Inefficient resource allocation is associated with reduced alpha activity in parietal regions in individuals with Parkinson's disease.

The brain's ability to act as an input filter and to suppress actions is crucial to navigate everyday life and impairments in these abilities affect quality of life substantially. Although Parkinson's disease (PD) is primarily known as a movement disorder, recent research has redefined it as a multisystem disorder affecting cognition, in particular inhibitory control and attentional resource allocation. Analysing the neural mechanisms underlying this cognitive deficit provides a better understanding of brain changes observed in patients affected by PD. Therefore, this study aimed to identify resource allocation to relevant and irrelevant stimuli in patients affected by PD. Besides neuropsychological tests, we employed electroencephalographic recordings during an auditory oddball paradigm in 13 patients suffering from idiopathic PD and 11 healthy controls (HC). Participants were instructed to ignore the standard stimulus and to respond as fast as possible to the rarely presented target tone. Event-related potentials (ERP) and time-frequency representations (TFR) were analyzed. Patients affected by PD showed faster response latencies to the task-irrelevant standard tones, but slower response latencies to target tones compared to HC. This observation was prominent at frontal sites during later P3-like processing stages. Reaction time, however, was prolonged in patients with PD, suggesting inefficient resource allocation. Additionally, TFR revealed reduced parietal alpha activity, which is associated with distractor suppression and functional inhibition in patients with PD compared to healthy controls. Thus, our results point towards inefficient resource allocation in patients with PD possibly driven by less functional inhibition through parietal alpha activity.

The effect of a psychomotor intervention on electroencephalography and neuropsychological performances in older adults with and without mild cognitive impairment.

AIM: The aim of this pilot study was to examine the acute effect of a psychomotor intervention (PMI) on auditory-verbal memory, emotional state, and electrocortical activity recorded by electroencephalography on subjectively healthy older adults (sHE) and older adults diagnosed with mild cognitive impairment (MCIs). METHODS: Eleven MCIs and 11 sHE underwent a single 45-min PMI. Resting state electroencephalography, the Rey Auditory-Verbal Learning Test, MoodMeter®, and the Positive and Negative Affect Schedule were compared between groups and pre- and post-PMI. RESULTS: Electroencephalography current source density and activity within the theta frequency band were higher in MCIs than in sHE at baseline, and brain frequency had a tendency to decrease in MCIs after training. Both groups showed improvement on the auditory-verbal memory test. Only among MCIs were there increases in perceived physical state and psychological strain and an improvement in negative affect. CONCLUSIONS: Our findings suggest that acute psychomotor activity may be more effective for MCIs than for sHE. It supports the notion that PMI does have functional influences on the central nervous level and therefore might prevent and treat cognitive, psychological, and psychiatric symptoms of people with mild cognitive impairment.

Neurophysiological, neuropsychological, and cognitive effects of 30 days of isolation.

The increasing demand of space flights requires a profound knowledge of the chronologic reactions of the human body to extreme conditions. Prior studies already have shown the adverse effects of long-term isolation on psycho-physiological well-being. The chronology of the effects and whether short-term isolation periods already lead to similar effects has not been investigated. Therefore, the aim of the current study was to investigate the effects of short-term isolation (30 days) on mood, cognition, cortisol, neurotrophic factors, and brain activity. 16 participants were isolated in the Human Exploration Research Analog at NASA for 30 days. 17 non-isolated control participants were tested simultaneously. On mission days - 5, 7, 14, 28, and + 5, multiple tests including the Positive and Negative Affect Schedule-X and cognitive tests were conducted, and a 5-min resting electroencephalography was recorded. A fasted morning blood drawing was also done. Increased stress was observed via augmented cortisol levels during the isolation period. Activity within the parietal cortex was reduced over time, probably representing a neural adaptation to less external stimuli. Cognitive performance was not affected, but rather enhanced in both groups. No further significant changes in neurotrophic factors BDNF/IGF-1 and mood could be detected. These results suggest that 30 days of isolation do not have a significant impact on brain activity, neurotrophic factors, cognition, or mood, even though stress levels were significantly increased during isolation. Further studies need to address the question as to what extent increased levels of stress do not affect mental functions during isolation periods.

