Brain Perfusion Change in Patients with Mild Cognitive Impairment After 12 Months of Aerobic Exercise Training

Article type: Research Article

Authors: Thomas, Binu P.^{a; b; *} | Tarumi, Takashi^{c; 1} | Sheng, Min^{a; 2} | Tseng, Benjamin^{c; 3} | Womack, Kyle B.^{d; e} | Cullum, C. Munro^{d; e} | Rypma, Bart^{e; f} | Zhang, Rong^{c; g} | Lu, Hanzhang^{a; h}

Affiliations: [a] Advanced Imaging Research Center, University of Texas Southwestern Medical Center, Dallas, TX, USA | [b] Department of Bioengineering, University of Texas at Arlington, Arlington, TX, USA | [c] Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital, Dallas, TX, USA | [d] Department of Neurology and Neurotherapeutics, University of Texas Southwestern Medical Center, Dallas, TX, USA | [e] Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA | [f] Department of Behavioral and Brain Sciences, University of Texas at Dallas, Dallas, TX, USA | [g] Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA | [h] Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, USA

Correspondence: [*] Correspondence to: Binu P. Thomas, Advanced Imaging Research Center, University of Texas Southwestern Medical Center, 2201 Inwood Rd. NE4.112, Dallas, TX, 75390, USA. Tel.: +1 214 645 2729; E-mail: [email protected].

Note: [1] Present address: Human Informatics Research Institute, National Institute of Advanced Industrial Science and Technology, Ibaraki, Japan.

Note: [2] Division of Neurology/Neurosciences & Mental Health, The Hospital for Sick Children, Toronto, ON, Canada.

Note: [3] Department of Health & Kinesiology, The University of Texas at Tyler, Tyler, TX, USA.

Abstract: Aerobic exercise (AE) has recently received increasing attention in the prevention of Alzheimer’s disease (AD). There is some evidence that it can improve neurocognitive function in elderly individuals. However, the mechanism of these improvements is not completely understood. In this prospective clinical trial, thirty amnestic mild cognitive impairment participants were enrolled into two groups and underwent 12 months of intervention. One group (n = 15) performed AE training (8M/7F, age = 66.4 years), whereas the other (n = 15) performed stretch training (8M/7F, age = 66.1 years) as a control intervention. Both groups performed 25–30 minutes training, 3 times per week. Frequency and duration were gradually increased over time. Twelve-month AE training improved cardiorespiratory fitness (p = 0.04) and memory function (p = 0.004). Cerebral blood flow (CBF) was measured at pre- and post-training using pseudo-continuous-arterial-spin-labeling MRI. Relative to the stretch group, the AE group displayed a training-related increase in CBF in the anterior cingulate cortex (p = 0.016). Furthermore, across individuals, the extent of memory improvement was associated with CBF increases in anterior cingulate cortex and adjacent prefrontal cortex (voxel-wise p < 0.05). In contrast, AE resulted in a decrease in CBF of the posterior cingulate cortex, when compared to the stretch group (p = 0.01). These results suggest that salutary effects of AE in AD may be mediated by redistribution of blood flow and neural activity in AD-sensitive regions of brain.

Keywords: Aerobic exercise training, Alzheimer’s disease, amnestic mild cognitive impairment, anterior cingulate cortex, cerebral blood flow, posterior cingulate cortex, stretch training

DOI: 10.3233/JAD-190977

Journal: Journal of Alzheimer's Disease, vol. 75, no. 2, pp. 617-631, 2020