Cognitive Benefits of Interactive Mental and Physical Exercise for MCI

描述（由申请人提供）：痴呆症病例的增加导致人们呼吁采取行为干预措施来增强大脑健康，以延缓认知障碍的发生或进展。越来越多的证据表明，锻炼对认知有好处，但对联合干预的了解却很少。我们的主要目标是复制和扩展我们最近结束的随机临床试验（RCT），研究互动身心锻炼，“认知健康的网络骑行”（Anderson-Hanley等人，2012a）。这项随机对照试验是由PI和合作者对63名独立生活的老年人进行的。我们发现，与单独进行体育锻炼相比，同时进行三个月的身体和心理锻炼（即运动）后，认知能力有显著提高。我们比较了在传统的固定自行车上进行的体育锻炼和在“赛博自行车”上进行的互动式身心锻炼。赛博自行车是一种虚拟现实增强的固定自行车，具有交互式骑行路线、屏幕上的竞争对手和视频游戏功能。结果表明，在同样的努力下，在网络自行车上进行互动的身心锻炼比在固定自行车上进行体育锻炼能产生更大的认知益处。我们希望将我们的研究扩展到患有轻度认知障碍（MCI）的人，以检验上述发现对那些已经经历认知衰退的人的普遍性，假设网络骑行比单独的身体或精神锻炼更能减缓衰退。我们还旨在通过比较网络自行车与单独进行的心理和身体锻炼，增加对身体和认知锻炼相互作用时认知益处增加现象的科学理解。本研究的主要方法是随机对照试验（Aim 1），我们建议入组81例轻度认知障碍患者。在六个月的时间里，参与者将被随机分配到三种情况中的一种：网络自行车、单独的固定自行车或单独的电子游戏。综合评估将包括：神经心理学（如执行功能和记忆）、行为学（如依从性和努力/瓦特）、生理学（如心肺适应性）、生物标志物（如BDNF）、[删除的EEG/ERP]和扩展的神经成像试点（n=30 MRI； Anderson-Hanley等，2012b）。我们预计，在赛博循环状态下，认知益处最大，其次是单独的体育锻炼，最后是单独的心理锻炼，效果较小。为了阐明运动与认知变化之间的联系机制（目的2），我们将对行为、生理、生物标志物、[已删除的神经生理]和神经影像学数据进行二次分析。我们计划通过在报告和出版物中综合我们的成果，将我们的科学发现转化为公共卫生领域的应用，这将导致对轻度认知障碍患者的干预措施的广泛传播和影响（例如，在辅助生活或家庭环境中安置网络循环；目标3）。

DESCRIPTION (provided by applicant): The rise in dementia cases has led to calls for behavioral interventions to enhance brain health to delay the onset or progression of cognitive impairment. There is growing evidence of the cognitive benefits of exercise, but less is known about combined interventions. Our primary goal is to replicate and extend our recently concluded randomized clinical trial (RCT) investigating interactive physical and mental exercise, "Cybercycling for Cognitive Health" (Anderson-Hanley et al., 2012a). This RCT was conducted by the PI and collaborators with 63 independent living older adults. We found significant cognitive benefit after three months of simultaneously combined physical and mental exercise (i.e., exergaming), when contrasted with physical exercise alone. We compared physical exercise on a traditional stationary bike, with interactive physical and mental exercise on a "cybercycle." A cybercycle is a virtual reality-enhanced stationary bike with interactive cycling tours, on-screen competitors, and videogame capabilities. Results suggest that for the same effort, interactive physical and mental exercise on a cybercycle can yield greater cognitive benefit than physical exercise alone on a stationary bike. We wish to extend our research to persons with mild cognitive impairment (MCI), to examine the generalizability of the above finding to those already experiencing cognitive decline, with the hypothesis that cybercycling can slow decline more than either physical or mental exercise alone. We also aim to add to the scientific understanding of the phenomenon of increased cognitive benefit when physical and cognitive exercises are interactive, by comparing cybercycling with mental and physical exercise implemented individually. The primary method of this study will be an RCT (Aim 1), and we propose to enroll 81 patients with MCI. Participants will be randomized into one of three conditions for six months: cybercycle, stationary bike alone, or videogame alone. Comprehensive evaluations will include: neuropsychological (e.g., executive function and memory), behavioral (e.g., compliance and effort/watts), physiological (e.g., cardiorespiratory fitness), biomarker (e.g., BDNF), [deleted EEG/ERP] and an expanded neuroimaging pilot (n=30 MRI; Anderson-Hanley et al., 2012b). We expect that cognitive benefit will be greatest for the cybercycle condition, followed by physical exercise alone, and finally a smaller effect from mental exercise alone. To clarify mechanisms linking exercise to cognitive change (Aim 2), we will conduct secondary analyses of behavioral, physiological, biomarker, [deleted neurophysiological], and neuroimaging data. We plan to translate our scientific findings for application in the public health sphere, by synthesizing our results in presentations and publications, which should lead to wide dissemination and implications for interventions for persons with MCI (e.g., cybercycle placement in assisted living or home environments; Aim 3).