Chronic cerebral ischemia (CCI) can lead to vascular cognitive impairment, but therapeutic options are limited. Cognitive‐exercise dual‐task (CEDT), as a potential rehabilitation intervention, can ...attenuate cognitive impairment. However, the related mechanisms remain unclear. In this study, 2‐vessel occlusion (2‐VO) in male SD rats was performed to establish the CCI model. The rats were treated with cognitive, exercise, or CEDT intervention for 21 days. The Morris water maze (MWM) test was used to assess cognitive ability. TUNEL staining was used to detect the neuronal apoptosis. Immunofluorescence, RT‐qPCR and Western blot were used to detect the protein or mRNA levels of EphrinA3, EphA4, p‐PI3K, and p‐Akt. The results showed that CEDT could improve performance in the MWM test, reverse the increased expression of EphrinA3 and EphA4, and the reduced expression of p‐PI3K and p‐Akt in CCI rats, which was superior to exercise and cognitive interventions. In vitro, oxygenglucose deprivation (OGD) challenge of astrocytes and neuronal cells were used to mimic cerebral ischemia. Immunofluorescence assay revealed that the levels of MAP‐2, p‐PI3K, and p‐Akt were reduced in EphrinA3 overexpressed cells after OGD stimulation. Finally, the knock‐down of EphrinA3 by shRNA significantly promoted the recovery of cognitive function and activation of PI3K/Akt after CEDT treatment in CCI rats. In conclusion, our study suggests that CEDT promotes cognitive function recovery after CCI by regulating the signaling axis of EphrinA3/EphA4/PI3K/Akt.
The exercise single‐task (EST), cognitive single‐task (CST), and cognitive‐exercise dual‐task (CEDT) interventions improved cognitive dysfunction after chronic cerebral ischemia (CCI) by regulating the signaling axis of EphrinA3/EphA4/PI3K/Akt.
Aging-related cognitive impairment (ARCI) is rapidly becoming a healthcare priority. However, there is currently no excellent cure for it. Cognitive-exercise dual-task intervention (CEDI) is a ...promising method to improve ARCI, while the underlying mechanisms remain unclear. Long non-coding RNAs (lncRNAs) and microRNAs (miRNAs) are involved in the onset, development, and rehabilitation of ARCI. This study aimed to investigate the effects of CEDI and the role of regulation of the lncRNA NEAT1/miR-124–3p on the caveolin-1-PI3K/Akt/GSK3β pathway in CEDI improving cognitive function. Forty 18-month-old natural aging rats were randomly assigned to four groups: exercise training group, cognitive training group, CEDI group, and aging control group, and underwent 12 weeks of intervention. A novel object recognition test was performed to determine the cognitive function, and the hippocampus was separated three days after the behavioral tests for further molecular detection. In an in vitro study, the mouse hippocampal neuronal cell line HT22 was cultured. MiR-124–3p and lncRNA NEAT1 were over-expressed or down-expressed, respectively. The expressions of related proteins, lncRNA, and miRNA were examined by WB and/or qRT-PCR. The results showed that compared with the aging control group, the CEDI group had a higher discrimination index, and significantly decreased the expressions of lncRNA NEAT1, and the protein expressions of caveolin-1 and p-GSK3β, while significantly increased the expressions of miR-124–3p, and the protein expressions of p-PI3K and p-Akt. Inhibition of the lncRNA NEAT1 could significantly increase the protein expressions of p-PI3K and p-Akt in HT22 cells. Upregulation of miR-124–3p decreased the protein expressions of caveolin-1 and p-GSK3β, and increased the protein expressions of p-PI3K and p-Akt significantly. Inhibition of miR-124–3p had the opposite effects. Our study demonstrated that CEDI improved cognitive function in aging rats better than a single intervention. The mechanisms of cognitive improvement could be related to the regulation of the lncRNA NEAT1/miR-124–3p on the caveolin-1-PI3K/Akt/GSK3β pathway.
