title: Effects of Aerobic Training on Cognition and Brain Glucose Metabolism in Subjects with Mild Cognitive Impairment.
abstract: BACKGROUND
  Aerobic training (AT) is a promising intervention for mild cognitive impairment (MCI).
  
  
  OBJECTIVE
  To evaluate the effects of AT on cognition and regional brain glucose metabolism (rBGM) in MCI patients.
  
  
  METHODS
  Subjects performed a twice-a-week, moderate intensity, AT program for 24 weeks. Assessment with ADAS-cog, a comprehensive neuropsychological battery, and evaluation of rBGM with positron emission tomography with 18F-fluorodeoxyglucose ([18F]FDG-PET) were performed before and after the intervention. Aerobic capacity was compared using the maximal oxygen consumption VO2max (mL/Kg/min). [18F]FDG-PET data were analyzed on a voxel-by-voxel basis with SPM8 software.
  
  
  RESULTS
  Forty subjects were included, with a mean (M) age of 70.3 (5.4) years and an initial Mini-Mental State Exam score of 27.4 (1.7). Comparisons using paired t-tests revealed improvements in the ADAS-cog (M difference: -2.7 (3.7), p <  0.001) and VO2max scores (M difference: 1.8 (2.0) mL/kg/min, p <  0.001). Brain metabolic analysis revealed a bilateral decrease in the rBGM of the dorsal anterior cingulate cortex, pFWE = 0.04. This rBGM decrease was negatively correlated with improvement in a visuospatial function/attentional test (rho =-0.31, p = 0.04). Several other brain areas also showed increases or decreases in rBGM. Of note, there was an increase in the retrosplenial cortex, an important node of the default mode network, that was negatively correlated with the metabolic decrease in the dorsal anterior cingulate cortex (r =-0.51, p = 0.001).
  
  
  CONCLUSIONS
  AT improved cognition and changed rBGM in areas related to cognition in subjects with MCI.
authors.affiliation: Department of Neurology and Cognitive Disorders Reference Center (CEREDIC), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil.
authors.forename: Fábio Henrique de Gobbi
authors.initials: FH
authors.lastname: Porto
authors.affiliation: Department of Radiology, Nuclear Medicine Center (LIM43), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil.
authors.forename: Artur Martins Novaes
authors.initials: AM
authors.lastname: Coutinho
authors.affiliation: Laboratory of Assessment and Conditioning in Rheumatology (LACRE), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil.
authors.forename: Ana Lucia de Sá
authors.initials: AL
authors.lastname: Pinto
authors.affiliation: Laboratory of Assessment and Conditioning in Rheumatology (LACRE), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil.
authors.forename: Bruno
authors.initials: B
authors.lastname: Gualano
authors.affiliation: Department of Psychiatry and LIM21, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil.
authors.forename: Fabio Luís de Souza
authors.initials: FL
authors.lastname: Duran
authors.affiliation: Department of Psychiatry and LIM21, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil.
authors.forename: Silvana
authors.initials: S
authors.lastname: Prando
authors.affiliation: Department of Radiology, Nuclear Medicine Center (LIM43), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil.
authors.forename: Carla Rachel
authors.initials: CR
authors.lastname: Ono
authors.affiliation: Department of Neurology and Cognitive Disorders Reference Center (CEREDIC), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil.
authors.forename: Lívia
authors.initials: L
authors.lastname: Spíndola
authors.affiliation: Department of Neurology and Cognitive Disorders Reference Center (CEREDIC), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil.
authors.forename: Maira Okada
authors.initials: MO
authors.lastname: de Oliveira
authors.affiliation: Department of Neurology and Cognitive Disorders Reference Center (CEREDIC), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil.
authors.forename: Patrícia Helena Figuerêdo
authors.initials: PH
authors.lastname: do Vale
authors.affiliation: Department of Neurology and Cognitive Disorders Reference Center (CEREDIC), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil.
authors.forename: Ricardo
authors.initials: R
authors.lastname: Nitrini
authors.affiliation: Department of Radiology, Nuclear Medicine Center (LIM43), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil.
authors.forename: Carlos Alberto
authors.initials: CA
authors.lastname: Buchpiguel
authors.affiliation: Department of Radiology, Nuclear Medicine Center (LIM43), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil.
authors.forename: Sonia Maria Dozzi
authors.initials: SM
authors.lastname: Brucki
mesh_terms: D000368:Aged; D001921:Brain / Q000000981:diagnostic imaging / Q000378:metabolism*; D060825:Cognitive Dysfunction / Q000134:cerebrospinal fluid / Q000473:pathology* / Q000534:rehabilitation*; D015444:Exercise; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D019788:Fluorodeoxyglucose F18; D005947:Glucose / Q000378:metabolism*; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging; D008297:Male; D008609:Mental Status Schedule; D008875:Middle Aged; D009483:Neuropsychological Tests; D010101:Oxygen Consumption; D049268:Positron-Emission Tomography
chemical_list: D019788:Fluorodeoxyglucose F18; D005947:Glucose
keywords: Aerobic physical exercise; aerobic training; anterior cingulate cortex; cognition; mild cognitive impairment; non-pharmacological interventions; positron emission tomography with 18F-fluorodeoxyglucose