The influence of microgravity on cerebral blood flow and electrocortical activity.

Changes in gravity conditions have previously been reported to influence brain hemodynamics as well as neuronal activity. This paper attempts to identify a possible link between changes in brain blood flow and neuronal activity during microgravity. Middle cerebral artery flow velocity (MCAv) was measured using Doppler ultrasound. Brain cortical activity (i.e., cortical current density) was measured using electroencephalography. Finger blood pressure was recorded and exported to generate beat-by-beat systolic (SBP), diastolic (DBP) and mean arterial pressure (MAP), heart rate (HR), cardiac output (CO), and cerebrovascular conductance index (CVCi). Seventeen participants were evaluated under normal gravity conditions and microgravity conditions, during 15 bouts of 22-s intervals of weightlessness during a parabolic flight. Although MAP decreased and CO increased, MCAv remained unchanged in the microgravity condition. CVCi as the quotient of MCAv and MAP increased in microgravity. Cortical current density showed a global decrease. Our data support earlier data reporting a decrease in the amplitude of event-related potentials recorded during microgravity. However, the general decrease in neural excitability in microgravity seems not to be dependent on hemodynamic changes.

Cognitive Impairment Is Reflected by an Increased Difference between Real and Imagined Timed Up and Go Test Performance.

BACKGROUND: Recent research suggests using an imaginary version of the Timed Up and Go test (TUG) for a first assessment of cognitive impairment. By using the time difference between a real (TUGr) and an imagined (TUGi) TUG task, the objective of this study was to examine the effect of cognitive impairment on motor imagery ability. METHODS: Fifty-two participants (mean age 69.3 ± 4.0 years) with mild cognitive impairment or subjective cognitive impairment were included in this study. The time difference between the TUGr and the TUGi was used as the main outcome. The Trail Making Test part B (TMT B), the ratio between TMT A and TMT B, and the Montreal Cognitive Assessment (MoCA) battery were the main independent variables. RESULTS: The difference between TUGr and TUGi performance time and the TMT B performance time increased with decreasing cognitive function (p < 0.01). There was no relationship between TUGr and TUGi performance time and TMT B/A ratio. There were significant correlations between TUG time differences and the MoCA score (r = -0.489, p < 0.01), the TMT B (r = 0.364, p < 0.01), and the TMT B/A ratio (r = 0.377, p < 0.01). CONCLUSION: The combination of TUGr and TUGi may have added value in assessing cognitive impairment, which is a possible pre-stage of dementia.

Psychophysiological responses of artificial gravity exposure to humans.

AIM: The aim of this study was to determine psychophysiological responses and cognitive performance after a single bout of artificial gravity, in order to investigate its use as a potential holistic countermeasure for long-duration human space flight, considering mental health. METHODS: Sixteen male participants were exposed to two different hypergravity protocols in a randomized order, one providing a constant +2 Gz environment for 30 min, the other providing participants for five times with repeated 3-min intervals of +2 Gz and rest, respectively. EEG was recorded prior, during and after AG. In addition, self-reported mood and cognitive performance was assessed before and after AG exposure. EEG data were analyzed using standardized brain electromagnetic tomography (sLORETA). RESULTS: Beta-1 EEG activity (12-18 Hz) was decreased in the left middle frontal gyrus after the continuous profile. Participants' motivation decreased after continuous artificial gravity, while perceived physical state was increased. The intermittent profile did not induce any changes in the observed parameters. Cognitive performance was not affected by either of both profiles. CONCLUSION: The continuous profile induced neurophysiological changes, which are considered with negative affect and withdrawal related motivation, according to the model of frontal asymmetry. This notion was further confirmed by decreases in self-reported mood after continuous AG. Therefore, the continuous profile would not be appropriate for the human space flight program. Intermittent AG did not induce any psychophysiological changes and might therefore provide a more appropriate approach as a countermeasure for further investigations.

