A Six-Month Cognitive-Motor and Aerobic Exercise Program Improves Executive Function in Persons with an Objective Cognitive Impairment: A Pilot Investigation Using the Antisaccade Task

A Comparison of Two Multi-Tasking Approaches to Cognitive Training in Cardiac Surgery Patients

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.

Look into my eyes: What can eye-based measures tell us about the relationship between physical activity and cognitive performance?

BACKGROUND

There is a growing interest to understand the neurobiological mechanisms that drive the positive associations of physical activity and fitness with measures of cognitive performance. To better understand those mechanisms, several studies have employed eye-based measures (e.g., eye movement measures such as saccades, pupillary measures such as pupil dilation, and vascular measures such as retinal vessel diameter) deemed to be proxies for specific neurobiological mechanisms. However, there is currently no systematic review providing a comprehensive overview of these studies in the field of exercise-cognition science. Thus, this review aimed to address that gap in the literature.

METHODS

To identify eligible studies, we searched 5 electronic databases on October 23, 2022. Two researchers independently extracted data and assessed the risk of bias using a modified version of the Tool for the assEssment of Study qualiTy and reporting in EXercise (TESTEX scale, for interventional studies) and the critical appraisal tool from the Joanna Briggs Institute (for cross-sectional studies).

RESULTS

Our systematic review (n = 35 studies) offers the following main findings: (a) there is insufficient evidence available to draw solid conclusions concerning gaze-fixation-based measures; (b) the evidence that pupillometric measures, which are a proxy for the noradrenergic system, can explain the positive effect of acute exercise and cardiorespiratory fitness on cognitive performance is mixed; (c) physical training- or fitness-related changes of the cerebrovascular system (operationalized via changes in retinal vasculature) are, in general, positively associated with cognitive performance improvements; (d) acute and chronic physical exercises show a positive effect based on an oculomotor-based measure of executive function (operationalized via antisaccade tasks); and (e) the positive association between cardiorespiratory fitness and cognitive performance is partly mediated by the dopaminergic system (operationalized via spontaneous eye-blink rate).

CONCLUSION

This systematic review offers confirmation that eye-based measures can provide valuable insight into the neurobiological mechanisms that may drive positive associations between physical activity and fitness and measures of cognitive performance. However, due to the limited number of studies utilizing specific methods for obtaining eye-based measures (e.g., pupillometry, retinal vessel analysis, spontaneous eye blink rate) or investigating a possible dose-response relationship, further research is necessary before more nuanced conclusions can be drawn. Given that eye-based measures are economical and non-invasive, we hope this review will foster the future application of eye-based measures in the field of exercise-cognition science.

Effects of computer-based cognitive training combined with physical training for older adults with cognitive impairment: A four-arm randomized controlled trial

Objective

Combined physical (PHY) and cognitive (COG) training in sequential (SEQ) and simultaneous (SIMUL) sessions may delay the progression of cognitive impairment. To date, no study has directly compared in older adults with cognitive impairment the effects of COG training, PHY training, SEQ motor-cognitive training and SIMUL motor-cognitve training on specific indices of cognitive performance and activities of daily living (ADL). The purpose of this study was to determine whether SEQ and SIMUL motor-cognitive training can improve treatment outcomes compared with PHY or COG training alone. We also aimed to compare the effects of SEQ versus SIMUL motor-cognitive training on cognitive functions and instrumental ADL (IADL) in older adults with cognitive impairment.

Methods

A cluster randomized controlled trial was conducted. Eighty older adults with cognitive impairment were randomly assigned to COG, PHY, SEQ or SIMUL training groups. The intervention consisted of 90-min training sessions, totaling 36 sessions. Outcome measures were the Montreal Cognitive Assessment, three subtests of the Wechsler Memory Scale (WMS) and the Lawton IADL scale.

Results

Significant interaction effects between group and time were found in WMS-spatial span (p = 0.04) and WMS-word lists (p = 0.041). For WMS-spatial span, the SIMUL group showed outperformed the COG (p = 0.039), PHY (p = 0.010) and SEQ groups (p = 0.017). For WMS-word lists, the SEQ group improve more than COG (p = 0.013), PHY (p = 0.030) and SIMUL (p = 0.019) groups. No significant differences were found in IADL performance among four groups (p = 0.645).