•Cognitive-exercise dual-task intervention ameliorates cognitive decline in natural aging rats.•Cognitive-exercise dual-task intervention improves aging-related cognitive impairment better than single interventions.•The lncRNA NEAT1/miR-124–3p regulates the caveolin-1-PI3K/Akt/GSK3β pathway in the central nervous system.•Dual-task intervention inhibits the promotion of lncRNA NEAT1/miR-124–3p on the caveolin-1-PI3K/Akt/GSK3β pathway.
Reminiscence therapy (RT) can improve the mood and communication of persons living with Alzheimer's disease and Alzheimer's-disease-related dementias (PLWD). Traditional RT requires professionals' ...facilitation, limiting its accessibility to PLWD. Social robotics has the potential to facilitate RT, enabling accessible home-based RT. However, studies are needed to investigate how PLWD would perceive a robot-mediated reminiscence therapy (RMRT) and how to develop RMRT for positive user experience and successful adoption. In this article, we develop a prototype of RMRT using a humanoid social robot and test it with 12 participants (seven PLWD, two with mild cognitive impairment, and three informal caregivers). The robot automatically displays a memory trigger on its tablet and engages participants in a relatable conversation during RMRT. A mixed-method approach is employed to assess its acceptability and usability. Our results show that PLWD have an overall positive user experience with the RMRT. Participants laugh and sing along with the robot during RMRT and demonstrate intention to use it. In addition, we discuss a robot control method and several critical problems for RMRT. The RMRT can facilitate both verbal and nonverbal social interaction for PLWD and holds promise for engaging, personalized, and efficient home-based cognitive exercises for PLWD.
Objectives
To investigate whether a 12‐week physical and cognitive exercise program can improve cognitive function and brain activation efficiency in community‐dwelling older adults.
Design
...Randomized controlled trial.
Setting
Kyoto, Japan.
Participants
Community‐dwelling older adults (N = 48) were randomized into an exercise group (n = 24) and a control group (n = 24).
Intervention
Exercise group participants received a weekly dual task–based multimodal exercise class in combination with pedometer‐based daily walking exercise during the 12‐week intervention phase. Control group participants did not receive any intervention and were instructed to spend their time as usual during the intervention phase.
Measurements
The outcome measures were global cognitive function, memory function, executive function, and brain activation (measured using functional magnetic resonance imaging) associated with visual short‐term memory.
Results
Exercise group participants had significantly greater postintervention improvement in memory and executive functions than the control group (P < .05). In addition, after the intervention, less activation was found in several brain regions associated with visual short‐term memory, including the prefrontal cortex, in the exercise group (P < .001, uncorrected).
Conclusion
A 12‐week physical and cognitive exercise program can improve the efficiency of brain activation during cognitive tasks in older adults, which is associated with improvements in memory and executive function.
The prevalence of vascular cognitive impairment induced by chronic cerebral ischemia (CCI) is increasing year by year. Cognitive-exercise dual-task intervention has shown beneficial effects on ...improving cognitive performance in ischemic patients. It is well known that the tyrosine kinase ligand-receptor (Ephrin-Eph) system plays an important role in synaptic transmission and that the cAMP/PKA pathway is associated with cognitive function. However, it is unclear whether they are responsible for the dual-task improving cognitive impairment in CCI.
Bilateral common carotid artery occlusion (BCCAO) in SD rats was used to establish the CCI model. The effects of dual-task and single-task on cognitive function and the expressions of EphrinA3, EphA4, cAMP, and PKA in rats were detected by the novel object recognition (NOR) test, immunofluorescence staining, quantitative real-time polymerase chain reaction (qPCR), and Western blotting (WB), respectively. Overexpression or knockdown of EphrinA3 in astrocytes or rats were constructed by lentivirus infection to verify the effects of EphrinA3/EphA4 on the cAMP/PKA pathway.
After dual-task intervention, the discrimination index of rats increased significantly compared with the rats in the CCI group. The expressions of EphrinA3 and EphA4 were decreased, while the expressions of cAMP and PKA were increased. Furthermore, knockdown of EphrinA3 alleviated the trend of CCI-induced cognitive decline in rats and OGD-stimulated cellular damage. It also increased cAMP/PKA expression in hippocampal neurons.