Effect of artificial gravity on neurocognitive performance during head-down tilt bedrest.

This study evaluated the acute and chronic effects of intermittent and continuous Artificial Gravity (AG) on cognitive performance during 60 days of Head-down tilt bedrest (HDTBR), a well-established ground-based spaceflight analogue method. Participants were randomly assigned to three groups: intermittent AG, continuous AG, and HDTBR control group without AG exposure. Task performance and electrophysiological measures of attention and working memory were investigated during Simple and Complex tasks in the Visual and the Auditory modality. Compared to baseline, faster reaction time and better accuracy was present during HDTBR regarding the Complex tasks, however, the practice effect was diminished in the three HDTBR groups compared to an ambulatory control group. Brain potentials showed a modality-specific decrease, as P3a was decreased only in the Auditory, while P3b decreased in the Visual modality. No evidence for acute or chronic AG-related cognitive impairments during HDTBR was found.

Changes in cerebral oxygenation during parabolic flight.

Assessing changes in brain activity under extreme conditions like weightlessness is a desirable, but difficult undertaking. Results from previous studies report specific changes in brain activity connected to an increase or decrease in gravity forces. Nevertheless, so far it remains unclear (1) whether this is connected to a redistribution of blood volume during micro- or hypergravity and (2) whether this redistribution might account for neurocognitive alterations. This study aimed to display changes in brain oxygenation caused by altered gravity conditions during parabolic flight. It was hypothesized that an increase in gravity would be accompanied by a decrease in brain oxygenation, whereas microgravity would lead to an increase in brain oxygenation. Oxygenized and deoxygenized haemoglobin were measured using two near infrared spectroscopy (NIRS) probes on the left and right prefrontal cortex throughout ten parabolas in nine subjects. Results show a decrease of 1.44 µmol/l in oxygenized haemoglobin with the onset of hypergravity, followed by a considerable increase during microgravity (up to 5.34 µmol/l). In contrast, deoxygenized haemoglobin was not altered during the first but only during the second hypergravity phase and showed only minor changes during microgravity. Changes in oxygenized and deoxygenized haemoglobin indicate an increase in arterial flow to the brain and a decrease in venous outflow during microgravity.

Short-term isolation effects on the brain, cognitive performance, and sleep-The role of exercise.

Isolation is stressful and negatively affects sleep and mood and might also affect the structure and function of the brain. Physical exercise improves brain function. We investigated the influence of physical exercise during isolation on sleep, affect, and neurobehavioral function. N = 16 were isolated for 30 days with daily exercise routines (ISO100) and n = 16 isolated for 45 days with every second day exercise (ISO50). N = 27 were non-isolated controls who either exercised on a daily basis (CTRLEx) or refused exercise (CTRLNonEx) for 30 days. At the beginning and the end of each intervention, intravenous morning cortisol, melatonin, brain-derived neurotrophic factor and IGF-1, positive and negative affect scales, electroencephalography, cognitive function, and sleep patterns (actigraphy) were assessed. High levels of cortisol were observed for the isolated groups (p < .05) without negative effects on the brain, cognitive function, sleep, and mood after 4 to 6 weeks of isolation, where physical exercise was performed regularly. An increase in cortisol and impairments of sleep quality, mood, cognitive function, and neurotrophic factors (p < .05) were observed after 4 weeks of absence of physical exercise in the CTRLNonEx group. These findings raise the assumption that regular physical exercise routines are a key component during isolation to maintain brain health and function.

Disease-inclusive exercise classes improve physical fitness and reduce depressive symptoms in individuals with and without Parkinson's disease-A feasibility study.

