Combating dementia is a public health priority. Worldwide, vascular cognitive impairment (VCI) is a leading cause of dementia. Many brain changes occur in people with VCI, including myelin loss. Myelin is an understudied part of the brain white matter that is critical for transmission of signals between brain regions. People with VCI have considerable myelin loss, which could impact grey matter in cortical regions that are responsible for cognitive abilities (i.e., thinking) and physical functioning (e.g., walking). Therefore, it is important to find ways to prevent myelin loss people with VCI. Animal studies suggest that physical exercise could minimize myelin loss. We are interested in finding out if exercise in the form of strength training (e.g., lifting weights) is an effective strategy for slowing down myelin loss. In this project, we will analyze data from a 12-month study in persons with VCI who received either strength training or a control intervention. We will compare the two groups on myelin content, cortical volume, cognitive abilities and physical functioning. We will look closely at changes in brain regions located in the frontal lobe. These regions are responsible for key cognitive abilities and physical functioning. Counteracting myelin loss with exercise could preserve cognitive abilities and reduce risk of dementia and loss of function. Our proposal is also timely as the number of persons with VCI will only increase with the world’s aging population. This investigation takes place in BC and is conducted by Dr. Nárlon Boa Sorte Silva. He is a postdoctoral research fellow at UBC’s Department of Physical Therapy and School of Biomedical Engineering supervised by Dr. Roger Tam (UBC’s School of Biomedical Engineering) and co-supervised by Dr. Teresa Liu-Ambrose (UBC’s Department of Physical Therapy). Dr. Boa Sorte Silva is funded by StrokeCog-Canadian Clinical Trials Platform and by MSHR BC.
Keywords: randomized controlled trial; exercise; cerebral small vessel disease; brain health; cognition; mobility.
End of Award Update – September 2024
Results
Our project is a 12-month randomized controlled trial assessing the impact of an exercise intervention on cerebral white matter myelin, cortex, and mobility outcomes in older individuals living with subcortical ischemic vascular cognitive impairment (SIVCI). The main aspects of the project were completed between 2017 and 2023 this includes recruitment, baseline and 12-month data collection. For the aims of the current fellowship, Dr. Nárlon C Boa Sorte Silva has completed the analysis relating to the primary objective: to assess the impact of the intervention on myelin levels in white matter tracts supporting frontal lobe cortical regions. The results will be included in a manuscript currently under preparation. Analysis and reporting of secondary objectives are currently underway.
Impact
Funding from StrokeCog and MSHR BC on this project was essential to support Dr. Silva’s postdoctoral research. The impact is still being assessed as the main results have not yet been made public, given the short funding window of 6 months. However, notable achievements related to the project in first 6 months of the funding include:
- Winning the Best Poster Presentation Postdoc Category at the 2024 Clinical Trials Training Summit in Montréal, Canada
- Presenting at a Featured Research Session and chairing a Perspectives Session at the 2024 AAIC in Philadelphia, USA
- Receiving the 2-year US $160,000 Alzheimer’s Association Research Fellowship (AARF) award
Dr. Silva has also joined the Department of Health, Kinesiology, and Applied Physiology at Concordia University and it is expected that he will be nominated Canada Research Chair Tier 2 in Applied Physiology of Healthy and Activity Aging. Support from MSHR BC was crucial in achieving this critical milestone in Dr. Silva’s career.
Potential Influence
The impact and influence of the findings of our research are still being assessed. We are hopeful that the main results will help inform interventions for individuals living with SIVCI once the main results are made public in the upcoming months. Dr. Silva is currently working on the analysis of secondary objectives related to this project and he hopes to soon make the findings public.
Next Steps
Dr. Silva in his new role at Concordia University will continue to pursue research in healthy and active aging, especially healthy brain aging. The knowledge gained from the current project will help inform his next steps particularly regarding interventions for individuals in midlife who are at risk of vascular-related neurodegeneration and cognitive impairment.