Distinct Brain and Behavioral Benefits from Cognitive vs. Physical Training: A Randomized Trial in Aging Adults

Sandra B Chapman, Sina Aslan, Jeffrey S Spence, Molly W Keebler, Laura F DeFina, Nyaz Didehbani, Alison M Perez, Hanzhang Lu, Mark D'Esposito, Sandra B Chapman, Sina Aslan, Jeffrey S Spence, Molly W Keebler, Laura F DeFina, Nyaz Didehbani, Alison M Perez, Hanzhang Lu, Mark D'Esposito

Abstract

Insidious declines in normal aging are well-established. Emerging evidence suggests that non-pharmacological interventions, specifically cognitive and physical training, may counter diminishing age-related cognitive and brain functions. This randomized trial compared effects of two training protocols: cognitive training (CT) vs. physical training (PT) on cognition and brain function in adults 56-75 years. Sedentary participants (N = 36) were randomized to either CT or PT group for 3 h/week over 12 weeks. They were assessed at baseline-, mid-, and post-training using neurocognitive, MRI, and physiological measures. The CT group improved on executive function whereas PT group's memory was enhanced. Uniquely deploying cerebral blood flow (CBF) and cerebral vascular reactivity (CVR) MRI, the CT cohort showed increased CBF within the prefrontal and middle/posterior cingulate cortex (PCC) without change to CVR compared to PT group. Improvements in complex abstraction were positively associated with increased resting CBF in dorsal anterior cingulate cortex (dACC). Exercisers with higher CBF in hippocampi bilaterally showed better immediate memory. The preliminary evidence indicates that increased cognitive and physical activity improves brain health in distinct ways. Reasoning training enhanced frontal networks shown to be integral to top-down cognitive control and brain resilience. Evidence of increased resting CBF without changes to CVR implicates increased neural health rather than improved vascular response. Exercise did not improve cerebrovascular response, although CBF increased in hippocampi of those with memory gains. Distinct benefits incentivize testing effectiveness of combined protocols to strengthen brain health.

Keywords: CBF; ClinicalTrials.gov; NCT# 00977418; aerobic exercise; aging; cognitive training; executive function; memory.

Figures

Figure 1
Figure 1
(A) Reultss of voxel based analysis are superimposed on an average CBF map of all participants for linear (T1 to T3 change) and quadratic (maximal T2 change) interaction contrasts at p < 0.01 (FWE corrected) and k ≥ 1232 mm3. The regions experiencing a linear increase are located in the frontal regions while the regions experiencing a quadratic pattern of CBF increase are located in the posterior regions. (B) The regional CBF difference between CT and PT (i.e., CT–PT) groups are shown to depict linear and quadratic trends. For instance, the CBF of bilateral medial OFC increases from T1 to T2 and T3, i.e., linear trend, whereas the bilateral posterior cingulate cortex (PCC) increases from T1 to T2 and then decreases at T3, i.e., quadratic trend.
Figure 2
Figure 2
CT group showed significant association between gains in regional CBF and behavioral measures compared to PT group. The CT group's TOSL (strategic reasoning) score at T3 also showed significant association to bilateral dACC CBF increase at T3 compared to PT group, p < 0.05 [FWE Corrected]. “at T3” refers to linear trend (i.e., change from T1 to T3).
Figure 3
Figure 3
Scatterplots of immediate logical memory (LM) against the left/right hippocampus (HC) CBF regions are shown. The PT group showed positive immediate logical memory (LM) change at T3 against maximal T2 change of CBF in the left and right hippocampus, p = 0.01 and 0.003, respectively. “at T3” refers to linear trend (i.e., change from T1 to T3) and “at T2” refers to quadratic trend (i.e., maximal T2 change).

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