有氧舞蹈对aMCI静息态FPN的影响及双重任务步态研究

The elderly with mild cognitive impairment(MCI) is the early clinical stage of dementia, which is a cognitive functional defect state between normal aging and dementia. Amnestic MCI(aMCI) was associate with greater risk for progression to Alzheimer's Disease(AD). MCI and AD are increasingly considered a large-scale network disconnection syndrome based on functional neuroimaging. Disconnections between the dorsolateral prefrontal cortex(DLPFC) of frontoparietal network(FPN) and parietal lobe，DLPFC and hippocampus were reported. Our previous studies have found that the moderate intensity aerobic dance can improve the logistic memory and processing speed of the aMCI patients. Meanwhile, the resting-sate functional magnetic resonance imaging(fMRI) showed increased brain activation in FPN and memory related cortex compared with baseline after 3-month intervention，which indicates that aerobic dance may be able to improve the cognition through brain functional network remodeling. .We aimed to use resting state functional connectivity analysis to investigate the influence of local activation and general functional connectivity of the brain in patients with amnestic MCI, multiple domain(aMCIm), and its correlation with the dual-task gait speed, cognitive evaluations, motion evoked potential and plasma Aß level. From this study we can set up a standard aerobic dance program for aMCI patients, provide the prevention of early Alzheimer's disease, which may reduce the social and economic costs.

轻度认知障碍（MCI）是介于正常衰老和痴呆之间的过渡阶段，遗忘型MCI（aMCI）向阿尔茨海默病（AD)的转化率最高。功能影像学发现，MCI与AD是一种“失连接综合征”，MCI额顶叶控制网络（FPN）内的背外侧前额叶（DLPFC）与顶叶之间、 DLPFC与海马之间的功能连接减弱。我们发现有氧舞蹈能够改善aMCI的认知及促进静息态双重任务相关脑网络（FPN)及与记忆相关的部分皮层活动水平增高。提示有氧舞蹈作为一种双重任务训练，有可能通过影响脑功能网络产生改善认知的作用。.本研究采用静息态脑功能网络分析探索3个月的双重任务干预（有氧舞蹈）对包含记忆障碍的复杂型轻度认知障碍（aMCIm）患者局部脑功能活动水平的影响及整体脑功能网络的重塑，及其与双重任务下三维步态、认知、运动诱发电位及血清学ß淀粉样蛋白水平的变化的关系。本研究旨在为aMCIm治疗提供标准化干预方案，缓解AD带来的沉重社会负担。

本项目旨在采用静息态脑功能分析探索3个月的双重任务干预（有氧舞蹈）对遗忘型轻度认知障碍（amnestic mild cognitive impairment, aMCI）患者局部脑功能活动水平的影响及整体脑功能连接和功能网络的重塑，及其与双重任务下三维步态、认知及血清学ß淀粉样蛋白水平的变化的关系。为aMCI治疗提供标准化干预方案，缓解阿尔茨海默病（Alzheimer's disease， AD带来的沉重社会负担。项目资助成果已在Frontiers in Aging Neuroscience, Journal of Alzheimer’s Disease 期刊发表SCI论文共2篇, 在《中国康复医学杂志》发表论文4篇、综述2篇，《中国伤残医学》发表论文1篇，均标注由本项目资助，部分成果在分析投稿中。研究发现MCI患者对比健康老年人，静息态功能磁共振检测的双侧背外侧前额叶（dorsal lateral prefrontal cortex， DLPFC）与额、颞、顶叶多个脑区之间的功能连接出现代偿性增强；有氧舞蹈能够改善MCI患者的认知功能和认知相关脑区的活动水平以及扣带束双侧扣带回、扣带束左侧海马、左侧上纵束等白质纤维束的各向异性分数（fractional anisotropy， FA）值。研究成果在江苏南京岱山社区、蓝天园社区、东南大学等社区得到大规模推广应用，疗效得到肯定。项目经费严格按照预算执行，经费使用率达90.05%。