Conclusions

Our study showed SEQ and SIMUL motor-cognitive training led to more pronounced improvements in visuospatial working memory or verbal memory compared with isolated COG or PHY training for community-based older adults with cognitive impairment. For enhancing effects on IADL, we suggest the use of sensitive measurement tools and context-enriched cognitive training involving real-life task demands.

Development of a Combined Exercise and Cognitive Stimulation Intervention for People with Mild Cognitive Impairment-Designing the MEMO_MOVE PROGRAM

Dementia patients are at high risk for the decline of both physical and cognitive capacities, resulting in an increased risk of the loss of autonomy. Exercise is regarded as a non-pharmacological therapy for dementia, considering the potential benefits of preventing cognitive decline and improving physical fitness. In this paper, we aim to describe the different design stages for an exercise program combined with cognitive stimulation for a population with mild cognitive impairment, i.e., the MEMO_MOVE program.

METHODS

The intervention design followed the Medical Research Council's guidelines for complex interventions and was structured according to the six steps in quality intervention development (6SQuID). The intervention was described considering the Template for Intervention Description and Replication (TIDieR). In order to establish the intervention characteristics, a literature review was conducted to collate and analyze previous work, which provided a summary the type of exercise that should be implemented among this population.

RESULTS

The MEMO_MOVE program was structured and described, regarding (i) inclusion of a cognitive stimulation component; (ii) the kind of cognitive stimulation; and (iii) the type of exercise, duration, frequency, intensity, and program length.

CONCLUSIONS

A systematic step-by-step process design was followed to create a specific intervention to promote physical fitness and cognitive stimulation in individuals with mild dementia.

Effectiveness of dual-task computerized cognitive training in the prevention of postoperative cognitive dysfunction in coronary bypass surgery

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.

Impact of aerobic exercise on cognitive function in patients with schizophrenia during daily care: A meta-analysis

To assess the effect of aerobic exercise (AZ) on global cognition and different cognition domains in patients with schizophrenia (SZ) in daily care. Selection of the literature was done through the Pubmed, Web of Science, Embase and Cochrane Library databases. Standardized mean difference (SMD) and 95% confidence intervals (CIs) were used to assess the effect of AZ on cognition of SZ patients. All assessment indicators were subjected to sensitivity analysis to test the stability of the result. Subgroup analysis was conducted on study type, follow-up time, supervisor and control method. Totally, 23 articles enrolling 1014 participants were included. The global cognition of SZ patients was improved after 6 months of follow-up. AE guided by an occupational therapist improved the global cognition of SZ patients. AE was associated with improved verbal learning and memory, reasoning and problem solving (SMD: 0.375, 95%CI: 0.009 to 0.741, P = 0.045). However, effects on speed of processing, attention/vigilance, work memory, visual learning and memory, social cognition were not significant. The effect of AE training on global cognition may be maintained over the long-term, and be domain specific. Patients with SZ can do AE guided by professional occupational therapist in their daily lives settings.

Increased cerebral blood flow supports a single-bout postexercise benefit to executive function: evidence from hypercapnia

