity in methodological approaches.
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Affiliation(s)
- Nick W Bray
- Faculty of Health Sciences, School of Kinesiology, Western University, London, ON, Canada; Gait and Brain Lab, Lawson Health Research Institute, Parkwood Institute, London, ON, Canada.
| | - Frederico Pieruccini-Faria
- Gait and Brain Lab, Lawson Health Research Institute, Parkwood Institute, London, ON, Canada; Department of Medicine and Division of Geriatric Medicine, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada.
| | - Robert Bartha
- Department of Medical Biophysics, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada; Robarts Research Institute, Western University, London, ON, Canada.
| | - Timothy J Doherty
- Faculty of Health Sciences, School of Kinesiology, Western University, London, ON, Canada; Neuromuscular Function Lab, Lawson Health Research Institute, Parkwood Institute, London, ON, Canada; Department of Clinical Neurological Sciences, Department of Physical Medicine and Rehabilitation, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada.
| | - Lindsay S Nagamatsu
- Faculty of Health Sciences, School of Kinesiology, Western University, London, ON, Canada; Exercise, Mobility and Brain Health Lab, Western University, London, ON, Canada; Brain and Mind Institute, Western University, London, ON, Canada.
| | - Manuel Montero-Odasso
- Faculty of Health Sciences, School of Kinesiology, Western University, London, ON, Canada; Gait and Brain Lab, Lawson Health Research Institute, Parkwood Institute, London, ON, Canada; Department of Medicine and Division of Geriatric Medicine, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada; Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada.
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50
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Yu Q, Herold F, Becker B, Klugah-Brown B, Zhang Y, Perrey S, Veronese N, Müller NG, Kramer AF, Zou L. Cognitive benefits of exercise interventions: an fMRI activation likelihood estimation meta-analysis. Brain Struct Funct 2021; 226:601-619. [PMID: 33675397 DOI: 10.1007/s00429-021-02247-2] [Citation(s) in RCA: 43] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Accepted: 02/26/2021] [Indexed: 12/13/2022]
Abstract
Despite a growing number of functional MRI studies reporting exercise-induced changes during cognitive processing, a systematic determination of the underlying neurobiological pathways is currently lacking. To this end, our neuroimaging meta-analysis included 20 studies and investigated the influence of physical exercise on cognition-related functional brain activation. The overall meta-analysis encompassing all experiments revealed physical exercise-induced changes in the left parietal lobe during cognitive processing. Subgroup analysis further revealed that in the younger-age group (< 35 years old) physical exercise induced more widespread changes in the right hemisphere, whereas in the older-age group (≥ 35 years old) exercise-induced changes were restricted to the left parietal lobe. Subgroup analysis for intervention duration showed that shorter exercise interventions induced changes in regions connected with frontoparietal and default mode networks, whereas regions exhibiting effects of longer interventions connected with frontoparietal and dorsal attention networks. Our findings suggest that physical exercise interventions lead to changes in functional activation patterns primarily located in precuneus and associated with frontoparietal, dorsal attention and default mode networks.
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Affiliation(s)
- Qian Yu
- Exercise and Mental Health Laboratory, School of Psychology, Shenzhen University, Shenzhen, 518060, China
| | - Fabian Herold
- Research Group Neuroprotection, German Center for Neurodegenerative Diseases (DZNE), Leipziger Str. 44, 39120, Magdeburg, Germany
| | - Benjamin Becker
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for Neuroinformation, University of Electronic Science and Technology of China, Chengdu, 610054, Sichuan, China
| | - Ben Klugah-Brown
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for Neuroinformation, University of Electronic Science and Technology of China, Chengdu, 610054, Sichuan, China
| | - Yanjie Zhang
- Exercise and Mental Health Laboratory, School of Psychology, Shenzhen University, Shenzhen, 518060, China
| | - Stephane Perrey
- , EuroMov Digital Health in Motion, Univ Montpellier, IMT Mines Ales, Montpellier, France
| | - Nicola Veronese
- Primary Care Department, Azienda ULSS 3 (Unità Locale Socio Sanitaria) Serenissima, Dolo-Mirano District, Venice, Italy
| | - Notger G Müller
- Research Group Neuroprotection, German Center for Neurodegenerative Diseases (DZNE), Leipziger Str. 44, 39120, Magdeburg, Germany
| | - Arthur F Kramer
- Center for Cognitive and Brain Health, Department of Psychology, Northeastern University, Boston, MA, 02115, USA.,Beckman Institute, University of Illinois At Urbana-Champaign, Champaign, IL, 61801, USA
| | - Liye Zou
- Exercise and Mental Health Laboratory, School of Psychology, Shenzhen University, Shenzhen, 518060, China.
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