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轻度认知障碍患者有氧舞蹈干预后认知功能和静息态fMRI低频振幅的改变
引用本文:张 玲,王 彤,朱 奕,吴 婷,吴 含,王石艳,祁 鸣.轻度认知障碍患者有氧舞蹈干预后认知功能和静息态fMRI低频振幅的改变[J].中国康复医学杂志,2019(4):378-385.
作者姓名:张 玲  王 彤  朱 奕  吴 婷  吴 含  王石艳  祁 鸣
作者单位:南京医科大学第一附属医院放射科,南京,210029
基金项目:江苏省科技厅“科技支撑-社会发展”项目(BE2013724, BE2017734)
摘    要:目的:本研究针对于轻度认知障碍患者(MCI)采用一套自主编制有氧舞蹈进行干预,探讨其对患者认知功能和静息态fMRI低频振幅(ALFF)的影响。方法:将38例MCI患者随机分组:训练组(19例)和对照组(19例)。分别接受不同干预方式。对于训练组,给予有氧舞蹈进行干预,共3个月;对照组则以健康教育为主,周期与训练组相同。期间所有患者均未接受任何药物治疗。在接受干预前对所有患者进行评分,了解他们的认知情况,评估工具为认知功能量表,同时进行静息态fMRI扫描,干预结束后再次进行评分和扫描。了解患者脑功能活动情况,根据低频振幅图像结果进行分析。结果:训练组干预完成后,认知功能量表结果显示训练组的简易精神状态评分、蒙特利尔认知评估量表、韦氏逻辑记忆和符号数字模式测试评分显著改善,与干预前相比差异显著。两组患者干预前后韦氏逻辑记忆评分皆发生变化,其中以训练组更为明显,相比有显著差异(P<0.05)。对照组的各项认知功能量表评分均无显著差异。静息态fMRI扫描结果显示,训练组干预前后发生明显变化,其双侧额颞叶、前扣带回、内嗅及海马旁皮层的ALFF值显著增高(P<0.05),而对照组3个月后仅右侧颞叶和后扣带回皮层的ALFF值显著增高(P<0.05)。结论:本套自主编制的中等强度有氧舞蹈能有效提高MCI患者的认知功能。静息态fMRI为评估有氧训练对认知功能的影响提供了一种量化方法。

关 键 词:轻度认知障碍  有氧舞蹈  认知功能  静息态fMRI  低频振幅  阿尔茨海默病
收稿时间:2019/1/30 0:00:00

Effects of aerobic dance on cognitive functions and amplitude of low-frequency fluctuation of resting-state functional MRI in patients with mild cognitive impairment
Institution:The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029
Abstract:Objective: This study was conducted in patients with mild cognitive impairment(MCI) using a self-developed aerobic dance to investigate its effects on cognitive functions and amplitude of low-frequency fluctuation of resting-state functional MRI(RS fMRI).Method: A total of 38 subjects with MCI were recruited to the current study and were randomized into two groups: the training group(19 cases) and the control group(19 cases). Different intervention methods were used respectively. For the training group, aerobic dance was given for a total of 3 months while the control group only received health education with the same cycle time. None of the patients were administered medicine that affected cognition during the intervention. All patients were evaluated prior to the intervention to understand their cognitive status, with a list of cognitive function tests and a resting-state fMRI scan, which were performed again after the intervention. The brain function was analyzed based on the results of the ALFF images.Result: After the intervention, the results of the cognitive function scale showed that the training group’s scores of simple mental state, Montreal cognitive assessment, Wechsler’s logical memory and symbolic digital model test significantly improved, and the difference was significant compared with the pre-intervention(P<0.05). The Wechsler’s logical memory scores were changed before and after intervention in the two groups,and the change of the training group was significant(P<0.05). There were no significant differences in the cognitive function scales of the control group. The resting-state fMRI scan showed significant changes in two groups after intervention. The ALFF values of bilateral fronto-temporal, anterior cingulate, entorhinal and parohippocampal cortex were significantly increased(P<0.05), while in the control group only the ALFF values of the right temporal lobe and posterior cingulate cortex were significantly increased(P<0.05).Conclusion: The self-developed aerobic dance can effectively improve the cognitive function of patients with MCI. Resting-state fMRI provides a quantitative method for evaluating the effect of aerobic exercise on cognitive function.
Keywords:mild cognitive impairment  aerobic dance  cognitive function  resting-state functional MRI  amplitude of low-frequency fluctuation  Alzheimer''s disease
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