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

• Published in: European journal of applied physiology Vol. 120; no. 10; pp. 2233 - 2245
• Main Authors: Pedrinolla, Anna, Venturelli, Massimo, Fonte, Cristina, Tamburin, Stefano, Di Baldassarre, Angela, Naro, Fabio, Varalta, Valentina, Giuriato, Gaia, Ghinassi, Barbara, Muti, Ettore, Smania, Nicola, Schena, Federico
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.10.2020; Springer Nature B.V
• Subjects: Acoustic Stimulation - methods; Aged; Aged, 80 and over; Alzheimer Disease - therapy; Alzheimer's disease; Biomedical and Life Sciences; Biomedicine; Blood flow; Cognition; Cognitive ability; Dementia; Exercise; Exercise Therapy - methods; Female; Fitness training programs; Hemodynamics; Human Physiology; Humans; Male; Movement; Neurodegenerative diseases; Occupational Medicine/Industrial Medicine; Original; Original Article; Patients; Photic Stimulation - methods; Physical training; Sports Medicine; Vascular endothelial growth factor; Vascular Endothelial Growth Factor A - blood; Visual stimuli; Flow-mediated dilation; Physical activity; Vascular endothelial growth factor; Passive-leg movement; Dementia
• ISSN: 1439-6319; 1439-6327; 1439-6327
• DOI: 10.1007/s00421-020-04447-w

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.