A single bout of aerobic exercise improves executive function; however, the mechanism for the improvement remains unclear. One proposal asserts that an exercise-mediated increase in cerebral blood flow (CBF) enhances the efficiency of executive-related cortical structures. To examine this, participants completed separate 10-min sessions of moderate- to heavy-intensity aerobic exercise, a hypercapnic environment (i.e., 5% CO₂), and a nonexercise and nonhypercapnic control condition. The hypercapnic condition was included because it produces an increase in CBF independent of metabolic demands. An estimate of CBF was achieved via transcranial Doppler ultrasound and near-infrared spectroscopy that provided measures of middle cerebral artery blood velocity (BV) and deoxygenated hemoglobin (HHb), respectively. Exercise intensity was adjusted to match participant-specific changes in BV and HHb associated with the hypercapnic condition. Executive function was assessed before and after each session via antisaccades (i.e., saccade mirror-symmetrical to a target) because the task is mediated via the same executive networks that demonstrate task-dependent modulation following single and chronic bouts of aerobic exercise. Results showed that hypercapnic and exercise conditions were associated with comparable BV and HHb changes, whereas the control condition did not produce a change in either metric. In terms of antisaccade performance, the exercise and hypercapnic, but not control, conditions demonstrated improved postcondition reaction times (RT), and the magnitude of the hypercapnic and exercise-based increase in estimated CBF was reliably related to the postcondition improvement in RT. Accordingly, results evince that an increase in CBF represents a candidate mechanism for a postexercise improvement in executive function.NEW & NOTEWORTHY Single-bout aerobic exercise "boosts" executive function, and increased cerebral blood flow (CBF) has been proposed as a mechanism for the benefit. In this study, participants completed 10 min of aerobic exercise and 10 min of inhaling a hypercapnic gas, a manipulation known to increase CBF independently of metabolic demands. Both exercise and hypercapnic conditions improved executive function for at least 20 min. Accordingly, an increase in CBF is a candidate mechanism for the postexercise improvement in executive function.

Oculomotor Executive Dysfunction during the Early and Later Stages of Sport-Related Concussion Recovery

Executive dysfunction represents the most persistent sequela of mild traumatic brain injury. It is, however, largely unclear whether a sport-related concussion similarly contributes to a persistent executive dysfunction even when an athlete has been cleared medically for return to play. Here, individuals with a diagnosis of a sport-related concussion-and their age- and sex-matched controls-completed an oculomotor assessment during the acute and later stages of injury recovery. Prosaccades (i.e., saccade to a target) and executive-related antisaccades (i.e., saccade mirror-symmetrical to a target) were completed: (1) 2-6 days after a concussive event (initial assessment), and (2) 14-20 days after the initial oculomotor assessment when individuals were cleared for return to play (follow-up assessment). At the initial assessment, the concussed group produced antisaccade reaction times (RT) that were 93 ms longer than the control group (p < 0.001), whereas prosaccade RTs did not differ between groups (p = 0.25). At the follow-up assessment, concussed and control groups produced comparable pro- and antisaccade RTs (ps >0.31); however, the former group exhibited a continued increase in directional errors (p < 0.05). That initial assessment antisaccades-but not prosaccades-differed between groups indicates that the acute recovery of a concussion is associated with a selective executive-related oculomotor deficit, and the continued increase in directional errors at the follow-up assessment suggests that such a deficit persists even when an athlete has been cleared medically for return to play. The antisaccade task may therefore serve to assess subtle executive deficits and determine when an athlete may return to play safely.

Aerobic exercise increases cortisol awakening response in older adults

Evidence from both preclinical and clinical studies suggests aerobic exercise may dampen age-related decline in cognitive performance. Alterations in hypothalamic-pituitary-adrenal (HPA) axis function and reactivity may be a mechanism by which aerobic exercise benefits cognitive performance, and reduces perceived stress. This investigation was completed as an ancillary investigation of the Brain in Motion (BIM) study, a 6-month supervised aerobic exercise intervention. Participants were generally healthy and screened for inclusion/exclusion criteria for the parent study. Thirty-eight participants were recruited (Mean age = 65.0 [SD = 5.1]; 60% female) and the final longitudinal sample was 32 participants. Participants provided a passive drool sample at: waking, 15, 30, and 45 min post-waking to assess the cortisol awakening response (CAR) and 3, 6, 9, and 12 h post-waking to assess daily area under the curve for cortisol. Salivary cortisol was quantified by liquid chromatography coupled to tandem mass spectrometry. The exercise intervention increased CAR but no differences were observed in daily AUC. In addition, larger increases in CAR were positively associated with greater decreases in subjective stress. Thus, aerobic exercise improved the CAR in otherwise healthy, but sedentary older adults and greater improvements in CAR were associated with greater reductions in perceived stress.

