The Combined Effects of Physical Exercise and Cognitive Training on Gait Speed and Primary Motor Cortex Metabolism in Individuals with Mild Cognitive Impairment: A 1H-MRS Analysis
Abstract
Mild cognitive impairment (MCI) is a transitional stage before dementia. Altered gait in MCI has been associated with progression to dementia. Using magnetic resonance spectroscopy, a relationship between primary motor cortex (M1) neurochemistry and dual task gait speed has been reported in MCI. Interventional research suggests exercise, cognitive training, and vitamin D supplementation may benefit MCI, yet the combined effect of these treatments on gait speed and M1 metabolism is unknown. Participants with MCI (N=75) were assigned to one of five intervention arms and dual task cost on gait speed and M1 metabolism was assessed before and five months after intervention. Cognitive training paired with exercise increased M1 N-acetyl aspartate (NAA)/creatine concentrations compared to physical exercise alone. Additionally, those with greater changes in dual task cost on gait speed showed greater decreases in NAA and choline, further establishing a relationship between gait speed and M1 function in MCI.