BACKGROUND AND PURPOSE: Exercise is an adjunctive treatment in the management of Parkinson's disease (PD), but barriers such as health status, fear of overexertion, and lack of transportation to the location prevent regular exercise participation. Disease-inclusive exercise classes may offer an opportunity to make exercise more accessible for older adults with and without diseases. However, the efficacy of such heterogenous exercise classes is still widely unknown. Therefore, it was the aim of this study to analyze the feasibility of disease-inclusive exercise classes in older adults with and without PD. METHODS: Twenty-one older adults (healthy older adults (HOA): n = 13; PD: n = 8) completed an 8-week multimodal exercise intervention in supervised group sessions. Exercise classes lasted 60 min with the goal of two participations a week. We assessed physical fitness (timed up and go test [TUG], 6-minute walking test [6MWT], single leg stance), depressive symptoms and cognitive functions, and we determined growth factors (BDNF & IGF-1) before and after the intervention to determine the effects and by that, the feasibility of a disease-inclusive exercise program. Repeated measures ANOVA were used to establish changes. RESULTS: TUG and 6MWT improved significantly after the training in both HOA (p = .008; p < .001) and individuals with PD (p = .024; p < .001). Furthermore, individuals with PD increased single leg stance left (p = .003). HOA (p = .003) and individuals with PD (p = .001) decreased their depressive symptoms between pre- and post-test significantly. Whereas growth factors tended to improve, no differences in cognitive functions were revealed. CONCLUSION: Disease-inclusive multicomponent exercise improved physical functions and reduced depressive symptoms independent of health status. This should encourage exercise providers, researchers, and clinicians to further investigate disease-inclusive exercise, because they may have an important social impact and represent a more inclusive society.

Shifts in broadband power and alpha peak frequency observed during long-term isolation.

Prolonged periods of social isolation and spatial confinement do not only represent an issue that needs to be faced by a few astronauts during space missions, but can affect all of us as recently shown during pandemic situations. The fundamental question, how the brain adapts to periods of sensory deprivation and re-adapts to normality, has only received little attention. Here, we use eyes closed and eyes open resting-state electroencephalographic (EEG) recordings to investigate how neural activity is altered during 120 days of isolation in a spatially confined, space-analogue environment. After disentangling oscillatory patterns from 1/f activity, we show that isolation leads to a reduction in broadband power and a flattening of the 1/f spectral slope. Beyond that, we observed a reduction in alpha peak frequency during isolation, but did not find strong evidence for isolation-induced changes that are of oscillatory nature. Critically, all effects reversed upon release from isolation. These findings suggest that isolation and concomitant sensory deprivation lead to an enhanced cortical deactivation which might be explained by a reduction in the mean neuronal population firing rate.

Rating of perceived exertion - a valid method for monitoring light to vigorous exercise intensity in individuals with subjective and mild cognitive impairment?

In rehabilitation settings, exercise intensity is often monitored with Borg's rating of perceived exertion (RPE). However, previous studies showed that severe cognitive impairment may limit the usability of the RPE. The aim of this study was to assess the relationship between RPE and heart rate (HR), and to establish whether a target RPE can be used to achieve exercise intensity based on an individual's HR-RPE in people with early cognitive impairment. 97 participants (74.7 ± 6 years) with early cognitive impairment completed an incremental exercise test. Of these, 54 were tested during a single, RPE guided exercise session. RPE and HR were monitored throughout. Correlations between HR and RPE were assessed using Spearman's correlation. Mean differences between measured HR and target HR were calculated and compared using a two-way ANOVA with factors cognition and exercise mode. Bland-Altman plots were constructed to analyse the agreement between target and measured HR. HR and RPE correlated moderately with each other (p < 0.001; r = 0.555) and no differences between target and measured HR were observed. Bland-Altman plots revealed a mean difference of 1.2 bpm and a 95% level of agreement was between 24.4 and -22.1 bpm. No differences in rating accuracy were observed between different cognitive impairment levels nor between different exercise modes. Bland-Altman plots revealed some variance between the participants with almost half of them missing target HR by 10bpm or more. Therefore, the RPE should only be applied with caution and, if possible, with other measurements (e.g. heart rate monitors) to ensure that target intensity is reached.