Older adults elicit a single-bout post-exercise executive benefit across a continuum of aerobically supported metabolic intensities

Ten minutes of aerobic or resistance training can 'boost' executive function in older adults. Here, we examined whether the magnitude of the exercise benefit is influenced by exercise intensity. Older adults (N = 17: mean age = 73 years) completed a volitional test to exhaustion (VO_2peak) via treadmill to determine participant-specific moderate (80% of lactate threshold (LT)), heavy (15% of the difference between LT and VO_2peak) and very-heavy (50% of the difference between LT and VO_2peak) exercise intensities. Subsequently, in separate sessions all participants completed 10-min constant load single-bouts of exercise at each intensity. Pre- and post-exercise executive function were examined via the antisaccade task. Antisaccades require a saccade mirror-symmetrical to a target and extensive evidence has shown that antisaccades are supported via frontoparietal networks that demonstrate task-dependent changes following single-bout and chronic exercise. We also included a non-executive task (saccade to veridical target location; i.e., prosaccade) to determine whether a putative post-exercise benefit is specific to executive-related oculomotor control. Results showed that VO₂ and psychological ratings of perceived exertion concurrently increased with increasing exercise intensity. As well, antisaccade reaction times showed a 24 ms (i.e., 8%) reduction from pre- to post-exercise assessments (p < .001), whereas prosaccade values did not (p = .19). Most notably, the post-exercise change in antisaccade RTs did not reliably vary with exercise intensity. Further, for each exercise intensity participants' cardiorespiratory fitness level was unrelated to the magnitude of the post-exercise executive benefit (ps > .13). Accordingly, an exercise duration as brief as 10-min provides a selective benefit to executive function in older adults across the continuum of moderate to very-heavy intensities.

A post-exercise facilitation of executive function is independent of aerobically supported metabolic costs

A single-bout of aerobic or resistance training facilitates executive function and is a benefit thought to be specific to exercise durations greater than 20 min. We sought to determine whether an executive benefit is observed for a session as brief as 10-min, and whether distinct and participant-specific exercise intensities - and associated metabolic costs - influence the magnitude of the benefit. Participants completed exercise sessions - via cycle ergometer - at moderate (80% of lactate threshold [LT]), heavy (15% of the difference between LT and VO_{2 peak}) and very-heavy (50% of the difference between LT and VO_{2 peak}) intensities determined via an incremental ramp test to volitional exhaustion. Pre- and post-exercise executive function was examined via antisaccades - an executive task requiring a saccade mirror-symmetrical to a visual stimulus. Antisaccades are an ideal tool for examining post-exercise executive changes due to the resolution of eye-tracking and because the task is mediated via the same frontoparietal networks as modified following single-bout and chronic exercise. A non-executive prosaccade task (i.e., saccade to veridical target location) was also completed to determine if the putative post-exercise benefit was specific to executive function. Results showed a 20 ms reduction in pre- to post-exercise antisaccade RTs (p < .02) and was independent of exercise intensity, whereas no such change was observed for prosaccades (p = .14). Furthermore, the antisaccade benefit occurred without concomitant changes in directional errors or endpoint accuracy; that is, participants did not decrease their post-exercise RTs at the cost of increased planning and execution errors (ps > 0.34). Accordingly, we propose that an exercise duration as brief as 10-min provides a reliable benefit to executive function and is an effect observed across the continuum of moderate to very-heavy intensities.

Effect of interactive cognitive motor training on gait and balance among older adults: A randomized controlled trial

BACKGROUND

Aging is a normal degenerative process that results in a decline in the gait and balance performance of older adults. Interactive cognitive motor training is an intervention that integrates cognitive and motor tasks to promote individuals' physical and cognitive fall risk factors. However, the additive effects of the interactive cognitive motor training on objective quantitative data and comprehensive descriptions of gait and balance warrants further investigation.

OBJECTIVES

To investigate the effect of interactive cognitive motor training on older adults' gait and balance from immediate to long-term time points.

DESIGN

A double-blind randomized control trial.

SETTINGS

Four senior service centers and community service centers in Taiwan.

PARTICIPANTS

62 older adults who met the inclusion criteria.

METHODS

The study participants were older adults without cognitive impairment, and they were randomly allocated to the experimental group or active control group. In both groups, older adults participated in three sessions of 30-min training per week for a total of 8 weeks, with the total number of training sessions being 24. The primary outcome was gait performance, which was measured using objective and subjective indicators. iWALK was used as an objective indicator to measure pace and dynamic stability; the Functional Gait Assessment was employed as a subjective indicator. The secondary outcome was balance performance, which was measured using iSWAY. A generalized estimating equation was used to identify whether the results of the two groups differ after receiving different intervention measures; the results were obtained from immediate to long-term posttests.

