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

描述(申请人提供)：帕金森病(PD)是一种与年龄相关的神经退行性疾病，其特征是黑质中产生多巴胺的神经元丢失，黑质是基底节的一个亚结构。这种多巴胺功能的丧失会导致典型的帕金森病运动症状，如肌肉僵硬、震颤和运动减慢。然而，帕金森病患者在记忆、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、抑制不适当和选择适当的动作、维持和操纵工作记忆中的信息以及选择性地注意相关信息。目前的药物主要针对帕金森病的运动症状，因此强调了开发治疗帕金森病患者报告的认知症状的必要性。有氧运动是治疗神经健康老年人认知能力的有效方法。幸运的是，有氧运动的最强效果与PD患者的认知症状(即执行功能)相同。这项建议的主要目的是确定在诊断为帕金森病的个体中招募、登记和保持遵守为期12周的有氧运动干预的可行性。进一步的子目标包括检查帕金森病患者12周的锻炼是否可以1)改善认知功能，2)增强受帕金森病影响的大脑网络的功能连通性。这项研究将招募30名患有轻中度帕金森病的参与者，并随机将他们分配到有氧运动(跑步机步行或骑自行车)或非有氧伸展运动组。两个运动组都将在小组环境中(3-4人)接受1小时的指导，每周3次，持续12周。认知能力的评估将使用威斯康星卡片分类测试来衡量选择性注意力和定势转移，并使用任务转换范式来衡量认知灵活性。功能连接性将使用静息状态功能磁共振成像进行测量。在12周的锻炼中，将评估基底神经节和丘脑与前额叶皮质各亚区之间的功能相关性。认知能力、身体功能和神经功能连通性的评估将在运动干预之前和之后立即收集。详细记录 遵守情况将被保持，以确定对演习方案的遵守。这项拟议的研究将以多学科的方式将研究和实践联系起来，通过收集有关运动干预中的招募和坚持、认知功能、大脑连接和被诊断为PD的个人的生活质量的信息。

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.