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

Figures

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  Fig. 1. Flow diagram of the randomized controlled trial

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  Fig. 2. Vascular outcomes. Data are given as mean ± standard deviation. Pre- and post-treatment values for passive limb movement test (PLM): blood flow delta peak (a) and area under the curve (AUC, b), and flow-mediated dilation (FMD, c), and as well as vascular endothelial growth factor (VEGF, d). †Within group difference with p < 0.05; ‡between groups difference with p < 0.05. Ctrl control group, EX exercise treatment

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  Fig. 3. Vascular response during treatments. Values of femoral (a) and brachial (b) blood flow (BF); femoral (c) and brachial (d) shear rate during EX (closed circle) and Ctrl (opened circle). Vascular measures were recorded at half-way of the treatments (about 3 months after the starting of the treatments). During EX, measures were taken at baseline and after each bout of aerobic and strength exercise (about every 15 min). Thus, record 0 = baseline, 1–2–3: end of endurance exercise, records 4–5: end of resistance exercise. The same timing was used for measurements during Ctrl. ‡significantly different from SE, p < 0.05; #significantly different from baseline values, p < 0.05

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  Fig. 4. Model of the direct effect of exercise on vascular function in Alzheimer’s disease. Exercise-induced effects may act directly on the peripheral and cerebral vascular function and consequently act indirectly on AD-related symptoms and comorbidities. Indeed, during exercise, blood flow and vascular shear stress greatly increase in tissue beds with high metabolic activity, leading to the activation of endothelial NO synthase, improving NO bioavailability. In addition, in response to the increased energy demand during exercise, VEGF is upregulated, which mediates mediating in morphology, number, and diameter of capillary and arteries. This angiogenic process is associated with functional changes and improvement in organ blood flow, including cerebral blood flow (CBF), which is significantly altered in the AD process