Impact of a multidomain lifestyle intervention on white matter integrity: the SUPERBRAIN exploratory sub-study

Sun Min Lee; Sohui Kim; Jee Hyang Jeong; Chang Hyung Hong; Yoo Kyoung Park; Hae Ri Na; Hong-Sun Song; Hee Kyung Park; Muncheong Choi; Buong-O Chun; Seong Hye Choi; Jong-Min Lee; So Young Moon

doi:10.3389/fnagi.2023.1242295

Impact of a multidomain lifestyle intervention on white matter integrity: the SUPERBRAIN exploratory sub-study

Front Aging Neurosci. 2023 Sep 20:15:1242295. doi: 10.3389/fnagi.2023.1242295. eCollection 2023.

Authors

Sun Min Lee¹, Sohui Kim², Jee Hyang Jeong³, Chang Hyung Hong⁴, Yoo Kyoung Park⁵, Hae Ri Na⁶, Hong-Sun Song⁷, Hee Kyung Park⁸, Muncheong Choi⁹, Buong-O Chun¹⁰, Seong Hye Choi¹¹, Jong-Min Lee¹², So Young Moon¹

Affiliations

¹ Department of Neurology, Ajou University School of Medicine, Suwon, Republic of Korea.
² Department of Electronic Engineering, Hanyang University, Seoul, Republic of Korea.
³ Department of Neurology, Ewha Womans University School of Medicine, Seoul, Republic of Korea.
⁴ Department of Psychiatry, Ajou University School of Medicine, Suwon, Republic of Korea.
⁵ Department of Medical Nutrition, Graduate School of East-West Medical Nutrition, Kyung Hee University, Suwon, Republic of Korea.
⁶ Department of Neurology, Bobath Memorial Hospital, Seongnam, Republic of Korea.
⁷ Department of Sports Sciences, Korea Institute of Sports Science, Seoul, Republic of Korea.
⁸ Division of Psychiatry, University College London, London, United Kingdom.
⁹ Exercowork, Seoul, Republic of Korea.
¹⁰ Graduate School of Physical Education, College of Arts and Physical Education, Myongji University, Yongin, Republic of Korea.
¹¹ Department of Neurology, Inha University School of Medicine, Incheon, Republic of Korea.
¹² Department of Biomedical Engineering, Hanyang University, Seoul, Republic of Korea.

Abstract

In the South Korean study to prevent cognitive impairment and protect BRAIN health through lifestyle intervention in at-risk elderly people (SUPERBRAIN), we evaluated the impact of a 24-week facility-based multidomain intervention (FMI) and home-based MI (HMI) on white matter integrity. Among 152 participants, aged 60-79 years without dementia but with ≥1 modifiable dementia risk factor, 19 FMI, 20 HMI, and 16 controls underwent brain MRI at baseline and 24 weeks. Between the intervention and control groups, we compared changes in fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD) and radial diffusivity (RD) at regions-of-interest (ROI) including the cingulum cingulate gyrus (CgC), cingulum hippocampus (CgH), superior longitudinal fasciculus (SLF), as well as the uncinate fasciculus (UF). In addition, correlations between total and standard scores cognitive domains of the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) or serum brain-derived neurotrophic factor (BDNF) and changes in brain image measures were evaluated at a statistical significance level of p < 0.05 (uncorrected for multiple corrections). The FA, MD, AD, and RD at each ROI at the baseline were not different among groups after Bonferroni correction. In the statistical analysis using two-way repeated measures ANOVA, any significant difference in longitudinal changes in the FA, MD, AD, and RD was not revealed. The statistical analysis, among the significant regions in paired t-test of the intervention group, compared with the control group, the FMI, HMI, and intervention group yielded significantly more beneficial effects on the AD of the CgC. In addition, longitudinal AD changes of the left CgC correlated with the BDNF changes (r = 0.280, p = 0.048). In this study, enhanced cognitive reserve after the multidomain lifestyle intervention could be revealed by changes in brain imaging for white matter integrity.

Keywords: SUPERBRAIN; cingulum cingulate gyrus; cognition; dementia; intervention; lifestyle; prevention; white matter integrity.