Cognitive-exercise dual-task can significantly improve the cognitive impairment induced by CCI, and this effect may be better than that of the cognitive or exercise single-task intervention. The improvement may be related to the inhibition of EphrinA3/EphA4, followed by activation of the cAMP/PKA pathway.
Objectives Epidemiological and preclinical studies suggest that mental activity levels may alter dementia risk. Clinical trials are now beginning to address the key issues of persistence of effect ...over extended follow-up and transfer of effect to nontrained domains. The aim of this report was to therefore systematically review results from clinical trials, which have examined the effect of cognitive exercise on longitudinal cognitive performance in healthy elderly individuals. Methods MEDLINE, PubMed, and key references were used to generate an initial list of relevant studies (N = 54). These were reviewed to identify randomized controlled trials, which tested the effect of a discrete cognitive exercise training regime on longitudinal (>3 months) posttraining neuropsychological performance in healthy older adults. Seven RCTs met entry criteria. Prechange and postchange scores were integrated using a random effects weighted mean difference (WMD) meta-analytic approach (Review Manager Version 4.2). Results A strong effect size was observed for cognitive exercise interventions compared with wait-and-see control conditions (WMD = 1.07, CI: 0.32–1.83, z = 2.78, N = 7, p = 0.006, N = 3,194). RCTs with follow-up greater than 2 years did not appear to produce lower effect size estimates than those with less extended follow-up. Quality of reporting of trials was in general low. Conclusion Cognitive exercise training in healthy older individuals produces strong and persistent protective effects on longitudinal neuropsychological performance. Transfer of these effects to dementia-relevant domains such as general cognition and daily functioning has also been reported in some studies. Importantly, cognitive exercise has yet to be shown to prevent incident dementia in an appropriately designed trial and this is now an international priority.
Background
Attentiveness during class is critical for learning. Teachers have strategies to promote active engagement and active learning, yet little control over students’ baseline level of ...alertness and focus upon arriving to class.
Objective
To evaluate the effect of pre-lecture cognitive exercise on attention and learning in lectures.
Method
In Experiment 1, college students (n = 28) in Introductory Psychology participated in a brief battery of complex cancellation tasks prior to a subset of lectures. Effectiveness measures included course exams and post-study student surveys. Experiment 2 replicated the first in a subsequent class (n = 35) with the same instructor and the addition of post-lecture quizzes.
Results
In both experiments, students performed higher on exam content from post-exercise lectures relative to control lectures. No effect was observed on post-lecture quizzes. On post-study surveys, students reported improved attentiveness to lecture after cognitive calisthenics.
Conclusion
Pre-lecture cognitive activity appears to benefit student attention and learning in lectures.
Teaching Implications
With so many students arriving to class either distracted or sleepy, the inclusion of a brief pre-lecture cognitive exercise program may be an engaging and effective method for optimizing student attentiveness and learning in lecture-based courses.
Primary objective: Motivation to initiate and persist with any kind of exercise activity is challenging. This pilot study queried adults with chronic-acquired brain injuries (ABI) regarding their ...perceptions about motivational facilitators of and barriers to engagement in cognitive exercise activity.
Research design: A mixed methods design was used to characterize individuals' perceptions regarding exercise and their exercise experience (written questionnaire) and to obtain their input regarding exercise-related motivational strategies and obstacles (semi-structured group interviews).
Methods: Thirty-four community-based individuals with chronic ABI and moderate-to-severe cognitive impairments completed questionnaires and engaged in audio-recorded scripted group interviews. Tallies of closed-ended questionnaire data and thematic analysis of open-ended questionnaire and group interview data were completed.
Main outcomes and results: Participants indicated a strong preference for engaging in cognitive exercise activity with others versus alone. Frequently recurring motivational facilitators regarding exercise in general and cognitive exercise in particular included 'receipt of positive reinforcement for exercise activity', 'possession of needed information to engage in exercise', and 'possession of exercise-related goals'. Frequently recurring motivational barriers included 'absence of exercise-related goals' and 'absence of consistent structure conducive to exercise'.
Conclusion: Study findings may facilitate successful engagement in cognitive exercise by chronic ABI survivors. Further research is needed.
