Exercise Training in Amnestic Mild Cognitive Impairment: A One-Year Randomized Controlled Trial

Article type: Research Article

Authors: Tarumi, Takashi^{a; b; c} | Rossetti, Heidi^d | Thomas, Binu P.^e | Harris, Thomas^b | Tseng, Benjamin Y.^f | Turner, Marcel^a | Wang, Ciwen^a | German, Zohre^b | Martin-Cook, Kristin^d | Stowe, Ann M.^b | Womack, Kyle B.^{b; d} | Mathews, Dana^g | Kerwin, Diana R.^h | Hynan, Linda^{d; i} | Diaz-Arrastia, Ramon^b | Lu, Hanzhang^e | Cullum, C. Munro^{b; d} | Zhang, Rong^{a; b; j}

Affiliations: [a] Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, Dallas, TX, USA | [b] Departments of Neurology and Neurotherapeutics, University of Texas Southwestern Medical Center, Dallas, TX, USA | [c] Human Informatics Research Institute, National Institute of Advanced Industrial Science and Technology, Tsukuba, Ibaraki, Japan | [d] Departments of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA | [e] Departments of Advanced Imaging Research Center, University of Texas Southwestern Medical Center, Dallas, TX, USA | [f] Department of Health and Kinesiology, The University of Texas at Tyler, Tyler, TX, USA | [g] Departments of Radiology, University of Texas Southwestern Medical Center, Dallas, TX, USA | [h] Institute for Texas Alzheimer’s and Memory Disorders, Texas Health Presbyterian Hospital Dallas, Dallas, TX, USA | [i] Departments of Population and Data Sciences, University of Texas Southwestern Medical Center, Dallas, TX, USA | [j] Departments of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA

Correspondence: [*] Correspondence to: Rong Zhang, PhD, 7232 Greenville Ave, Dallas, TX 75231, USA. Tel.: +1 214 345 8843; Fax: +1 214 345 4618; E-mail: [email protected].

Abstract: Background:The current evidence is inconclusive to support the benefits of aerobic exercise training (AET) for preventing neurocognitive decline in patients with amnestic mild cognitive impairment (aMCI). Objective:To examine the effect of a progressive, moderate-to-high intensity AET program on memory and executive function, brain volume, and cortical amyloid-β (Aβ) plaque deposition in aMCI patients. Methods:This is a proof-of-concept trial that randomized 70 aMCI patients to 12 months of AET or stretching and toning (SAT, active control) interventions. Primary neuropsychological outcomes were assessed by using the California Verbal Learning Test-second edition (CVLT-II) and the Delis–Kaplan Executive Function System (D-KEFS). Secondary outcomes were the global and hippocampal brain volumes and the mean cortical and precuneus Aβ deposition. Results:Baseline cognitive scores were similar between the groups. Memory and executive function performance improved over time but did not differ between the AET and SAT groups. Brain volume decreased and precuneus Aβ plaque deposition increased over time but did not differ between the groups. Cardiorespiratory fitness was significantly improved in the AET compared with SAT group. In amyloid positive patients, AET was associated with reduced hippocampal atrophy when compared with the SAT group. Conclusion:The AET and SAT groups both showed evidence of slightly improved neuropsychological scores in previously sedentary aMCI patients. However, these interventions did not prevent brain atrophy or increases in cortical Aβ deposition over 12 months. In amyloid positive patients, AET reduced hippocampal atrophy when compared with the SAT group.

Keywords: Aerobic exercise, amyloid deposition, brain volume, cardiovascular fitness, mild cognitive impairment

DOI: 10.3233/JAD-181175

Journal: Journal of Alzheimer's Disease, vol. 71, no. 2, pp. 421-433, 2019