Efeito do treinamento aeróbio nos níveis do fator de crescimento semelhante à insulina-1 e funções cognitivas na doença de Alzheimer
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2017-12-18
Autores
Stein, Angelica Miki [UNESP]
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Universidade Estadual Paulista (Unesp)
Resumo
Para auxiliar o tratamento da doença de Alzheimer (DA), existem alternativas não farmacológicas, como o exercício físico. Efeitos do exercício físico em supostos mecanismos como o fator de crescimento semelhante a insulina (IGF-1), tem sido associado a melhoras encefálica, relacionadas à melhora de desempenho cognitivo, neurogênese, depuração do peptídeo beta-amilóide e redução da tau fosforilada. Dessa forma, o objetivo geral desta tese foi verificar a relação entre exercício físico, níveis circulantes de IGF-1 e DA. A tese foi estruturada em 6 capítulos, sendo Capítulo 1: descrição dos objetivos, revisão de literatura e delineamento do estudo; Capítulo 2: artigo de revisão sistemática sobre os estudos que investigaram o efeito do exercício físico nas funções cognitivas e IGF-1 circulante em idosos; Capítulo 3: estudo que teve como objetivo comparar a resposta ao exercício aeróbio agudo nos níveis de IGF-1 circulante de idosos cognitivamente preservados e idosos com DA; Capítulo 4: o objetivo deste estudo foi verificar o efeito do treinamento aeróbio nas funções cognitivas e níveis de IGF-1 em idosos com DA; Capítulo 5: estudo que teve como objetivo comparar a resposta ao exercício aeróbio agudo na cognição e atividade encefálica em camundongos selvagens, pré sintomáticos da DA e com deficiência de IGF-1; Capítulo 6: considerações gerais e conclusões da tese. No Capítulo 2 foram encontrados 7 estudos que verificaram o efeito do exercício nos níveis de IGF-1 e na função cognitiva de idosos em diferentes condições, como idosos cognitivamente preservados, idosos com comprometimento cognitivo leve e idosos pré-diabéticos. Os resultados apontaram que não há consenso entre melhor tipo de exercício, intensidade, frequência e duração para provocar melhora das funções cognitivas e regulação de IGF-1 circulante. O capítulo 3 traz um estudo em que participaram 74 idosos: 40 idosos cognitivamente preservados e 34 idosos com doença de Alzheimer. Todos os participantes responderam a uma avaliação cognitiva e foram submetidos a um teste incremental em esteira ergométrica. Sobretudo, foi demonstrado que idosos com DA e idosos cognitivamente preservados responderam ao exercício aeróbio agudo de maneira diferente: idosos com DA tiveram aumento dos níveis de IGF-1 e idosos cognitivamente preservados tiveram manutenção nestes mesmos níveis. No Capítulo 4, 16 idosos com DA compuseram o Grupo Controle (GC) e 18 idosos com DA, o Grupo Treinamento (GT). O GT participou de um protocolo de treinamento aeróbio, realizado a 80% da frequência cardíaca, com duração de 25-40 min/sessão, três vezes semanais, com duração de 12 semanas. Após o período experimental, não foram identificadas diferenças significativas entre grupos e momentos para as funções cognitivas e níveis de IGF-1. Porém, resultados clínicos na cognição e no controle de quadros de insulino-resistência foram observados no GT. No Capítulo 5 foi verificado camundongos selvagens tiveram aumento significativo na banda theta e desempenho cognitivo superior quando comparados aos outros grupos de animais. Por último, o Capítulo 6 traz as considerações gerais e conclusões da tese: não existe um protocolo único capaz de modificar os níveis de IGF-1 e provocar melhora cognitiva; idosos cognitivamente preservados e idosos com DA respondem de maneira diferente ao exercício aeróbio agudo quanto aos níveis de IGF-1; o treinamento aeróbio adotado não foi efetivo para melhora cognitiva, nem para modificações nos níveis de IGF-1; camundongos selvagens, pré-sintomáticos da DA e com deficiência de IGF-1 respondem de maneira diferente ao exercício aeróbio agudo na atividade encefálica, sendo que o exercício agudo se mostrou efetivo no desempenho cognitivo.
