轻度认知障碍患者有氧舞蹈干预后认知功能和静息态fMRI低频振幅的改变
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摘要
目的:本研究针对于轻度认知障碍患者(MCI)采用一套自主编制有氧舞蹈进行干预,探讨其对患者认知功能和静息态fMRI低频振幅(ALFF)的影响。方法:将38例MCI患者随机分组:训练组(19例)和对照组(19例)。分别接受不同干预方式。对于训练组,给予有氧舞蹈进行干预,共3个月;对照组则以健康教育为主,周期与训练组相同。期间所有患者均未接受任何药物治疗。在接受干预前对所有患者进行评分,了解他们的认知情况,评估工具为认知功能量表,同时进行静息态fMRI扫描,干预结束后再次进行评分和扫描。了解患者脑功能活动情况,根据低频振幅图像结果进行分析。结果:训练组干预完成后,认知功能量表结果显示训练组的简易精神状态评分、蒙特利尔认知评估量表、韦氏逻辑记忆和符号数字模式测试评分显著改善,与干预前相比差异显著。两组患者干预前后韦氏逻辑记忆评分皆发生变化,其中以训练组更为明显,相比有显著差异(P<0.05)。对照组的各项认知功能量表评分均无显著差异。静息态fMRI扫描结果显示,训练组干预前后发生明显变化,其双侧额颞叶、前扣带回、内嗅及海马旁皮层的ALFF值显著增高(P<0.05),而对照组3个月后仅右侧颞叶和后扣带回皮层的ALFF值显著增高(P<0.05)。结论:本套自主编制的中等强度有氧舞蹈能有效提高MCI患者的认知功能。静息态fMRI为评估有氧训练对认知功能的影响提供了一种量化方法。
Objective: This study was conducted in patients with mild cognitive impairment(MCI) using a self-developed aerobic dance to investigate its effects on cognitive functions and amplitude of low-frequency fluctuation of resting-state functional MRI(RS fMRI).Method: A total of 38 subjects with MCI were recruited to the current study and were randomized into two groups: the training group(19 cases) and the control group(19 cases). Different intervention methods were used respectively. For the training group, aerobic dance was given for a total of 3 months while the control group only received health education with the same cycle time. None of the patients were administered medicine that affected cognition during the intervention. All patients were evaluated prior to the intervention to understand their cognitive status, with a list of cognitive function tests and a resting-state fMRI scan, which were performed again after the intervention. The brain function was analyzed based on the results of the ALFF images.Result: After the intervention, the results of the cognitive function scale showed that the training group's scores of simple mental state, Montreal cognitive assessment, Wechsler's logical memory and symbolic digital model test significantly improved, and the difference was significant compared with the pre-intervention(P<0.05). The Wechsler's logical memory scores were changed before and after intervention in the two groups,and the change of the training group was significant(P<0.05). There were no significant differences in the cognitive function scales of the control group. The resting-state fMRI scan showed significant changes in two groups after intervention. The ALFF values of bilateral fronto-temporal, anterior cingulate, entorhinal and parohippocampal cortex were significantly increased(P<0.05), while in the control group only the ALFF values of the right temporal lobe and posterior cingulate cortex were significantly increased(P<0.05).Conclusion: The self-developed aerobic dance can effectively improve the cognitive function of patients with MCI. Resting-state fMRI provides a quantitative method for evaluating the effect of aerobic exercise on cognitive function.
Objective: This study was conducted in patients with mild cognitive impairment(MCI) using a self-developed aerobic dance to investigate its effects on cognitive functions and amplitude of low-frequency fluctuation of resting-state functional MRI(RS fMRI).Method: A total of 38 subjects with MCI were recruited to the current study and were randomized into two groups: the training group(19 cases) and the control group(19 cases). Different intervention methods were used respectively. For the training group, aerobic dance was given for a total of 3 months while the control group only received health education with the same cycle time. None of the patients were administered medicine that affected cognition during the intervention. All patients were evaluated prior to the intervention to understand their cognitive status, with a list of cognitive function tests and a resting-state fMRI scan, which were performed again after the intervention. The brain function was analyzed based on the results of the ALFF images.Result: After the intervention, the results of the cognitive function scale showed that the training group's scores of simple mental state, Montreal cognitive assessment, Wechsler's logical memory and symbolic digital model test significantly improved, and the difference was significant compared with the pre-intervention(P<0.05). The Wechsler's logical memory scores were changed before and after intervention in the two groups,and the change of the training group was significant(P<0.05). There were no significant differences in the cognitive function scales of the control group. The resting-state fMRI scan showed significant changes in two groups after intervention. The ALFF values of bilateral fronto-temporal, anterior cingulate, entorhinal and parohippocampal cortex were significantly increased(P<0.05), while in the control group only the ALFF values of the right temporal lobe and posterior cingulate cortex were significantly increased(P<0.05).Conclusion: The self-developed aerobic dance can effectively improve the cognitive function of patients with MCI. Resting-state fMRI provides a quantitative method for evaluating the effect of aerobic exercise on cognitive function.
引文
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[25]Smith EE,Jonides J.Storage and executive processes in the frontal lobes[J].Science,1999,283(5408):1657-1661.
