Graded Intensity Aerobic Exercise to Improve Cerebrovascular Function and Performance in Aged Veterans

分级强度有氧运动可改善老年退伍军人的脑血管功能和表现

• 批准号: 9900570
• 负责人: Joe Robert Nocera
• 金额: --
• 依托单位: VETERANS HEALTH ADMINISTRATION
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-04-01 至 2023-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9900570
• 关键词: Address; Aerobic; Aerobic Exercise; Age; Aging; Area; Attenuated; Bilateral; Biological Assay; Blood Vessels; Brain; Brain region; Carbon Dioxide; Cerebrovascular Circulation; Cerebrovascular Disorders; Cerebrovascular system; Cerebrum; Characteristics; Cognitive; Control Groups; Cross-Sectional Studies; Data; Development; Disease; Educational Intervention; Elderly; Exercise; Functional Magnetic Resonance Imaging; Future; Goals; Health; Health system; Healthcare; Individual; Inferior; Inferior frontal gyrus; Intelligence; Interval training; Intervention; Knowledge; Lead; Measurable; Measures; Motor; Motor Cortex; Neuraxis; Neurodegenerative Disorders; Neurophysiology - biologic function; Nutraceutical; Outcome; Participant; Pathologic; Pattern; Performance; Perfusion; Pharmacologic Substance; Physiological; Population; Prevention strategy; Quality of life; Rehabilitation therapy; Research; Rest; Risk; Signal Transduction; Spin Labels; Stretching; Task Performances; Techniques; Testing; Training; Veterans; age related; age related neurodegeneration; aged; base; behavioral outcome; blood oxygen level dependent; brain health; cardiovascular fitness; cerebrovascular; cerebrovascular health; clinical implementation; comorbidity; evidence base; exercise intervention; frontal lobe; functional decline; improved; improved outcome; innovation; interest; programs; relating to nervous system; response; sedentary; young adult; Address; Aerobic; Aerobic Exercise; Age; Aging; Area; Attenuated; Bilateral; Biological Assay; Blood Vessels; Brain; Brain region; Carbon Dioxide; Cerebrovascular Circulation; Cerebrovascular Disorders; Cerebrovascular system; Cerebrum; Characteristics; Cognitive; Control Groups; Cross-Sectional Studies; Data; Development; Disease; Educational Intervention; Elderly; Exercise; Functional Magnetic Resonance Imaging; Future; Goals; Health; Health system; Healthcare; Individual; Inferior; Inferior frontal gyrus; Intelligence; Interval training; Intervention; Knowledge; Lead; Measurable; Measures; Motor; Motor Cortex; Neuraxis; Neurodegenerative Disorders; Neurophysiology - biologic function; Nutraceutical; Outcome; Participant; Pathologic; Pattern; Performance; Perfusion; Pharmacologic Substance; Physiological; Population; Prevention strategy; Quality of life; Rehabilitation therapy; Research; Rest; Risk; Signal Transduction; Spin Labels; Stretching; Task Performances; Techniques; Testing; Training; Veterans; age related; age related neurodegeneration; aged; base; behavioral outcome; blood oxygen level dependent; brain health; cardiovascular fitness; cerebrovascular; cerebrovascular health; clinical implementation; comorbidity; evidence base; exercise intervention; frontal lobe; functional decline; improved; improved outcome; innovation; interest; programs; relating to nervous system; response; sedentary; young adult