RESULTS

Stride length in the pace category of the experimental group improved significantly in immediate posttest (p = 0.01), 3-month follow-up (p = 0.01), and 6-month follow-up (p = 0.04). The range of motion of the leg exhibited significant improvement in immediate posttest (p = 0.04) and 3-month follow-up (p = 0.04). The Functional Gait Assessment result indicated that statistically significant improvement was observed in immediate posttest (p = 0.02) and 12-month follow-up (p = 0.01). The results of balance performance showed that the experimental group attained statistically significant improvement in centroid frequency in the immediate posttest (p = 0.02).

CONCLUSIONS

The research results validated that the 24 sessions of the interactive cognitive motor training intervention significantly improved gait and balance performance. Future studies should extend the sample to communities to promote the gait and balance performance of community-dwelling older adults without cognitive impairment and reduce their risk of falling and developing gait-related diseases.

Results From a Feasibility Study of Square-Stepping Exercise in Older Adults With Type 2 Diabetes and Self-Reported Cognitive Complaints to Improve Global Cognitive Functioning

OBJECTIVES

Adults with type 2 diabetes mellitus have an increased risk for dementia. Therefore, we proposed an intervention called the Square-stepping exercise (SSE) program to mitigate this risk. Our primary aim was to determine the feasibility of SSE in adults with type 2 diabetes and self-reported cognitive complaints. Our secondary aim was to determine whether 24 weeks of SSE improved cognition. Our tertiary aim was to determine whether SSE improved antisaccade reaction time, which is a measure of executive-related oculomotor control.

METHODS

Adults >49 years with type 2 diabetes and self-reported cognitive complaints were randomized to an SSE group (2×/week for 24 weeks of SSE) or a control group. Feasibility was assessed by recruitment and attendance. Participants were assessed at baseline, after 12 weeks and after 24 weeks for global cognitive function, memory, planning, reasoning and concentration via a computer-based cognitive battery (Cambridge Brain Sciences) and antisaccade reaction time (at baseline and 24 weeks).

RESULTS

Participants in the SSE group were (mean [SD]): 65.9 (5.2) years old; 33% female; body mass index 33.3 kg/m² (4.8) (n=12). Participants in the control group were 71.2 (6.9) years old; 31% female; body mass index 31.9 kg/m² (4.6) (n=13). Over 24 weeks, attendance was 70.2% (SD 17.2) for 4/12 participants. There were 4 withdrawals and 1 adverse event. There were no differences in global cognitive functioning. The SSE group improved in planning domain change scores between 12 and 24 weeks (F=5.8, p=0.03, η_p²=0.28) compared to controls. In the SSE group, we found a nonsignificant improvement in antisaccade reaction time of 38 ms (SD 16), n=2, compared to 9 ms (SD 45) in the control group, n=8.

CONCLUSIONS

SSE should be evaluated further to improve its feasibility in older adults with type 2 diabetes. This study provides preliminary evidence that SSE improves executive function in adults with type 2 diabetes and self-reported cognitive complaints.

Long-Term Maintenance of Executive-Related Oculomotor Improvements in Older Adults with Self-Reported Cognitive Complaints Following a 24-Week Multiple Modality Exercise Program

Adults (≥55 years) with self-reported cognitive complaints (sCC) were randomized to: multiple-modality exercise (M2), or multiple-modality plus mind-motor exercise (M4), for 24-weeks. Participants (n = 58) were assessed on antisaccade reaction time (RT) to examine executive-related oculomotor control and self-reported physical activity (PA) at pre-intervention (V0), post-intervention (V1), and 52-weeks follow-up (V2). We previously reported significant improvements in antisaccade RT of 23 ms at V1, in both groups. We now report maintenance of antisaccade RT improvement from V1 to V2, t(57) = 0.8, p = 0.45, and improved PA from V1 to V2, t(56) = -2.4, p = 0.02. Improvements in executive-related oculomotor control attained at V1 were maintained at V2.

