Tai Chi Training Evokes Significant Changes in Brain White Matter Network in Older Women

Physical Exercise Prevents the Cognitive Decline among Older Adults in Romania

Cognitive decline is one of the most important challenges related to the aging process, due to its important impact on individuals. Several studies have reported that physical exercise with a specific intensity and frequency is beneficial for maintaining cognitive health in the ageing population. The present study investigated the impact of general physical exercise on cognitive health in the older population in Romania. The study involved 60 individuals (60% male, 40% female), with a mean age of 60.78 years (SD = 2.97). The Health Interview Survey and The Minnesota Heart Survey assessed exercise frequency and intensity, while the Montreal Cognitive Assessment (MoCA) determined mild cognitive impairment (MCI) levels. The results of the statistical analysis showed that high-intensity physical exercise at a frequency of three to four times a week at the age of 40-50 years is recommended in order to significantly reduce cognitive decline. In addition, for the age of 60 years old, the results established that engaging in physical activities of a moderate intensity with a frequency of 2-3 times per month is sufficient to maintain healthy cognition. The findings suggest that exercise can serve as a behavioral intervention to mitigate cognitive dysfunction and complement past research on its cognitive health advantages.

From inflammatory signaling to neuronal damage: Exploring NLR inflammasomes in ageing neurological disorders

The persistence of neuronal degeneration and damage is a major obstacle in ageing medicine. Nucleotide-binding oligomerization domain (NOD)-like receptors detect environmental stressors and trigger the maturation and secretion of pro-inflammatory cytokines that can cause neuronal damage and accelerate cell death. NLR (NOD-like receptors) inflammasomes are protein complexes that contain NOD-like receptors. Studying the role of NLR inflammasomes in ageing-related neurological disorders can provide valuable insights into the mechanisms of neurodegeneration. This includes investigating their activation of inflammasomes, transcription, and capacity to promote or inhibit inflammatory signaling, as well as exploring strategies to regulate NLR inflammasomes levels. This review summarizes the use of NLR inflammasomes in guiding neuronal degeneration and injury during the ageing process, covering several neurological disorders such as Alzheimer's disease, Parkinson's disease, amyotrophic lateral sclerosis, stroke, and peripheral neuropathies. To improve the quality of life and slow the progression of neurological damage, NLR-based treatment strategies, including inhibitor-related therapies and physical therapy, are presented. Additionally, important connections between age-related neurological disorders and NLR inflammasomes are highlighted to guide future research and facilitate the development of new treatment options.

Alexa, let's train now! - A systematic review and classification approach to digital and home-based physical training interventions aiming to support healthy cognitive aging

BACKGROUND

There is mounting evidence that regular physical activity is an important prerequisite for healthy cognitive aging. Consequently, the finding that almost one-third of the adult population does not reach the recommended level of regular physical activity calls for further public health actions. In this context, digital and home-based physical training interventions might be a promising alternative to center-based intervention programs. Thus, this systematic review aimed to summarize the current state of the literature on the effects of digital and home-based physical training interventions on adult cognitive performance.

METHODS

In this pre-registered systematic review (PROSPERO; ID: CRD42022320031), 5 electronic databases (PubMed, Web of Science, PsycInfo, SPORTDiscus, and Cochrane Library) were searched by 2 independent researchers (FH and PT) to identify eligible studies investigating the effects of digital and home-based physical training interventions on cognitive performance in adults. The systematic literature search yielded 8258 records (extra 17 records from other sources), of which 27 controlled trials were considered relevant. Two reviewers (FH and PT) independently extracted data and assessed the risk of bias using a modified version of the Tool for the assEssment of Study qualiTy and reporting in EXercise (TESTEX scale).

RESULTS

Of the 27 reviewed studies, 15 reported positive effects on cognitive and motor-cognitive outcomes (i.e., performance improvements in measures of executive functions, working memory, and choice stepping reaction test), and a considerable heterogeneity concerning study-related, population-related, and intervention-related characteristics was noticed. A more detailed analysis suggests that, in particular, interventions using online classes and technology-based exercise devices (i.e., step-based exergames) can improve cognitive performance in healthy older adults. Approximately one-half of the reviewed studies were rated as having a high risk of bias with respect to completion adherence (≤85%) and monitoring of the level of regular physical activity in the control group.

CONCLUSION

The current state of evidence concerning the effectiveness of digital and home-based physical training interventions is mixed overall, though there is limited evidence that specific types of digital and home-based physical training interventions (e.g., online classes and step-based exergames) can be an effective strategy for improving cognitive performance in older adults. However, due to the limited number of available studies, future high-quality studies are needed to buttress this assumption empirically and to allow for more solid and nuanced conclusions.

