Exercise training improves vascular function in patients with Alzheimer’s disease

Abstract

Purpose Vascular dysfunction has been demonstrated in patients with Alzheimer’s disease (AD). Exercise is known to positively affect vascular function. Thus, the aim of our study was to investigate exercise-induced effects on vascular function in AD. Methods Thirty-nine patients with AD (79 ± 8 years) were recruited and randomly assigned to exercise training (EX, n = 20) or control group (CTRL, n = 19). All subjects performed 72 treatment sessions (90 min, 3 t/w). EX included moderate–high-intensity aerobic and strength training. CTRL included cognitive stimuli (visual, verbal, auditive). Before and after the 6-month treatment, the vascular function was measured by passive-leg movement test (PLM, calculating the variation in blood flow: ∆peak; and area under the curve: AUC) tests, and flow-mediated dilation (FMD, %). A blood sample was analyzed for vascular endothelial growth factor (VEGF). Arterial blood flow (BF) and shear rate (SR) were measured during EX and CTRL during a typical treatment session. Results EX group has increased FMD% (+ 3.725%, p < 0.001), PLM ∆peak (+ 99.056 ml/min, p = 0.004), AUC (+ 37.359AU, p = 0.037) and VEGF (+ 8.825 pg/ml, p = 0.004). In the CTRL group, no difference between pre- and post-treatment was found for any variable. Increase in BF and SR was demonstrated during EX (BF + 123%, p < 0.05; SR + 134%, p < 0.05), but not during CTRL treatment. Conclusion Exercise training improves peripheral vascular function in AD. These ameliorations may be due to the repetitive increase in SR during exercise which triggers NO and VEGF upregulation. This approach might be included in standard AD clinical practice as an effective strategy to treat vascular dysfunction in this population.

Connecting vascular aging and frailty in Alzheimer’s disease

“…Interestingly, MCI subjects randomized to receive a 7-month program including cognitive, social and exercise training showed an increase in FMD and in hematopoietic stem cell mobilization, along with a significant improvement of the ADAS-Cog score, whereas non-training MCI patients showed a decline in FMD and carotid distensibility over the followup period (Bruno et al, 2018). Similarly, a 6-month exercise training intervention induced a 3.7% mean increase of FMD, associated with increased VEGF and NO circulating levels, in a group of 39 AD patients (Pedrinolla et al, 2020). On the contrary, another study from the same group showed no alterations of endothelial function in MCI and AD individuals (mean FMD=7.8±2.6%), and no associations between FMD and the Mini-Mental State Examination (MMSE) score (Pedrinolla et al, 2019).…”

Effects of traditional Chinese exercise on vascular function in patients with Alzheimer’s disease: A protocol for systematic review and network meta-analysis of randomized controlled trials

“…It is possible that VEGF and NO levels are up-regulated due to the repetitive increase in shear rate during exercise. [25] TCEs are based on the doctrine of "yin and yang" and "the holistic concept" as the guiding ideology, and through mobilization of the body's own potential, 1 can achieve strengthening the body, cure and prevent diseases, prevent and improve health. TCEs usually include Taijiquan (TJQ), Baduanjin (BDJ), Wuqinxi (WQX), Liuzijue Qigong (LQG), and Yijinjing (YJJ).…”

“…It is possible that VEGF and NO levels are up-regulated due to the repetitive increase in shear rate during exercise. [ 25 ]…”

The role of muscle mass in vascular remodeling: insights from a single-leg amputee model

“…Also, shear-stress (known as the tractive force on endothelial cells induced by blood flow) activates a flow-sensitive potassium channel that induces hyperpolarization and promotes calcium influx, altering vascular tone (Gibbons and Dzau 1994 ). Current literature provides evidence about vascular remodeling coming from studies focused on the effect of physical inactivity in healthy individuals, but this model does not reflect the typical human behavior since it induces a sudden and extreme physical inactivity and a consequent dramatic change in hemodynamics, especially in the shear rate (Green et al 2017 ; Pedrinolla et al 2020a , b ; Thijssen et al 2011 ), as well as reduction in muscle mass together with several other physical inactivity side effect. Another model used to investigate vascular remodeling is the study of individuals with spinal cord injury (SCI) (Thijssen, Green and Hopman, 2011 ; Venturelli et al 2014 ).…”