Multifunctional training on subjects with amnestic mild cognitive impairment due to AD: effects on clinical parameters and functional and structural neuroimaging

Author(s)

Camila Vieira Ligo Teixeira

• Document type: Doctoral Thesis
• Press: Campinas, SP.
• Institution: Universidade Estadual de Campinas (UNICAMP). Faculdade de Ciências Médicas
• Defense date: 2018-01-25

Examining board members

Marcio Luiz Figueredo Balthazar; Franscisco de Assis Carvalho do Vale; Eduardo Bodnariuc Fontes; Marco Carlos Uchida; André Fattori

• Advisor: Marcio Luiz Figueredo Balthazar

Abstract

Amnestic Mild Cognitive Impairment (aMCI) is a clinical term applied to patients with memory decline but with normal social functional performance. These patients are more likely to develop the dementia in Alzheimer's disease (AD), in which there is a dependency on daily lining activities. There are molecular markers found in cerebrospinal fluid (CSF), such as amyloid- beta peptide (Aß1-42) and total tau and phosphorylated tau proteins that, when altered, show that the subject has pathophysiology of AD and a higher chance of developing dementia. The practice of aerobic and resistance exercises demonstrated to be effective improving the cognitive and socio-functional performance in elders. Another type of exercise is multicomponent (MEP), which involves several physical capabilities in one program. There is a positive relationship between physical exercise and brain in elders, but the literature showing physical exercise efficacy in elderly CCL patients with a pathophysiology of AD is scarce. Thus, the main objective of the present thesis was to evaluate the effects of 12 months of a multicomponent exercise program in episodic memory, daily life activities and brain structure and connectivity of elderly with aMCI due to AD. Besides that, we analyzed possible relation between brain structure integrity and aerobic fitness in those subjects. Three studies were carried out. In all, the subjects studied were old adults diagnosed with aMCI due to AD, that is, they presented alterations, at least, in the concentration of peptide beta-amyloid and/or in the ratio Aß1-42/ptau analyzed in the CSF. In the first study, we observed relationship between aerobic fitness and gray matter of frontal areas and also positive relationship with various white matter tracts that connect the frontal, temporal and parietal regions. In studies 2 and 3, we analyzed the effect of the MEP intervention. Study 2 showed that in addition to an improvement in aerobic fitness and memory, the left and right hippocampus volume of the elderly who practiced MEP for 6 months also increased, while the group that did not practice showed worsening in functional activities and memory. Study 3 showed that 12 months of MEP practice significantly increased aerobic fitness, memory and performance in social-functional activity of its practitioners, but without changes in Default mode network connectivity. Our results suggest that aerobic fitness is positively related to the frontal cortex and white matter tracts that connect frontal, parietal and temporal areas. In addition, MEP training not only contributed to an improvement in aerobic fitness, memory performance and functionality, but also had a positive influence on the hippocampi volume of elders with aMCI due to AD (AU)

• FAPESP's process: 14/02359-9 - Amnestic mild cognitive impairment with increased risk factor for Alzheimer's Disease: effect of cardiorespiratory training on clinical parameters and functional and structural neuroimaging
• Grantee: Camila Vieira Ligo Teixeira
• Support Opportunities: Scholarships in Brazil - Doctorate