Auditory event-related potentials in individuals with subjective and mild cognitive impairment.

OBJECTIVE: The analysis of event-related potentials (ERPs) is a useful tool to differentiate between healthy older adults, and individuals with mild cognitive impairment (MCI). Less is known about the ERPs' sensitivity of differentiating between individuals with subjective cognitive impairment (SCI) and MCI, as early evidence indicates similar brain alterations between these two groups. In order, to establish tests that are sensitive to subclinical impairment, this study compared auditory evoked ERPs between individuals with SCI and MCI. METHODS: Besides assessing cognitive performance in four neuropsychological tests (Trail Making Test A + B, verbal fluency letter and category task), latency and amplitude of ERP components evoked by an auditory oddball paradigm were compared between two groups of either individuals with SCI (n = 13) or MCI (n = 13). RESULTS: While individuals with MCI performed significantly worse in all neuropsychological tests (TMT A: p = 0.001, Cohen's d = 1.5; TMT B: p = 0.030, Cohen's d = 0.94; verbal fluency letter: p = 0.0011, Cohen's d = 1.08; verbal fluency category: p = 0.038; Cohen's d = 0.86), no significant differences (p > 0.05) were found in ERP components with small to moderate effect sizes (Cohen's d ranged between 0.11 - 0.59). CONCLUSION: ERPs evoked by an auditory oddball paradigm lack sensitivity to differentiate between individuals with SCI and MCI, although significant differences in cognitive performance were detected by neuropsychological tests. Similar pathophysiological brain alterations may limit utility of ERPs as indicated by previous research and results of this study. Cognitively more challenging tasks than the auditory oddball paradigm may be considered by future investigations.

Transient cerebral blood flow responses during microgravity.

PURPOSE: A number of studies has well described central cardiovascular changes caused by changing gravity levels as they occur e.g. during parabolic flight. limited data exists describing the effect of microgravity on the cerebrovascular system and brain perfusion. METHODS: In this study middle cerebral artery velocity (MCAv) of 16 participants was continuously monitored on a second-by-second basis during 15 consecutive parabolas (1G, 1,8G, 0G, 1,8G) using doppler ultrasound. Simultaneously central cardiovascular parameters (heart rate, mean arterial blood pressure, cardiac output) were assessed. RESULTS: Results revealed an immediate reaction of central cardiovascular parameters to changed gravity levels. In contrast, changes in MCAv only initially were in accordance with a normal cerebral autoregulation. Whereas all of the measured central cardiovascular parameters seemed to have reached a steady state after approximately 8 s of microgravity, MCAv, after an initial decrease with the onset of microgravity, increased again during the second half of the microgravity phase. CONCLUSION: It is concluded that this increase in MCAv during the second half of the microgravity period reflects a decrease of cerebrovascular resistance caused by a pressure driven increased venous outflow and/or a contraction of precapillary sphincters in order to avoid hyperperfusion of the brain.

NeuroExercise: The Effect of a 12-Month Exercise Intervention on Cognition in Mild Cognitive Impairment-A Multicenter Randomized Controlled Trial.