Tai Chi for the prophylaxis of episodic migraine: protocol of a non-inferiority randomized controlled trial with mechanism exploration

BACKGROUND

Migraine is a complex neurovascular disorder with considerable clinical, social and economic issues. Tai chi has the potential to be an alternative prophylactic treatment for migraine with high safety since the adverse effects and limited efficacy of available medications.

AIMS

The proposed study aims to compare the prophylaxis efficacy of 24-week Tai Chi training on migraine attacks with the standard prophylactic medication; and to explore the mechanism of Tai Chi in preventing migraine attacks by analyzing the associations between changes of migraine attacks and changes of neurovascular functions and inflammatory makers.

METHOD

This is a two-arm parallel non-inferiority randomized controlled trial. In total 220 Hong Kong Chinese women aged 18-65 years with diagnosis of episodic migraine will be recruited and randomized to either the Tai Chi training group or the standard prophylactic medication group with 1:1 ratio, and receive the 24 weeks of modified 33-short form Yang-style Tai Chi training and the standard prophylactic medications, respectively. A 24-week follow-up will be implemented for both groups. For efficacy examination, the primary outcome was the frequency of migraine attacks measured by the migraine diary; and for the mechanism exploration, the primary outcome was the volume and number of white matter hyperintensity (WMH) measured by magnetic resonance imaging (MRI). The measurements will be conducted at the baseline, 24th weeks, and 48th weeks. Linear mixed model will be adopted to comprehensively analyze the changes of variables within and between groups.

DISCUSSION

Given the importance of reducing disease burden and financial cost of migraine attacks, the findings of this study will provide new insights regarding the role of Tai Chi in alleviating migraine burden and further shed light on the mechanism action of Tai Chi on preventing headache attacks.

TRIAL REGISTRATION

ClinicalTrials.gov NCT05690737. Registered on January 28, 2023.

Enhanced Integrity of White Matter Microstructure in Mind-Body Practitioners: A Whole-Brain Diffusion Tensor Imaging Study

Tai Chi Chuan (TCC) is an increasingly popular multimodal mind-body practice with potential cognitive benefits, yet the neurobiological mechanisms underlying these effects, particularly in relation to brain white matter (WM) microstructure, remain largely unknown. In this study, we used diffusion tensor imaging (DTI) and the attention network test (ANT) to compare 22 TCC practitioners and 18 healthy controls. We found extensive differences in fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD), and radial diffusivity (RD) between the two groups. Specifically, TCC practitioners had significantly different diffusion metrics in the corticospinal tract (CST), fornix (FX)/stria terminalis (ST), and cerebral peduncle (CP). We also observed a significant correlation between increased FA values in the right CP and ANT performance in TCC practitioners. Our findings suggest that optimized regional WM microstructure may contribute to the complex information processing associated with TCC practice, providing insights for preventing cognitive decline and treating neurological disorders with cognitive impairment in clinical rehabilitation.

The effect of Bafa Wubu of Tai Chi on college students' anxiety and depression: A randomized, controlled pilot study

Objective: This pilot study aimed to explore the mechanism of the effects of Bafa Wubu of Tai Chi (BWTC) on anxiety and depression in college students using resting-state functional magnetic resonance imaging (RS-fMRI). Methods: Eighteen college students (5 males and 13 females) with anxiety and depression met the study criteria and were randomly divided into an experimental group (aged 24.20 ± 4.07 years) and a control group (aged 22.50 ± 5.95). The experimental group received an eight-week BWTC intervention five times/week for 60 min/session. The control group maintained normal daily life without any exercise intervention. These students were assessed using RS-fMRI scans, the self-rating anxiety scale (SAS), and the self-rating depression scale (SDS). Spearman correlation analysis was used, and statistical significance was defined as a two-sided p-value of <0.05. Results: After the intervention, the SAS and SDS scores of the BWTC group significantly reduced (p = 0.002; p = 0.001). Compared with the control group, the fALFF values of the right middle frontal gyrus, orbital part (Frontal_Mid_Orb_R) (p = 0.043), right inferior occipital gyrus (Occipital_Inf_R) (p = 0.003), and right middle temporal gyrus of the temporal pole (Temporal_Pole_Mid_R) (p = 0.003) in the BWTC group increased significantly; the fALFF values of the left middle frontal gyrus (Frontal_Mid_L) (p = 0.001) and right supplementary motor area (Supp_Motor_Area_R) (p = 0.010) in BWTC group decreased significantly. The fALFF values of Frontal_Mid_Orb_R were significantly positively correlated with the SDS score (r = 0.852, p = 0.015) and the fALFF values of Frontal_Mid_L were significantly negatively correlated with the SAS score (r = -0.797, p = 0.032). Conclusion: In this pilot study with college students, BWTC alleviated anxiety and depression, potentially through modulating activity in the Frontal_Mid_L and Frontal_Mid_Orb_R, respectively.