[2]Sofi F,Valecchi D,Bacci D,et al.Physical activity and risk of cognitive decline:a meta-analysis of prospective studies[J].J Intern Med,2011,269(1):107-17.
[3]Jones LW,Douglas PS,Khouri MG,et al.Safety and efficacy of aerobic training in patients with cancer who have heart failure:an analysis of the HF-ACTION randomized trial[J].J Clin Oncol,2014,32(23):2496-2502.
[4]Doi T,Makizako H,Shimada H,et al.Objectively measured physical activity,brain atrophy,and white matter lesions in older adults with mild cognitive impairment[J].Exp Gerontol,2015,62(62C):1-6.
[5]Biswal B,Yetkin FZ,Haughton VM,et al.Functional connectivity in the motor cortex of resting human brain using echo-planar MRI[J].Magn Reson Med,1995,34(4):537-541.
[6]Zou QH,Zhu CZ,Yang Y,et al.An improved approach to detection of amplitude of low-frequency fluctuation(ALFF)for resting-state fMRI:Fractional ALFF[J].J Neurosci Methods,2008,172(1):137-141.
[7]Li R,Zhu X,Yin S,et al.Multimodal intervention in older adults improves resting-state functional connectivity between the medial prefrontal cortex and medial temporal lobe[J].Front Aging Neurosci,2014,6(2):1-13.
[8]Rosano C,Venkatraman VK,Guralnik J,et al.Psychomotor speed and functional brain MRI 2 years after completing a physical activity treatment[J].Journals Gerontol-Ser A Biol Sci Med Sci,2010,65(6):639-647.
[9]Zhang H,Zhao L,Yang S,et al.Clinical observation on effect of scalp electroacupuncture for mild cognitive impairment[J].J Tradit CHINESE Med,2013,33(1):46-50.
[10]Folstein MF,Folstein SE,McHugh PR.Mini-Mental State:A practice method for grading the cognitive state of patients for the clinician[J].J Psychiatr Res 1975,12(3):189-198.
[11]Yu J,Li J,Huang X.The Beijing version of the Montreal Cognitive Assessment as a brief screening tool for mild cognitive impairment:a community-based study[J].BMCPsychiatry,2012,12(1):156.
[12]Román GC,Tatemichi TK,Erkinjuntti T,et al.Vascular dementia:diagnostic criteria for research studies.Report of the NINDS-AIREN International Workshop[J].Neurology,1993,43(2):250-260.
[13]Nasreddine Z,Phillips N,Bédirian V,et al.The Montreal Cognitive Assessment,MoCA:a brief screening tool for mild cognitive impairment[J].J Am Geriatr Soc,2005,53(4):695-699.
[14]Hayden KM,Makeeva OA,Newby LK,et al.A comparison of neuropsychological performance between US and Russia:Preparing for a global clinical trial[J].Alzheimer’s Dement,2014,10(6):760-768.
[15]Song XW,Dong ZY,Long XY,et al.REST:a toolkit for resting-state functional magnetic resonance imaging data processing[J].PLoS One,2011,6(9):e25031.
[16]Geda YE.Mild cognitive impairment in older adults[J].Curr Psychiatry Rep,2012,14(4):320-327.
[17]Lazarou I,Parastatidis T,Tsolaki A,et al.International ballroom dancing against neurodegeneration:a randomized controlled trial in Greek community-dwelling elders with mild cognitive impairment[J].American Journal of Alzheimer's Disease and Other Dementias,2017,32(8):489-499.
[18]Doi T,Verghese J,Makizako H,et al.Effects of cognitive leisure activity on cognition in mild cognitive impairment:results of a randomized controlled trial[J].Journal of the American Medical Directors Association,2017,18(8):686-691.
[19]Han Y,Wang J,Zhao Z,et al.Frequency-dependent changes in the amplitude of low-frequency fluctuations in amnestic mild cognitive impairment:A resting-state fMRI study[J].Neuroimage,2011,55(1):287-295.
[20]Jonker C,Geerlings MI,Schmand B.Are memory complaints predictive for dementia?A review of clinical and population-based studies[J].Int J Geriatr Psychiatry,2000,15(11):983-991.
[21]Wilson RS,Schneider JA,Arnold SE,et al.Olfactory identification and incidence of mild cognitive impairment in older age[J].Arch Gen Psychiatry,2007,64(7):802-808.
[22]Erickson KI,Raji CA,Lopez OL,et al.Physical activity predicts gray matter volume in late adulthood:The Cardiovascular Health Study[J].Neurology,2010,75(16):1415-1422.
[23]Cabeza R,Dennis NA.Frontal lobes and aging:Deterioration and compensation.In:Principles of Frontal Lobe Function.Stuss DT and Knight RT(eds).Oxford University Press,Oxford,United Kingdom,628 652,2013.
[24]Hadland KA,Rushworth MF,Gaffan D,et al.The effect of cingulate lesions on social behaviour and motion[J].Neuropsychologia,2003,41(8):919-931.
[25]Smith EE,Jonides J.Storage and executive processes in the frontal lobes[J].Science,1999,283(5408):1657-1661.