The Influence of an Exercise Intervention on Cognitive and Brain Health in Parkin

描述（由申请人提供）：帕金森病（PD）是一种年龄相关的神经退行性疾病，其特征在于黑质（基底神经节亚结构）中产生多巴胺的神经元丢失。这种多巴胺功能的丧失导致经典的PD运动症状，如肌肉僵硬、震颤和运动减慢。然而，PD患者在记忆、视觉空间能力和执行功能方面也表现出认知症状。执行功能是一组认知过程，包括认知灵活性，抑制和选择适当的行动，保持和操纵工作记忆中的信息，并选择性地注意相关信息。目前的药物主要针对PD的运动症状，因此强调需要开发针对PD患者报告的认知症状的治疗方法。有氧运动是治疗神经健康老年人认知功能的有效方法。幸运的是，有氧运动的最强效果见于PD患者中所见的相同认知症状（即，执行功能）。该提案的主要目的是确定在诊断为PD的个体中招募，登记和维持12周有氧运动干预的可行性。进一步的子目标包括检查PD患者12周的运动是否可以1）改善认知功能和2）增强受PD影响的大脑网络的功能连接。本研究将招募30名轻度至中度PD受试者，并将其随机分配到有氧运动（跑步机步行或骑自行车）或非有氧拉伸运动组。两个运动组都将在一个小组（3-4人）中接受1小时的指导，每周3次，持续12周。将使用威斯康星州卡片分类测试评估认知能力，以测量选择性注意力和集合转移，并使用任务转换范式评估认知灵活性。将使用静息状态功能磁共振成像测量功能连接。将评估基底神经节和丘脑与前额叶皮层的子区域之间的功能相关性，并与参与12周的运动有关。在运动干预之前和之后立即收集认知能力、身体功能和神经功能连接的评估。的详细记录 将保持遵守情况，以确定是否遵守演习规程。这项拟议的研究将通过收集有关运动干预、认知功能、大脑连接和PD患者生活质量的招募和坚持信息，以多学科的方式连接研究和实践。

DESCRIPTION (provided by applicant): Parkinson's disease (PD) is an age-related neurodegenerative disease that is characterized by the loss of dopamine-producing neurons in the substantia nigra, a basal ganglia sub-structure. This loss of dopamine functioning leads to the classic PD motor symptoms such as muscular rigidity, tremor, and slowed movements. However, individuals with PD also exhibit cognitive symptoms in the areas of memory, visuospatial ability, and executive function. Executive functions are a set of cognitive processes that include cognitive flexibility, inhibiting inappropriate and selecting appropriate actions, maintaining and manipulating information in working memory, and selectively attending to relevant information. Current medications primarily target the motor symptoms of PD, thus underscoring the need to develop treatments for the cognitive symptoms reported by PD patients. Aerobic exercise is a potent method to treat cognition in neurologically healthy older adults. Fortunately, the strongest effects of aerobic exercise are seen in the same cognitive symptoms seen in PD patients (i.e., executive function). The primary aim of this proposal is to determine the feasibility of recruiting, enrolling, and maintaining adherence in a 12-week aerobic exercise intervention in individuals diagnosed with PD. Further sub-aims include examining whether 12 weeks of exercise in PD patients can 1) improve cognitive function and 2) enhance functional connectivity in brain networks that are affected by PD. This study will enroll 30 participants with mild to moderate PD and randomly assign them to either an aerobic exercise (treadmill walking or cycling) or non-aerobic stretching exercise group. Both exercise groups will receive 1 hour of instruction in a small group setting (3-4 people), 3 times per week for 12 weeks. Cognitive ability will be assessed using the Wisconsin Card Sorting Test to measure selective attention and set-shifting and a task- switching paradigm to measure cognitive flexibility. Functional connectivity will be measured using resting state functional magnetic resonance imaging. Functional correlations between sub-regions in the basal ganglia and thalamus with the prefrontal cortex will be assessed in relation to participation in 12 weeks of exercise. Assessments of cognitive ability, physical function, and neural functional connectivity will be collected prior to and immediately following the exercise intervention. Detailed records of compliance will be kept to determine adherence to the exercise protocol. The proposed study will bridge research and practice in a multidisciplinary fashion by gathering information about recruitment and adherence in an exercise intervention, cognitive function, brain connectivity, and quality of life for individuals diagnosed with PD.