Abstract
Background
Electronic health (eHealth) technology offers the potential to support and motivate physical activity for symptom management in Parkinson’s disease (PD). It is also recommended ...that motor exercise in PD be complemented with cognitive training aimed at attentional or executive functions. This paper describes the protocol for a double-blind randomized controlled trial to evaluate the effects of motor-cognitive training in the home environment, supported by eHealth.
Methods/design
The Support for home Training using Ehealth in Parkinsons diseaSe (STEPS) is a double-blind single center randomized controlled trial. Two parallel groups will include in total 120 participants with mild to moderate PD who will receive either (i) the intervention (a progressive 10-week individualized motor-cognitive eHealth training with cognitive behavioral elements to increase physical activity levels) or (ii) an active control group (an individualized 10-week paper-based home exercise program). The active control group will not receive motor-cognitive exercises or cognitive behavioral approaches to increase physical activity level. The primary outcome is walking capacity assessed by the six-minute walk test (6MWT). Secondary outcomes will include gait performance during single and dual task conditions, gait speed, functional mobility and lower limb strength, balance, physical activity behavior and a range of patient reported outcome measures relevant in PD.
Discussion
The STEPS trial will answer the question whether 10 weeks of eHealth supported motor-cognitive exercise in the home environment can improve walking capacity in PD when compared to a standard paper exercise program. Findings from this study will also strengthen the evidence concerning the efficacy of PD-specific eHealth interventions with a view meeting future health care demands by addressing issues of inaccessibility to specialized neurological rehabilitation in PD.
Trial registration
ClinicalTrials.gov August 2022, NCT 05510739.
Abstract
Background
Responsiveness and minimal clinically important difference (MCID) are critical indices to understand whether observed improvement represents a meaningful improvement after ...intervention. Although simultaneous cognitive-exercise training (SCET; e.g., performing memory tasks while cycling) has been suggested to enhance the cognitive function of older adults, responsiveness and MCID have not been established. Hence, we aimed to estimate responsiveness and MCIDs of two dual task performance involving cognition and hand function in older adults with and without cognitive impairment and to compare the differences in responsiveness and MCIDs of the two dual task performance between older adults with and without cognitive impairment.
Methods
A total of 106 older adults completed the Montreal Cognitive Assessment and two dual tasks before and after SCET. One dual task was a combination of Serial Sevens Test and Box and Block Test (BBT), and the other included frequency discrimination and BBT. We used effect size and standardized response mean to indicate responsiveness and used anchor- and distribution-based approaches to estimating MCID ranges. When conducting data analysis, all participants were classified into two cognitive groups, cognitively healthy (Montreal Cognitive Assessment ≥ 26) and cognitively impaired (Montreal Cognitive Assessment < 26) groups, based on the scores of the Montreal Cognitive Assessment before SCET.
Results
In the cognitively healthy group, Serial Seven Test performance when tasked with BBT and BBT performance when tasked with Serial Seven Test were responsive to SCET (effect size = 0.18–0.29; standardized response mean = 0.25–0.37). MCIDs of Serial Seven Test performance when tasked with BBT ranged 2.09–2.36, and MCIDs of BBT performance when tasked with Serial Seven Test ranged 3.77–5.85. In the cognitively impaired group, only frequency discrimination performance when tasked with BBT was responsive to SCET (effect size = 0.37; standardized response mean = 0.47). MCIDs of frequency discrimination performance when tasked with BBT ranged 1.47–2.18, and MCIDs of BBT performance when tasked with frequency discrimination ranged 1.13–7.62.
Conclusions
Current findings suggest that a change in Serial Seven Test performance when tasked with BBT between 2.09 and 2.36 corrected number (correct responses – incorrect responses) should be considered a meaningful change for older adults who are cognitively healthy, and a change in frequency discrimination performance when tasked with BBT between 1.47 and 2.18 corrected number (correct responses – incorrect responses) should be considered a meaningful change for older adults who are cognitively impaired. Clinical practitioners may use these established MCIDs of dual tasks involving cognition and hand function to interpret changes following SCET for older adults with and without cognitive impairment.
Trial registration
NCT04689776, 30/12/2020.
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