Mitigating effects and mechanisms of Tai Chi on mild cognitive impairment in the elderly

Mild cognitive impairment (MCI) is a major public health concern that endangers health and decreases the quality of life of the elderly around the world. A recent clinical guideline has recommended regular exercise (twice per week) for patients with MCI as part of an overall approach to management. Tai Chi, a form of light-to-moderate-intensity mind-body exercise, is particularly suitable for seniors. This review aims to summarize epidemiological studies related to the effects of Tai Chi on symptom remission in older adults with MCI and reveal the potential mechanisms. Evidence suggested that Tai Chi can improve cognitive functions and alleviate the accompanying symptoms of MCI in the elderly potentially by activating the expression of signals in different brain regions, altering their connectivity, increasing the brain volume, and modulating brain-derived neurotropic and inflammation factors. Studies comparing various types of Tai Chi may contribute to the identification of paradigms that have appropriate intensities and difficulty and exert good effects on older people with MCI. In addition, studies are warranted to determine the frequency and duration of training that can optimize the beneficial effects of Tai Chi on MCI.

The relationship between physical activity, physical health, and mental health among older Chinese adults: A scoping review

The aging Chinese population is growing fast, and the proportion of the population aged 60 years old is projected to reach 28% by 2040, estimated 402 million. With increased life expectancy, the aging population tends to suffer from health risks and diseases, which create a burden on public health policy. Hence, it is essential to promote healthy and active aging, which includes improving older adults' physical and mental capacities and advocating for the achievement of a healthy life expectancy. Despite the rapidly growing aging population in China, there have been no reviews investigating the effect of physical activity on physical and mental health among older Chinese adults. Therefore, the current study aimed to review studies from the past 15 years that illustrate the effect of physical activity on physical and mental health among Chinese older adults. Based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) extension for scoping reviews (PRISMA-ScR), this review addresses the associations between physical activity, physical health and mental health among older Chinese adults. A total of 371 studies were included in the scoping review, which covered the relationships between physical activity, physical health and mental health variables. The scoping review also revealed the impact of various kinds of physical activity affecting older adults' physical health, such as functional fitness, body composition, fall risk and balance, and mental health issues, such as depression, anxiety, cognitive function and quality of life. Moreover, studies have identified innovative forms of physical activity as emerging trends in physical activity interventions for older adults. To conclude, this scoping review captured the common effects between physical activity and overall wellbeing, including physical, mental, and cognitive health. Additionally, diverse forms of physical activity intervention, such as group-based and supervised individual interventions, should be supported, and cross-cultural exercise comparisons should be made in future explorations.

A Study on the Effect of Traditional Chinese Exercise Combined With Rhythm Training on the Intervention of Older Adults With Mild Cognitive Impairment

BACKGROUND

To examine the effect of combination exercise program on cognitive function of older adults with mild cognitive impairment (MCI), and identify biomarkers associated with improvement of cognitive functions.

METHODS

Subjects were 42 older adults (ages, 60-80 years) with MCI. The subjects were randomly classified to traditional Chinese exercise combined with rhythm training group (TCE + RTG, n = 14), walking group (WG, n = 14), and control group (CG, n = 14), according to their level of MMSE scores. These groups exercised for 60 minutes at 1 session, 3 sessions a week for 12 weeks. The intervention program was conducted under multitask conditions to stimulate attention and memory, and the control group attended 3 education classes. Measurements were administered before, after the 6-week, and after the 12-week intervention period; Measurements: The Mini-mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), Symbol Digit Modalities Test (SDMT), Activities of Daily Living Scale (ADL), and the 17-item Hamilton Depression Scale (HAMD-17), along with the brain-derived neurotrophic factor (BDNF). A repeated-measures analysis of variance was used to examine differences among the 3 groups and between the 3 testing times (pre-test vs middle-test vs post-test).

RESULTS

(1) The TCE + RTG showed significant improvement in the MMSE, MoCA, SDMT, and ADL scale test results (P < .01) and HAMD-17 scale test results (P < .05). The WG also showed significant improvement in the MMSE, MoCA, and HAMD-17 scale test results (P < .05) and the ADL scale test results (P < .01). While there was no significant change in the CG after the intervention. (2) The TCE + RTG and WG showed positive improvement in peripheral blood BDNF levels, while the CG showed a decrease in these test results. There were significant differences between the TCE + RTG and CG before and after the intervention.

CONCLUSION

The results suggested that a TCE + RT is beneficial for improving memory and maintaining general cognitive function and peripheral blood BDNF levels in older adults with MCI. Peripheral blood BDNF levels may predict improvement of cognitive functions in older adults with MCI. Further studies are required to determine the positive effects of TCE + RT on cognitive function in older adults with MCI. Trial Registration: ChiCTR2200058545, Registered 10 April 2022.

