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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:
      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
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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