Exercise intervention studies in mild cognitive impairment (MCI), a prodromal stage of Alzheimer's disease (AD), have demonstrated inconsistent yet promising results. Addressing the limitations of previous studies, this trial investigated the effects of a 12-month structured exercise program on the progression of MCI. The NeuroExercise study is a multicenter randomized controlled trial across three European countries (Ireland, Netherlands, Germany). Hundred and eighty-three individuals with amnestic MCI were included and were randomized to a 12-month exercise intervention (3 units of 45 min) of either aerobic exercise (AE; n = 60), stretching and toning exercise (ST; n = 65) or to a non-exercise control group (CG; n = 58). The primary outcome, cognitive performance, was determined by an extensive neuropsychological test battery. For the primary complete case (CC) analyses, between-group differences were analyzed with analysis of covariance under two conditions: (1) the exercise group (EG = combined AE and ST groups) compared to the CG and (2) AE compared to ST. Primary analysis of the full cohort (n = 166, 71.5 years; 51.8% females) revealed no between-group differences in composite cognitive score [mean difference (95% CI)], 0.12 [(-0.03, 0.27), p = 0.13] or in any cognitive domain or quality of life. VO2 peak was significantly higher in the EG compared to the CG after 12 months [-1.76 (-3.39, -0.10), p = 0.04]. Comparing the two intervention groups revealed a higher VO2peak level in the aerobic exercise compared to the stretching and toning group, but no differences for the other outcomes. A 12-month exercise intervention did not change cognitive performance in individuals with amnestic MCI in comparison to a non-exercise CG. An intervention effect on physical fitness was found, which may be an important moderator for long term disease progression and warrants long-term follow-up investigations. Clinical Trial Registration: https://clinicaltrials.gov/ct2/show/NCT02913053, identifier: NCT02913053.

Cerebral Blood Flow during Interval and Continuous Exercise in Young and Old Men.

PURPOSE: Aging is associated with impaired cerebral blood flow (CBF) and increased risk of cerebrovascular disease. Acute increases in CBF during exercise may initiate improvements in cerebrovascular health, but the CBF response is diminished during continuous exercise in older adults. The effect of interval exercise for promoting increases in CBF in young and old adults is unknown. METHODS: We compared middle cerebral artery blood velocity (MCAv), end-tidal CO2 (PETCO2) and blood pressure (mean arterial pressure [MAP]) during intensity- and work-matched bouts of continuous (10-min 60%Wmax, followed by 10-min rest) and interval cycling (10 × 1-min 60%Wmax, separated by 1-min rest) in 11 young (25 ± 3 yr) and 10 old (69 ± 3 yr) men. RESULTS: Middle cerebral artery velocity was higher during continuous compared with interval exercise in the young (P < 0.001), but not in the old. This trend was also seen for changes in PETCO2. Although absolute MAP was higher in the old, the relative rise (%[INCREMENT]) in MAP was similar between age groups and was greater during continuous exercise than interval. When we assessed the total accumulated change in MCAv (area under curve: exercise + recovery), it was higher with interval compared with continuous exercise in both groups (P = 0.018). CONCLUSION: These findings suggest that interval exercise may be an effective alternative for promoting acute increases in CBF velocity, particularly in those older adults who may have difficulty sustaining continuous exercise.

Validation of a widely used heart rate monitor to track steps in older adults.

BACKGROUND: Activity tracking devices gain popularity in research, which is due to their multiple features (e.g. heart rate monitor, step count) and easy handling. Nevertheless, many devices used for research are lacking validation of specific features. This study aimed to assess the validity of the Polar M400© activity tracker to count steps in older adults and, therefore, compared it to a previously validated pedometer (Omron Walking Style©) and observed step count. METHODS: Thirty-two older adults (mean age: 74.8±5.9 years) walked at a self-selected, normal gait speed on a tartan track for 200 meters while wearing the activity tracker and the pedometer. Additionally, steps were counted manually. Data was analysed using Kruskal-Wallis test and Lin's concordance coefficient. Furthermore, Bland Altman plots were employed to evaluate accuracy of the activity tracker. RESULTS: Kruskal-Wallis test revealed significant differences between the step count of the activity tracker and the pedometer (P=0.011) but no further differences were observed. Lin's concordance showed a moderate correlation between activity tracker and pedometer (rc=0.561) and between pedometer and observed step count (rc=0.690). A high correlation was detected between activity tracker and observed step count (rc=0.802). Bland Altman plots revealed good accuracy of the activity tracker. CONCLUSIONS: The Polar M400© activity tracker accurately assesses steps during walking in older adults. Nevertheless, a slight overestimation compared to the pedometer was observed, which should be considered when using the activity tracker for tracking steps over a longer period of time.