Participation in community seniors' organizations and mental health among retired adults in urban China: The mediating role of interpersonal needs

Purpose

This study aimed to investigate the association between participation in community seniors' organizations (CSOs) and mental health among retired adults in urban China, and illustrate the causal mechanism.

Methods

We collected data on participation from a community seniors' organization and mental health survey in Shenzhen City, China, in July 2022. The survey used a two-stage cluster sample design, based on administrative divisions as the primary sampling unit and communities as the second sampling unit, where retired adults were randomly sampled. The inclusion criteria were individuals >60 years old (the mandatory age for retirement in China) or women who retired early at the age of 45 years. We used three multivariable regression models to estimate the effects of participation in CSOs on mental health. Furthermore, we used structural equation models to examine the mediator of acquired interpersonal needs in the association between CSOs participation and mental health.

Results

The study examined the values of CSOs, generated explicitly for older adults and explained how participation in such organizations benefits retired adults' mental health. Mental health is defined in three dimensions: aggregate mental health, positive emotions, and negative emotions. The results show that constituting social networks with like-minded individuals and perceiving interpersonal needs are the two main benefits of CSOs on mental health. The retired individual who participated in CSOs with a higher level of diversity and frequency, joined specific types such as health- and study-related CSOs, could receive more interpersonal needs and were probably mentally healthier. The mediating mechanism of interpersonal needs associated with participation in mental health was significant. Besides, mental health is generally affected by physical health, sleep quality, and socioeconomic status.

Conclusion

This study suggested that CSOs have expanded the social interaction channels of retired adults and affected their mental health by providing basic interpersonal needs such as inclusion, dominance, and affection. Among the types of CSOs, health and study organizations might enhance mental health most effectively, while semi-official organizations have no effect.

Efficacy and feasibility of a 12-week Tai Chi training for the prophylaxis of episodic migraine in Hong Kong Chinese women: A randomized controlled trial

Background

Tai Chi has been broadly applied as alternative treatment for many neurological and psychological disorders. Whereas no study using Tai Chi as prophylactic treatment for migraine. The purpose of this study was to preliminarily examine the efficacy and feasibility of a 12-week Tai Chi training on migraine attack prevention in a sample of Chinese women.

Methods

A two-arm randomized controlled trial was designed. Women aged 18 to 65 years and diagnosed with episodic migraine were randomized to either Tai Chi group (TC group) or the waiting list control group. A modified 33-short form Yang-style Tai Chi training with 1 h per day, 5 days per week for 12 weeks was implemented in the TC group, with a 12-week follow up period. The control group received a "delayed" Tai Chi training at the end of the trial. The primary outcome was the differences in attack frequency between 4 weeks before baseline and at the 9-12 weeks after randomization. The intensity and duration of headache were also measured. The feasibility was evaluated by the maintenance of Tai Chi practice and satisfactory level of the participants toward training.

Results

Eighty-two women were randomized, finally 40 in TC group and 33 in control group were involved in the analysis. On average, women in TC group had 3.0 times (95% CI: -4.0 to -2.0, P < 0.01) and 3.6 days (95% CI: -4.7 to -2.5, P < 0.01) reduction of migraine attack per month. Compared with the control group, the differences were statistically significant (-3.7 attacks/month, 95% CI: -5.4 to -1.9; and -3.0 migraine days/month, 95% CI: -4.5 to -1.5; both P < 0.001). The intensity and duration of headache had 0.6 (95% CI: -1.2 to -0.0, P < 0.05) units and 1.2 (IQR: -5.0 to 1.1, P < 0.05) hours reduction in TC group, respectively. Most of the participants (69.2%-97.4%) were satisfied with the training. At the end of 24 weeks, on average, the participants maintained 1.5 times of practice per week and 20 min for each practice.

Conclusion

The 12-week Tai Chi training significantly decreased the frequency of migraine attack. It was acceptable and practicable among female migraineurs.

Clinical trial registration

www.ClinicalTrials.gov, identifier: NCT03015753.

Chronic effects of different exercise types on brain activity in healthy older adults and those with Parkinson’s disease: A systematic review

Objective: This study aimed to compare the regulation of brain activity by different kinds of long-term exercises (Tai Chi, treadmill training, and dancing) in healthy older adults and those with PD.

Methods: From January 2000 to October 2021, the electronic databases PubMed, Web of Science, and Scopus were searched. All articles were screened throughout the inclusion and exclusion criteria, which was followed by PICOS criteria. Finally, all articles were systematically reviewed with analyses.

Results: 29 studies were identified for this review, 24 of which were finally included in a group of healthy older adults, and five of which in a group of people with PD. All studies showed that significant changes were showed on people with PD and healthy older adults’ brain activity after three terms of the exercises we chose. An inverse change trend on the functional connectivity in people with PD was observed after treadmill training, whereas increased brain activity, cognitive function, memory, and emotion were noticed in healthy older adults.

