| 王 蔚,王 彤,沙李菊,张 蕊,刘 韵,谢 怡,祁 鸣,朱 奕,吴 婷.阿尔茨海默病患者有氧运动前后低频振幅fMRI及认知功能的改变[J].中国康复医学杂志,2019,(4):371~377 |
| 阿尔茨海默病患者有氧运动前后低频振幅fMRI及认知功能的改变 点此下载全文 |
| 王 蔚 王 彤 沙李菊 张 蕊 刘 韵 谢 怡 祁 鸣 朱 奕 吴 婷 |
| 南京医科大学第一附属医院神经内科，南京，210029 |
| 基金项目：国家自然科学基金项目(81472163)；江苏省“六大人才高峰”第八批高层次人才资助项目；江苏省高校“青蓝工程”中青年学术带头人培养对象项目(JX2161015003)；江苏省科技计划项目（社会发展-临床前沿）（BE2017734） |
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| 摘要
目的：研究轻中度阿尔茨海默病（Alzheimer's disease，AD）患者有氧运动前后低频振幅fMRI及认知功能的变化。探讨静息态fMRI在有氧运动疗效中的应用价值。
方法：本研究为单盲随机对照试验，最终纳入有氧运动组(18例)和对照组（18例）。有氧运动组采用由本研究团队设计的有氧运动操的方式，运动强度设定为中等强度，每次有氧运动35min（包括热身5min,有氧阶段25min，整理运动5min），训练频率为3次/周，持续训练3个月；对照组仅进行日常活动及护理。在干预前及3个月时，分别对两组进行认知功能（包括MMSE、韦氏记忆测验、连线测验A-B）及精神行为量表（NPI）测定，获取静息态fMRI数据，进行低频振幅（ALFF）分析。
结果：3个月的运动干预后，与基线水平相比，有氧运动组MMSE评分较前提高，而连线测试A和连线测试B、NPI评分较基线水平均明显下降，差异有显著性意义(P<0.05)，提示有氧运动可以改善AD的认知功能和精神状态；但韦氏逻辑记忆和韦氏数字广度测试与基线水平相比，无显著性差异（P>0.05）。3个月后有氧运动组较干预前出现多个脑区ALFF值明显提高，主要集中在右侧顶叶及中央前后回，左侧额叶及前扣带回（P<0.05）；而对照组则出现多个脑区ALFF值下降，主要集中在左侧颞叶、右额叶及前扣带回和双侧小脑。
结论：有氧运动可有效改善AD患者的认知功能，静息态fMRI低频振幅分析可作为AD患者有氧运动有效性评估的辅助指标。 |
| 关键词：有氧运动 阿尔茨海默病 静息态功能磁共振 认知功能 |
| The event-related potential P300 and cognition changes in patients with Alzheimer's disease before and after specially designed aerobics Download Fulltext |
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| Department of Neurology，the First Affiliated Hospital of Nanjing Medical University，Nanjing，210029 |
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| Abstract: |
| Abstract
Objective: To evaluate the effect of amplitude of low frequency fluctuation(ALFF) and cognitive function after aerobic exercise in patients with mild and moderate Alzheimer's disease（AD）.
Method: As a single-blind randomized controlled trial, a total of 36 mild AD patients in clinic were randomized into either aerobics group(n=18) or control group(n=18). The aerobics group cycled for 35 min/d, 3d/wk for 3 months. Each patient was examined with amplitude of low frequency fluctuation(ALFF) and scored with mini-mental state examination (MMSE)，Wechsler memory scale(WMS) and Digital memory scale，Trail making test(TMT) and neuropsychiatric inventory(NPI) after 3 months training.
Result: Thirty-six subjects completed the whole observation. After 3 months, scores of MMSE increased and WMS, TMT and NPI scores decreased significantly as compared to the baseline in AG (P<0.05), while there were no significantly difference against the baseline in CG (P>0.05). We found that the EG showed increased ALFF in bilateral frontal lobe, genu of corpus callosum and right parietal lobe after 3 months’ training (P<0.05), whereas the CG showed decreased ALFF in left cerebellum, right cerebellum posterior lobe, right frontal lobe, right caudate nucleus, right cingulate gyrus and left inferior temporal gyrus(P<0.05).
Conclusion: Aerobic exercise could effectively promote cognitive function of AD patients.The data of resting-state fMRI can be used as a supplementary method to evaluate effectiveness of aerobic exercise. |
| Keywords:aerobic exercise Alzheimer's disease resting-state fMRI cognitive function |
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