Neurocognitive performance is enhanced during short periods of microgravity-Part 2.

Previous studies showed a decrease in reaction time during the weightlessness phase of a parabolic flight. This effect was found to be stronger with increasing task complexity and was independent of previous experience of weightlessness as well as anti-nausea medication. Analysis of event related potentials showed a decreased amplitude of the N100-P200 complex in weightlessness but was not able to distinguish a possible effect of task complexity. The present study aimed to extend this previous work, by comparing behavioral (reaction time) and neurological (event related potentials analysis) performance to a simple (oddball) and a complex (mental arithmetic + oddball) task during weightlessness. 28 participants participated in two experiments. 11 participants performed a simple oddball experiment in the 1G and 0G phases of a parabolic flight. 17 participants were presented a complex arithmetic task in combination with an oddball task during the 1G and 0G phases of a parabolic flight. Reaction time as well as event related potentials (ERP) were assessed. Results revealed a reduced reaction time (p < .05) for the complex task during 0G. No gravity effects on reaction time were found for the simple task. In both experiments a reduction of typical ERP amplitudes was noticeable in weightlessness. It is assumed that the weightlessness induced fluid shift to the brain is positively affecting neuro-behavioral performance.

Cardiorespiratory Fitness and Cognitive Function are Positively Related Among Participants with Mild and Subjective Cognitive Impairment.

BACKGROUND: By 2030, about 74 million people will be diagnosed with dementia, and many more will experience subjective (SCI) or mild cognitive impairment (MCI). As physical inactivity has been identified to be a strong modifiable risk factor for dementia, exercise and physical activity (PA) may be important parameters to predict the progression from MCI to dementia, but might also represent disease trajectory modifying strategies for SCI and MCI. OBJECTIVE: A better understanding of the relationship between activity, fitness, and cognitive function across the spectrum of MCI and SCI would provide an insight into the potential utility of PA and fitness as early markers, and treatment targets to prevent cognitive decline. METHODS: 121 participants were stratified into three groups, late MCI (LMCI), early MCI (EMCI), and SCI based on the Montreal Cognitive Assessment (MoCA). Cognitive function assessments also included the Trail Making Test A+B, and a verbal fluency test. PA levels were evaluated with an interviewer-administered questionnaire (LAPAQ) and an activity monitor. An incremental exercise test was performed to estimate cardiorespiratory fitness and to determine exercise capacity relative to population normative data. RESULTS: ANCOVA revealed that LMCI subjects had the lowest PA levels (LAPAQ, p = 0.018; activity monitor, p = 0.041), and the lowest exercise capacity in relation to normative values (p = 0.041). Moreover, a modest correlation between MoCA and cardiorespiratory fitness (r = 0.25; p < 0.05) was found. CONCLUSION: These findings suggest that during the earliest stages of cognitive impairment PA and exercise capacity might present a marker for the risk of further cognitive decline. This finding warrants further investigation using longitudinal cohort studies.

Computer-Based Exercise Program: Effects of a 12-Week Intervention on Mood and Fatigue in Pediatric Patients With Cancer
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BACKGROUND: Increasing rates of survival present a new set of physical and psychological challenges for children dealing with side effects during cancer treatment. Physical activity has been shown to be an effective strategy to reduce several side effects.
. OBJECTIVES: The purpose of this pilot study was to determine the benefits of a 12-week computer-based exercise intervention on perceived physical, motivational, and fatigue syndrome and psychological state.
. METHODS: Nine inpatient and outpatient pediatric patients with cancer participated in a 12-week intervention consisting of supervised computer-based exercise sessions. Participants completed measures assessing mood and fatigue pre- and postintervention.
. FINDINGS: The intervention was feasible and provided preliminary evidence for the benefits on mood and fatigue in pediatric patients with cancer. The results promote the effectiveness of physical activity in pediatric oncology and call for continuing research in pediatric patients with cancer where sedentary behavior and the associated side effects are a growing concern.