Conclusion: Our findings suggest that different patterns of brain activity were also observed between healthy older adults and people with PD after treadmill training. However, more robust evidence and comprehensive studies are needed to determine if there is a difference between healthy older adults and people with PD.

Determining Whether Tai Chi Chuan Is Related to the Updating Function in Older Adults: Differences Between Practitioners and Controls

Background

Tai Chi Chuan (TCC) is an effective method for delaying cognitive decline in older adults. However, in older adults, the association between long-term TCC practice and working memory updating has not been extensively studied.

Objective

This cross-sectional study investigated how updating function operationalized via Reaction Times (RTs) and Accuracy Rates (ARs) of N-Back tasks being measured in a laboratory setting is related to long term practice of TCC.

Methods

Twenty-six healthy elderly people participated in this experiment. According to the duration of time TCC was practiced, 13 subjects in the TCC group had more than 5 years of experience with TCC exercise, and 13 elderly subjects who had not been systematically exposed to mind-body exercise were assigned to the control group. The N-back task was administered to every participant to evaluate the updating function.

Results

The TCC group had faster RTs than the control group (p < 0.05). For the 1-back task, the TCC group showed faster RTs than the control group; for the 2-back task, the TCC group exhibited faster RTs than the control group. The TCC group had higher ARs than the control group (p < 0.05). For the 1-back task, the TCC group showed higher ARs than the control group; for the 2-back task, the TCC group exhibited higher ARs than the control group.

Conclusions

Long-term TCC practitioners exhibit a better updating function as compared to controls who did not practice TCC. Thus, our findings suggest that long-term TCC positively influences the updating function of older adults, making it, in turn, an effective mind-body exercise to maintain specific aspects of cognitive functioning.

Tai Chi Improves Brain Functional Connectivity and Plasma Lysophosphatidylcholines in Postmenopausal Women With Knee Osteoarthritis: An Exploratory Pilot Study

Objective: A pre/post pilot study was designed to investigate neurobiological mechanisms and plasma metabolites in an 8-week Tai-Chi (TC) group intervention in subjects with knee osteoarthritis.

Methods: Twelve postmenopausal women underwent Tai-Chi group exercise for 8 weeks (60 min/session, three times/week). Outcomes were measured before and after Tai Chi intervention including pain intensity (VAS), Brief Pain Inventory (BPI), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), plasma metabolites (amino acids and lipids), as well as resting-state functional magnetic resonance imaging (rs-fMRI, 10 min, eyes open), diffusion tensor imaging (DTI, 12 min), and structural MRI (4.5 min) in a subgroup. Clinical data was analyzed using paired t-tests; plasma metabolites were analyzed using Wilcoxon signed-rank tests; and rs-fMRI data were analyzed using seed-based correlations of the left and right amygdala in a two-level mixed-effects model (FSL software). Correlations between amygdala-medial prefrontal cortex (mPFC) connectivity and corresponding changes in clinical outcomes were examined. DTI connectivity of each amygdala was modeled using a Bayesian approach and probabilistic tractography. The associations between neurobiological effects and pain/physical function were examined.

Results: Significant pre/post changes were observed with reduced knee pain (VAS with most pain: p = 0.018; WOMAC-pain: p = 0.021; BPI with worst level: p = 0.018) and stiffness (WOMAC-stiffness, p = 0.020), that likely contributed to improved physical function (WOMAC-physical function: p = 0.018) with TC. Moderate to large effect sizes pre/post increase in rs-fMRI connectivity were observed between bilateral mPFC and the amygdala seed regions (i.e., left: d = 0.988, p = 0.355; right: d = 0.600, p = 0.282). Increased DTI connectivity was observed between bilateral mPFC and left amygdala (d = 0.720, p = 0.156). There were moderate-high correlations (r = 0.28–0.60) between TC-associated pre-post changes in amygdala-mPFC functional connectivity and pain/physical function improvement. Significantly higher levels of lysophosphatidylcholines were observed after TC but lower levels of some essential amino acids. Amino acid levels (alanine, lysine, and methionine) were lower after 8 weeks of TC and many of the lipid metabolites were higher after TC. Further, plasma non-HDL cholesterol levels were lower after TC.

Conclusion: This pilot study showed moderate to large effect sizes, suggesting an important role that cortico-amygdala interactions related to TC have on pain and physical function in subjects with knee osteoarthritis pain. Metabolite analyses revealed a metabolic shift of higher lyso-lipids and lower amino acids that might suggest greater fatty acid catabolism, protein turnover and changes in lipid redistribution in response to TC exercise. The results also support therapeutic strategies aimed at strengthening functional and structural connectivity between the mPFC and the amygdala. Controlled clinical trials are warranted to confirm these observed preliminary effects.