To address the growing healthcare challenges of an aging Veteran population it is critical to understand effective rehabilitation techniques that mitigate age-related co-morbidity and improve quality of life. To date, exercise is one of a few proven interventions that attenuates age-related declines in brain health and function. A consistent but unexplained finding in many of these studies is a change in the cortical activation pattern during task, assessed using blood-oxygen-level dependent (BOLD) signal with fMRI that corresponds with improved task performance. Two key metrics of cerebrovascular health and functioning that are underexplored but may influence the documented changes in the BOLD response that is observed with post-aerobic activity are: 1) changes in resting or basal cerebral blood flow (perfusion) to key brain regions; and 2) changes in the ability of cerebrovasculature to dilate in the face of increased demand, termed cerebrovascular reactivity (CVR). Our goal is to quantify the impact of aerobic exercise on cerebrovascular function and how both perfusion and CVR contributes to the BOLD signal during task-based fMRI. Consistent with our previous aging and exercise studies participants will complete one of two conditions; 1) an aerobic, interval-training intervention (Spin; n= 44), or 2) a non-aerobic, stretching control condition (Control; n=44). Cardiovascular fitness, arterial spin labeling for basal cerebral perfusion, CVR, task-based fMRI (cognitive-executive and motor), and behavioral outcomes will be assessed before and after the interventions. The specific aims will determine the effect of a 12-week aerobic exercise intervention on changes in cerebral perfusion and CVR in older Veterans. We hypothesize that compared to the Control group, the aerobically-trained group will have increased basal perfusion and CVR in areas that demonstrate age-related decline and that have been demonstrated to be malleable to aerobic exercise (inferior frontal and motor cortices). Research over the last few decades have driven the continual promotion of exercise as one of the most impactful interventions of central nervous system health and function. At the forefront of much of this research is the use of task-based fMRI BOLD to quantify beneficial changes in cortical function following aerobic exercise. While transformative, the true impact of this research is limited in scope until we can define the influence of cerebrovascular function on the well-documented beneficial change in BOLD response. We do know that older adults who are physically active have improved vascular health but we do not know the full impact of an exercise intervention on cerebrovascular health. If our hypotheses of improved perfusion and CVR is supported it would inform current intervention strategies and would add important additional information about the potential of exercise to improve brain health in aging. This would have implications for aging Veterans at risk for neurodegenerative disease brought on by cerebrovascular dysfunction.

为了应对老年人口的医疗保健挑战日益增长的挑战，了解至关重要 有效减轻与年龄有关的合并症并改善生活质量的有效康复技术。迄今为止， 运动是少数已验证的干预措施之一，可减弱与年龄相关的大脑健康和功能下降。 在许多研究中，一致但无法解释的发现是皮质激活模式的变化 在任务期间，使用fMRI使用血氧级依赖（BOLD）信号进行评估，与 改进的任务性能。脑血管健康和功能的两个主要指标 但是可能会影响1年后活动观察到的大胆响应的记录变化 是：1）静息或基础脑血流动（灌注）的变化； 2）变化 面对需求增加的脑血管形系统扩张的能力称为脑血管反应性 （CVR）。我们的目标是量化有氧运动对脑血管功能的影响以及如何 在基于任务的fMRI期间，灌注和CVR有助于大胆的信号。与我们以前的衰老一致 和锻炼研究参与者将完成两个条件之一； 1）有氧，间隔训练 干预（旋转； n = 44），或2）一种非氧化，拉伸控制条件（控制； n = 44）。心血管 适应性，基于CVR的基础脑灌注的动脉自旋标记，基于任务的fMRI（认知 - 执行和 电动机）和行为结果将在干预之前和之后评估。具体目标将 确定12周有氧运动干预对脑灌注变化和CVR的影响 年长的退伍军人。我们假设与对照组相比，有氧训练组将具有 在表现出与年龄相关的地区的基础灌注和CVR增加，并且 证明具有有氧运动（下额叶和运动皮层）可延展。 在过去几十年中 中枢神经系统健康和功能有影响力的干预措施。在这项研究的大部分时间里 是使用基于任务的fMRI BOLD来量化有氧运动后皮质功能的有益变化 锻炼。虽然具有变革性，但这项研究的真正影响在范围上受到限制，直到我们可以定义 脑血管功能对大胆反应有益的有益变化的影响。我们做 知道身体活跃的老年人有改善的血管健康，但我们不知道 运动干预对脑血管健康的影响。如果我们的假设改善了灌注和 支持CVR将为当前的干预策略提供信息，并将添加重要的其他信息 关于运动在衰老中改善大脑健康的潜力。这将对衰老有影响 脑血管功能障碍带来的神经退行性疾病风险的退伍军人。