To help the treatment of Alzheimer's disease (AD), there are non-pharmacological alternatives, such as physical exercise. Possible effects of physical exercise on putative mechanisms, such as the insulin-like growth factor-1 (IGF-1), have been associated with improvements on brain health, related to cognition, neurogenesis, clearance of the protein beta-amyloid and p-tau. Thus, the objective of this thesis was to verify the relation among physical exercise, circulating IGF-1 and AD. The thesis was structured in 6 chapters - Chapter 1: description of the objectives, literature review and design of the study; Chapter 2: systematic review manuscript about studies that investigated the physical exercise effects on cognitive functions and circulating IGF-1 in elderlies; Chapter 3: the objective was to compare the response to aerobic acute exercise in circulating IGF-1 levels in cognitively preserved elderly and elderly with AD; Chapter 4: the objective was to verify the aerobic training effect on cognitive functions and IGF-1 levels in elderly with AD; Chapter 5: the objective was to compare the response to acute aerobic exercise on cognition and brain activity in wild mice, pre symptomatic AD mice and IGF-1 deficiency mice; Chapter 6: general considerations and conclusions. In the Chapter 2, 7 papers verified the exercise effect on IGF-1 levels and cognitive function in elderlies with different conditions, as cognitively preserved elderly, mild cognitive impairment and pre diabetes was found. The results pointed that there was no consensus about recommendation of best type of exercise, intensity, frequency and duration to induce improvement on cognition and circulating IGF-1 regulation. The Chapter 3 brings a study with transversal profile, with 74 participants: 40 cognitively preserved elderly and 34 elderly with AD. All participants responded to cognitive evaluation and they were submitted to a incremental test in ergometric treadmill. Mainly, elderly with AD and cognitively preserved elderlies responded to acute aerobic exercise in different ways. Elderly with AD had an increase on IGF-1 levels whereas cognitively preserved elderlies had a maintaining in this same levels. In the Chapter 4 in order to verify the training effect on cognitive functions and IGF-1, 16 elderlies with AD participated in Control Group (CG) and 18 elderlies with AD, in Training Group (TG). The TG participated in an aerobic training protocol, 75% of heart rate, 4 km/h, 25-40 min/session, 3 times weekly, during 12 weeks. After the experimental period, significant differences between groups and moments for cognitive functions and IGF-1 levels were not identified. However, interesting clinical results was observed in cognition and insulin-resistance control of TG. In Chapter 5, wild mice had a significant increase on theta rhythm and better cognitive performance when they were compared to another animal groups. Finally, the Chapter 6 brings us general considerations and conclusions of the thesis: there is not only one protocol capable to modify IGF-1 levels and induce cognition improvement; cognitively preserved elderly and elderly with AD responded differently to acute aerobic exercise in IGF-1 levels; the training protocol adopted in this study was not effective neither to improve cognition, nor to modified IGF-1 levels in elderlies with AD; wild mice, AD pre symptomatic mice and IGF-1 deficiency mice responded different to acute aerobic exercise in brain activity, considering acute exercise effective on cognitive performance.
To help the treatment of Alzheimer's disease (AD), there are non-pharmacological alternatives, such as physical exercise. Possible effects of physical exercise on putative mechanisms, such as the insulin-like growth factor-1 (IGF-1), have been associated with improvements on brain health, related to cognition, neurogenesis, clearance of the protein beta-amyloid and p-tau. Thus, the objective of this thesis was to verify the relation among physical exercise, circulating IGF-1 and AD. The thesis was structured in 6 chapters - Chapter 1: description of the objectives, literature review and design of the study; Chapter 2: systematic review manuscript about studies that investigated the physical exercise effects on cognitive functions and circulating IGF-1 in elderlies; Chapter 3: the objective was to compare the response to aerobic acute exercise in circulating IGF-1 levels in cognitively preserved elderly and elderly with AD; Chapter 4: the objective was to verify the aerobic training effect on cognitive functions and IGF-1 levels in elderly with AD; Chapter 5: the objective was to compare the response to acute aerobic exercise on cognition and brain activity in wild mice, pre symptomatic AD mice and IGF-1 deficiency mice; Chapter 6: general considerations and conclusions. In the Chapter 2, 7 papers verified the exercise effect on IGF-1 levels and cognitive function in elderlies with different conditions, as cognitively preserved elderly, mild cognitive impairment and pre diabetes was found. The results pointed that there was no consensus about recommendation of best type of exercise, intensity, frequency and duration to induce improvement on cognition and circulating IGF-1 regulation. The Chapter 3 brings a study with transversal profile, with 74 participants: 40 cognitively preserved elderly and 34 elderly with AD. All participants responded to cognitive evaluation and they were submitted to a incremental test in ergometric treadmill. Mainly, elderly with AD and cognitively preserved elderlies responded to acute aerobic exercise in different ways. Elderly with AD had an increase on IGF-1 levels whereas cognitively preserved elderlies had a maintaining in this same levels. In the Chapter 4 in order to verify the training effect on cognitive functions and IGF-1, 16 elderlies with AD participated in Control Group (CG) and 18 elderlies with AD, in Training Group (TG). The TG participated in an aerobic training protocol, 75% of heart rate, 4 km/h, 25-40 min/session, 3 times weekly, during 12 weeks. After the experimental period, significant differences between groups and moments for cognitive functions and IGF-1 levels were not identified. However, interesting clinical results was observed in cognition and insulin-resistance control of TG. In Chapter 5, wild mice had a significant increase on theta rhythm and better cognitive performance when they were compared to another animal groups. Finally, the Chapter 6 brings us general considerations and conclusions of the thesis: there is not only one protocol capable to modify IGF-1 levels and induce cognition improvement; cognitively preserved elderly and elderly with AD responded differently to acute aerobic exercise in IGF-1 levels; the training protocol adopted in this study was not effective neither to improve cognition, nor to modified IGF-1 levels in elderlies with AD; wild mice, AD pre symptomatic mice and IGF-1 deficiency mice responded different to acute aerobic exercise in brain activity, considering acute exercise effective on cognitive performance.
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Palavras-chave
Doença de Alzheimer, Exercício agudo, Treinamento aeróbio, IGF-1, Cognição, Alzheimer’s disease, Acute exercise, Aerobic training, Cognition