Effectiveness of Tai Chi Exercise Program on Sleep, Quality of Life, and Physical Performance in Postmenopausal Working Women

Background

Menopause being an unavoidable time in every woman's life brings up various challenges. Inevitable changes in body systems affect the life of a woman permanently. The symptoms constitute the postmenopausal syndrome which further affects the quality of life (QOL). Women spend most of the time working during the menopausal transition period and also during postmenopause. The discussion of symptoms is still considered a taboo. Exercise intervention to reduce the symptoms related to menopause which can show a positive impact on health status and work needs to be incorporated.

Methodology

Tai Chi exercise intervention was given for 8 weeks to the women who achieved natural menopause and were included in the study (n = 76). They were assessed for sleep, QOL, and physical performance before and after the intervention.

Results

A significant difference was observed in all the outcomes after 8 weeks of intervention (Sleep Quality Scale (SQS)-t = 7.57, P = 0.0001; WHOQOL-BREF-t = 7.56, P = 0.0001; and Physical Performance Test PPT-t = 19.93, P = 0.0001). The results were consistent due to the active participation and high adherence rate of the individuals to the protocol.

Conclusion

Our study revealed that besides being low velocity and low impact exercise, Tai Chi was a safe and effective mode of treatment in postmenopausal working women. In this group approach sessions were interactive and improved socialization skills because it was conducted in a community setting minimum equipment's and greater feasibility. Hence, this could also be incorporated in different age group population.

Evidence for exercise-related plasticity in functional and structural neural network connectivity

The number of studies investigating exercise and cardiorespiratory fitness (CRF)-related changes in the functional and structural organization of brain networks continues to rise. Functional and structural connectivity are critical biomarkers for brain health and many exercise-related benefits on the brain are better represented by network dynamics. Here, we reviewed the neuroimaging literature to better understand how exercise or CRF may facilitate and maintain the efficiency and integrity of functional and structural aspects of brain networks in both younger and older adults. Converging evidence suggests that increased exercise performance and CRF modulate functional connectivity of the brain in a way that corresponds to behavioral changes such as cognitive and motor performance improvements. Similarly, greater physical activity levels and CRF are associated with better cognitive and motor function, which may be brought about by enhanced structural network integrity. This review will provide a comprehensive understanding of trends in exercise-network studies as well as future directions based on the gaps in knowledge that are currently present in the literature.

Nutrition, Physical Activity, and Other Lifestyle Factors in the Prevention of Cognitive Decline and Dementia

Multiple factors combined are currently recognized as contributors to cognitive decline. The main independent risk factor for cognitive impairment and dementia is advanced age followed by other determinants such as genetic, socioeconomic, and environmental factors, including nutrition and physical activity. In the next decades, a rise in dementia cases is expected due largely to the aging of the world population. There are no hitherto effective pharmaceutical therapies to treat age-associated cognitive impairment and dementia, which underscores the crucial role of prevention. A relationship among diet, physical activity, and other lifestyle factors with cognitive function has been intensively studied with mounting evidence supporting the role of these determinants in the development of cognitive decline and dementia, which is a chief cause of disability globally. Several dietary patterns, foods, and nutrients have been investigated in this regard, with some encouraging and other disappointing results. This review presents the current evidence for the effects of dietary patterns, dietary components, some supplements, physical activity, sleep patterns, and social engagement on the prevention or delay of the onset of age-related cognitive decline and dementia.

The Relations Between Physical Activity Level, Executive Function, and White Matter Microstructure in Older Adults

The population of older adults is increasing, indicating a need to examine factors that may prevent or mitigate age-related cognitive decline. The current study examined whether microstructural white matter characteristics mediated the relation between physical activity and executive function in older adults without any self-reported psychiatric and neurological disorders or cognitive impairment (N = 43, mean age = 73 y). Physical activity was measured by average intensity and number of steps via accelerometry. Diffusion tensor imaging was used to examine microstructural white matter characteristics, and neuropsychological testing was used to examine executive functioning. Parallel mediation models were analyzed using microstructural white matter regions of interest as mediators of the association between physical activity and executive function. Results indicated that average steps was significantly related to executive function (β = 0.0003, t = 2.829, P = .007), while moderate to vigorous physical activity was not (β = 0.0007, t = 1.772, P = .08). White matter metrics did not mediate any associations. This suggests that microstructural white matter characteristics alone may not be the mechanism by which physical activity impacts executive function in aging.