A 24-Week Multi-Modality Exercise Program Improves Executive Control in Older Adults with a Self-Reported Cognitive Complaint: Evidence from the Antisaccade Task

Exercise programs involving aerobic and resistance training (i.e., multiple-modality) have shown promise in improving cognition and executive control in older adults at risk, or experiencing, cognitive decline. It is, however, unclear whether cognitive training within a multiple-modality program elicits an additive benefit to executive/cognitive processes. This is an important question to resolve in order to identify optimal training programs that delay, or ameliorate, executive deficits in persons at risk for further cognitive decline. In the present study, individuals with a self-reported cognitive complaint (SCC) participated in a 24-week multiple-modality (i.e., the M2 group) exercise intervention program. In addition, a separate group of individuals with a SCC completed the same aerobic and resistance training as the M2 group but also completed a cognitive-based stepping task (i.e., multiple-modality, mind-motor intervention: M4 group). Notably, pre- and post-intervention executive control was examined via the antisaccade task (i.e., eye movement mirror-symmetrical to a target). Antisaccades are an ideal tool for the study of individuals with subtle executive deficits because of its hands- and language-free nature and because the task's neural mechanisms are linked to neuropathology in cognitive decline (i.e., prefrontal cortex). Results showed that M2 and M4 group antisaccade reaction times reliably decreased from pre- to post-intervention and the magnitude of the decrease was consistent across groups. Thus, multi-modality exercise training improved executive performance in persons with a SCC independent of mind-motor training. Accordingly, we propose that multiple-modality training provides a sufficient intervention to improve executive control in persons with a SCC.

Executive-related oculomotor control is improved following a 10-min single-bout of aerobic exercise: Evidence from the antisaccade task

Previous work has shown that a single-bout of moderate-to-vigorous intensity exercise improves task-specific activity within frontoparietal networks and produces a short-term 'boost' to executive-related cognitive control - an effect in healthy young adults that is reported to be selective to exercise durations of 20min or greater. The present study sought to determine whether such a 'boost' extends to an exercise duration as brief as 10min. Healthy young adults performed a 10-min single-bout of moderate-to-vigorous intensity aerobic exercise (i.e., via a cycle ergometer) and pre- and post-exercise executive control was examined via the antisaccade task. Antisaccades are an executive task requiring a goal-directed eye movement (i.e., a saccade) mirror-symmetrical to a visual stimulus. The hands- and language-free nature of antisaccades coupled with the temporal precision of eye-tracking technology make it an ideal tool for identifying executive performance changes. Moreover, an extensive literature has shown that antisaccades are mediated via frontoparietal networks that are modulated following single-bout and chronic exercise training. Results showed that antisaccade reaction time (RT) reliably decreased by 27ms from pre- to post-exercise assessments. Further, the percentage of antisaccade directional errors did not reliably vary from the pre- (13%) to post-exercise (9%) assessments - a result indicating that the RT improvement was unrelated to a speed-accuracy trade-off. A follow-up experiment involving antisaccade sessions separated by a non-exercise interval did not show a similar RT modulation. Thus, a 10-min bout of moderate-to-vigorous intensity aerobic exercise benefits executive-related oculomotor control, and is a finding we attribute to an exercise-based increase in attention/arousal and/or improved task-specific activity within the frontoparietal networks supporting antisaccades.

What do we know from clinical trials on exercise and Alzheimer's disease?

Alzheimer's disease (AD) is the most common form of dementia in elderly with major symptoms of a general term for memory loss and other intellectual abilities impairment which are serious enough to interfere with daily life. While there is no treatment can prevent and revise the cognitive function impairment in AD, physical activity becomes a potential beneficial intervention for AD. Multiple evidences suggested that exercise in general plays beneficial roles in improving brain function. Most common mechanisms of exercise-induced enhancement of brain function are including alteration of neurogenesis, neuron plasticity, neuronal signaling and receptors, as well as neuronal networks. This mini review includes most recent clinical studies and focuses on the effects of physical exercise, cognitive stimulation, and combination of both physical and cognitive training on protection and rescue cognitive decline in people with AD.