Fitness on White Matter and Cognition in Aging

December 16, 2018 updated by: Ryan Mace, Suffolk University

Neuroprotective Effects of Cardiorespiratory Fitness on White Matter Integrity and Cognition Across the Adult Lifespan

Cardiorespiratory fitness (CRF) is associated with decreased risk for mild cognitive impairment (MCI) and dementia. CRF is linked with more conserved gray and white matter (WM) volume, improved WM microstructural integrity, and better cognitive performance among healthy older adults. Additional research is needed to determine: (1) which WM tracts are most strongly related to CRF, (2) whether CRF-related benefits on WM translate to enhanced cognitive functioning, and (3) factors that mediate and moderate CRF effects. Higher CRF was hypothesized to be associated with stronger WM integrity, both globally and locally in WM tracts that connect frontal brain regions. The neuroprotective effects were hypothesized to be age-dependent, such that the association between CRF and WM integrity would be stronger in old age compared to younger age. Finally, higher CRF was hypothesized to predict stronger performance on tests of executive functioning (EF), partially mediated by frontal WM integrity. Delineation of specific neurocognitive effects of CRF may serve clinicians in individually tailoring wellness interventions to meet patients' specific cognitive concerns with aging.

Study Overview

Status

Completed

Conditions

Detailed Description

Sample: Participant data from the "Cross-Sectional Lifespan Connectomics Study" of the Nathan Kline Institute - Rockland Sample (NKI-RS) will be analyzed for the present study. Zip code-based recruitment and monitoring enrollment for key demographic variables (e.g., age, sex, ethnicity) were used to maintain adequate representation of Rockland County and prevent sampling biases (e.g., cohort effects). NKI-RS eligibility was designed for inclusivity.

Procedure: All participants completed a medical evaluation, psychiatric interview, self-report questionnaires, standardized battery of cognitive tests, and neuroimaging at NKI. Complete details about the MRI measurement parameters can be located on the NKI-RS website for DTI and MPRAGE and protocols. Quality assurance of raw data, inclusive of monitoring standard operating procedures, error-handling, and compiling the data dictionary, is maintained by NKI-RS. Raw neuroimaging data was acquired by NKI-RS and processed at Suffolk University using TRACULA and FreeSurfer 5.3.

Statistical Plan: Analyses will be performed on de-identified phenotypic and neuroimaging data from adult NKI-RS participants available at the start of this study (October 2016). Analyses will evaluate the potential for CRF to modulate decline in WM integrity and EF observed with aging. Mixed-effects modeling will investigate the extent to which CRF predicts WM integrity, as both a global measurement of fractional anisotropy (FA) and FA within nine major WM tracts. Structural equation modeling will examine whether higher FA within frontal WM tracts partially mediates a positive relationship between CRF and EF. The role of age and clinical characteristics (e.g., cardiovascular risk factors, depression) will also be explored as covariates in the link between CRF, WM, and EF.

Study Type

Observational

Enrollment (Actual)

645

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

20 years to 85 years (Adult, Older Adult)

Accepts Healthy Volunteers

Yes

Genders Eligible for Study

All

Sampling Method

Non-Probability Sample

Study Population

Participants are community-dwelling adults from the "Cross-Sectional Lifespan Connectomics Study" of the Nathan Kline Institute - Rockland Sample (NKI-RS)-a large cross-sectional sample of adult brain development. NKI prospectively recruited community-dwelling residents of Rockland County, New York-a region that is socioeconomically comparable to United States demographics.

Description

NKI-RS eligibility criteria was designed for inclusivity. Nearly half of recruited individuals met criteria for at least one Diagnostic Statistical Manual - 4th Edition diagnosis based on a semi-structured clinical interview.

Inclusion Criteria (present study):

  • diffusion tensor imaging (DTI) without significant artifacts
  • T1-weighted structural imaging (Magnetization-Prepared Rapid Gradient-Echo; MPRAGE) without significant artifacts
  • CRF data from a standardized cycle ergometer test (commonly used for predicting maximal oxygen uptake; VO2 max).

Exclusion Criteria (per NKI-RS protocol):

  • severe psychiatric illness (bipolar disorder, schizophrenia disorder, schizoaffective disorder)
  • severe developmental disorders (autism spectrum disorders, intellectual disabilities)
  • current suicidal or homicidal ideation
  • severe cerebral trauma (stroke, moderate to severe traumatic brain injury, ischemic attack in the past two years)
  • severe neurodegenerative disorders (Parkinson's disease, Huntington's Disease, dementia)
  • a history of substance dependence in the past two years (with an exception for cannabis)
  • a lifetime history of psychiatric hospitalization
  • current pregnancy
  • MRI contraindications

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

Cohorts and Interventions

Group / Cohort
Cross-Sectional Lifespan Connectomics Study

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
white matter (WM) microstructure integrity
Time Frame: Measured between 9:00 and 10:00 am on the single assessment day.
fractional anisotropy (FA) diffusion tensor imaging (DTI)
Measured between 9:00 and 10:00 am on the single assessment day.
executive function (EF)
Time Frame: Measured between 12:30 and 2:30 pm on the single assessment day.
Delis-Kaplan Executive Function System (D-KEFS) subtests will include the Trail Making Test, Design Fluency Test, Color-Word Interference Test, and Tower Tests. Scores from each subtest will be transformed into z-scores to yield the same units of measurement. Then, structural equation modeling (SEM) will aggregate these values quantify a construct of overall EF.
Measured between 12:30 and 2:30 pm on the single assessment day.
executive function (EF)
Time Frame: Measured between 11:00 am and 12:00 pm on the single assessment day.
Penn Computerized Neurocognitive Battery (CNB) subtests will include the CNB Letter N-back Test and Conditional Exclusion Test. Scores from each subtest will be transformed into z-scores to yield the same units of measurement. Then, structural equation modeling (SEM) will aggregate these values quantify a construct of overall EF.
Measured between 11:00 am and 12:00 pm on the single assessment day.

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Suffolk University

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Helpful Links

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

March 1, 2012

Primary Completion (Actual)

July 1, 2016

Study Completion

July 1, 2016

Study Registration Dates

First Submitted

November 29, 2018

First Submitted That Met QC Criteria

December 11, 2018

First Posted (Actual)

December 14, 2018

Study Record Updates

Last Update Posted (Actual)

December 19, 2018

Last Update Submitted That Met QC Criteria

December 16, 2018

Last Verified

December 1, 2018

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • NKI-RS
  • R01MH094639-01 (U.S. NIH Grant/Contract)

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

YES

IPD Plan Description

The Nathan Kline Institute - Rockland Sample is a public, open-access data repository that is available upon approval of the NKI data usage agreement.

R code for all study analyses will be made available for reproducibility with open-access NKI-RS data.

IPD Sharing Supporting Information Type

  • STUDY_PROTOCOL
  • SAP
  • ANALYTIC_CODE

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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