The Specific and Nonspecific Effects of Tai Chi and Its Possible Central Responses: A Protocol of Neuroimaging Study

Tai Chi has been proven to be a safe and effective assistant therapy for healthcare and disease treatment. However, whether the adjuvant therapeutic effect of Tai Chi is general or disease-oriented remains uncertain. This trial focuses on exploring the specific and nonspecific effects of Tai Chi and its potential central responses. The results will deepen our understanding of the characteristics of Tai Chi exercise for adjuvant therapeutic effects and promote its application in the clinic. In this neuroimaging trial, 40 functional constipation (FC) patients and 40 healthy subjects (HS) will be recruited and will receive 10 weeks of Tai Chi exercise. The motor function, respiratory function, stool-related symptoms, quality of life, and emotional state of the participants will be evaluated at the baseline, the 5-week Tai Chi practice, and the end of practice. The potential changes in the heart rate variability and the cerebral function will be recorded by the 24 h dynamic electrocardiogram at the baseline and the functional magnetic resonance imaging at the end of practice. The possible correlations among the clinical variables, the heart rate variability, and the cerebral activity alterations in FC patients and HS will be analyzed. The healthcare and therapeutic effects of Tai Chi exercise might consist of the specific and nonspecific effects. This study provides not only a new perspective for understanding Tai Chi but also a new approach for investigating the mind-body exercise. This trial was registered in the Chinese Clinical Trial Registry (http://www.chictr.org.cn/showproj.aspx?proj=33243) on 28 November 2018 (registration number: ChiCTR1800019781; protocol version number: V1.0). This trial is currently in the stage of recruiting patients. The first patient was included on 1 December 2018. To date, 18 FC patients and 20 HS have been included. Recruitment will be completed in December 2020.

Cognitive Benefits of Activity Engagement among 12,093 Adults Aged over 65 Years

OBJECTIVE

The present study includes two aims: (1) to understand patterns of activity engagement among older Chinese adults; (2) to further investigate associations between activity engagement and cognitive abilities in this population.

METHODS

Latent class analysis was applied to answer the aforementioned research questions across different age ranges while controlling for confounding variables (age, health, socioeconomic status (SES), and living alone). Specifically, five latent classes (non-active, working-active, comprehensive-active, physical-active, and less-active) were identified. Furthermore, associations between the classes of activity engagement and cognition were examined separately in three age groups: less than 80 years (young-old group), 80-99.5 years (old-old group) and more than 100 years (oldest-old group) of age.

RESULTS

Compared with Non-active older individuals, the other classes with a higher probability of engagement in various activities generally showed higher cognitive abilities (including general cognition, orientation, calculation, recall, and language), but not all patterns of active engagement in daily life were positively associated with better cognitive status across different age ranges. In particular, differences in the individuals' cognitive abilities across the four active latent classes were especially obvious in the old-old group as follows: the Comprehensive-active class had higher general cognitive and recall abilities than the other three active classes and higher calculation and language abilities than the Working-active class. In addition, significant sex differences were observed in activity patterns, cognition, and their associations in the young-old and old-old groups. Culture-specific programs should be customized to subgroups of different ages and genders by providing different training or activity modules based on their related dimensions of cognitive decline.

Regular Tai Chi Practice Is Associated With Improved Memory as Well as Structural and Functional Alterations of the Hippocampus in the Elderly

OBJECTIVE

The current study aimed at comparing the effects of Tai Chi (a motor-cognitive exercise) with walking (an exercise without cognitive demands) on cognitive performance, brain structure, and brain function in the elderly.

METHODS

This cross-sectional study included 42 healthy elderly women within two groups: Tai Chi (n = 20; mean age = 62.90 ± 2.38 years) and brisk walking exercise (n = 22; mean age = 63.27 ± 3.58 years). All the participants underwent a cognitive assessment via the Montreal Cognitive Assessment and brain structural and resting state functional magnetic resonance imaging (rsfMRI) assessments.

RESULTS

Episodic memory in the Tai Chi group was superior to that of the walking group. Higher gray matter density in the inferior and medial temporal regions (including the hippocampus) and higher ReHo in temporal regions (specifically the fusiform gyrus and hippocampus) were found in the Tai Chi group. Significant partial correlations were found between the gray matter density of the left hippocampus and episodic memory in the whole sample. Significant partial correlations were observed between the ReHo in left hippocampus, left parahippocampal, left fusiform, and delayed memory task, which was observed among all subjects.

CONCLUSION

The present study suggests that long-term Tai Chi practice may improve memory performance via remodeling the structure and function of the hippocampus.

Physical Activity and Exercise in Mild Cognitive Impairment and Dementia: An Umbrella Review of Intervention and Observational Studies

OBJECTIVES

The aim of this umbrella review was to determine the effect of physical activity/exercise on improving cognitive and noncognitive outcomes in people with MCI (mild cognitive impairment) and dementia.

DESIGN

Umbrella review of systematic reviews (SR), with or without meta-analyses (MAs), of randomized controlled trials (RCTs) and observational studies.

SETTINGS AND PARTICIPANTS

People with MCI or dementia, confirmed through validated assessment measures. Any form of physical activity/exercise was included. As controls, we included participants not following any prespecified physical activity/exercise intervention or following the same standard protocol with the intervention group.

METHODS

The protocol was registered in PROSPERO (CDR 164197). Major databases were searched until December 31, 2019. The certainty of evidence of statistically significant outcomes was evaluated using the Grading of Recommendations Assessment, Development and Evaluation approach. SRs' findings, without a formal MA, were reported descriptively.

RESULTS

Among 1160 articles initially evaluated, 27 SRs (all of RCTs, 9 without MA) for a total of 28,205 participants with MCI/dementia were included. In patients with MCI, mind-body intervention (standardized mean difference [SMD] = 0.36; 95% confidence intervals [CI] 0.20-0.52; low certainty) and mixed physical activity interventions (SMD = 0.30; 95% CI 0.11-0.49; moderate certainty) had a small effect on global cognition, whereas resistance training (SMD = 0.80; 95% CI 0.29-1.31; very low certainty) had a large effect on global cognition. In people affected by dementia, physical activity/exercise was effective in improving global cognition in Alzheimer disease (SMD = 1.10; 95% CI 0.65-1.64; very low certainty) and in all types of dementia (SMD = 0.48; 95% CI 0.22-0.74; low certainty). Finally, physical activity/exercise improved noncognitive outcomes in people with dementia including falls, and neuropsychiatric symptoms.

CONCLUSIONS AND IMPLICATIONS

Supported by very low-to-moderate certainty of evidence, physical activity/exercise has a positive effect on several cognitive and noncognitive outcomes in people with MCI and dementia, but RCTs, with low risk of bias/confounding, are still needed to confirm these relationships.

Altered Brain Functional Connectivity Density in Fast-Ball Sports Athletes With Early Stage of Motor Training

The human brain shows neuroplastic adaptations caused by motor skill training. Of note, there is little known about the plastic architecture of the whole-brain network in resting state. The purpose of the present study was to detect how motor training affected the density distribution of whole-brain resting-state functional connectivity (FC). Resting-state functional magnetic resonance imaging data was assessed based on a comparison of fast-ball student athletes (SA) and non-athlete healthy controls (NC). The voxel-wise data-driven graph theory approach, global functional connectivity density (gFCD) mapping, was applied. Results showed that the SA group exhibited significantly decreased gFCD in brain regions centered at the left triangular part of the inferior frontal gyrus (IFG), extending to the opercular part of the left IFG and middle frontal gyrus compared to the NC group. In addition, findings suggested the idea of an increased neural efficiency of athletes’ brain regions associated with attentional–motor modulation and executive control. Furthermore, behavioral results showed that in the SA group, faster executive control reaction time relates to smaller gFCD values in the left IFG. These findings suggested that the motor training would decrease the numbers of FC in IFG to accelerate the executive control with high attentional demands and enable SA to rapidly focus the attention to detect the intriguing target.

Lactate and BDNF: Key Mediators of Exercise Induced Neuroplasticity?

Accumulating evidence from animal and human studies supports the notion that physical exercise can enhance neuroplasticity and thus reduce the risk of several neurodegenerative diseases (e.g., dementia). However, the underlying neurobiological mechanisms of exercise induced neuroplasticity are still largely unknown. One potential mediator of exercise effects is the neurotrophin BDNF, which enhances neuroplasticity via different pathways (e.g., synaptogenesis, neurogenesis, long-term potentiation). Current research has shown that (i) increased peripheral lactate levels (following high intensity exercise) are associated with increased peripheral BDNF levels, (ii) lactate infusion at rest can increase peripheral and central BDNF levels and (iii) lactate plays a very complex role in the brain’s metabolism. In this review, we summarize the role and relationship of lactate and BDNF in exercise induced neuroplasticity.

Differential Effects of Tai Chi Chuan (Motor-Cognitive Training) and Walking on Brain Networks: A Resting-State fMRI Study in Chinese Women Aged 60

Background: This cross-sectional study aimed to investigate whether a long-term engagement in different types of physical exercise may influence resting-state brain networks differentially. In particular, we studied if there were differences in resting-state functional connectivity measures when comparing older women who are long-term practitioners of tai chi chuan or walking. Method: We recruited 20 older women who regularly practiced tai chi chuan (TCC group), and 22 older women who walked regularly (walking group). Both the TCC group and the walking group underwent a resting-state functional magnetic resonance imaging (rs-fMRI) scan. The acquired rs-fMRI data of all participants were analyzed using independent component analysis. Age and years of education were added as co-variables. Results: There were significant differences in default network, sensory-motor network, and visual network of rs-fMRI between the TCC group and walking group (p < 0.05). Conclusions: The findings of the current study suggested that long-term practice of different types of physical exercises (TCC vs. walking) influenced brain functional networks and brain functional plasticity of elderly women differentially. Our findings encourage further research to investigate whether those differences in resting-state functional connectivity as a function of the type of physical exercise have implications for the prevention of neurological diseases.