Zusammenfassung
Epidemiologische Studien konnten zeigen, dass sich regelmäßige körperliche Aktivität und bewusste Ernährung positiv auf die kardiovaskuläre Gesundheit auswirken. Bei chronisch-neurodegenerativen Erkrankungen wie dem idiopathischen Parkinson-Syndrom und dem Morbus Alzheimer wird körperliche Aktivität in Form von Physiotherapie seit langem als symptomatische Begleittherapie eingesetzt. Es wird jedoch zunehmend deutlich, dass freiwillige körperliche Aktivität über den positiven Effekt auf die Motorik hinaus fördernd auf Kognition sowohl im (alternden) gesunden als auch im neurodegenerativ veränderten Gehirn wirkt. Auch das Ernährungsverhalten scheint positive Auswirkungen auf die gesamte Gehirnfunktion auszuüben.
Tierexperimentelle Studien legen nahe, dass die zugrunde liegenden Mechanismen auf eine Verstärkung endogener Plastizität zurückzuführen sein könnten, u. a. durch Aktivierung neuronaler Vorläuferzellen in unterschiedlichen Hirnarealen, die mit besseren funktionellen Leistungen korrelieren. Auch erste experimentelle Studien beim Menschen zeigten, dass sich durch Aktivität oder Ernährungsumstellung eine Ausschüttung neurotropher Faktoren, eine Zunahme des Volumens der grauen Hirnsubstanz in gedächtnisrelevanten Arealen sowie eine verbesserte kognitive Funktion erreichen lässt. Damit eröffnet sich die Möglichkeit, durch Änderungen des Lebensstils Alterungsprozesse und degenerative Prozesse kausal und nichtinvasiv zu beeinflussen. Hiermit stünde potenziell ein sowohl sozioökonomisch als auch ethisch praktikabler therapeutischer Ansatz bei neurodegenerativen Erkrankungen zur Verfügung.
Der Beitrag fasst die bisherigen Entwicklungen auf diesem Gebiet aus tierexperimentellen Studien und Untersuchungen am Menschen zusammen. Dabei werden mögliche zelluläre und molekulare Grundlagen aufgezeigt sowie translationale klinische Studien und erste klinische Applikationen vorgestellt.
Summary
Epidemiological studies demonstrated positive effects of continuous physical activity and balanced diet on cardiovascular fitness. In chronic neurodegenerative disorders, e.g. Parkinson’s disease and Alzheimer’s disease, physical activity has become a successful supportive symptomatic therapy. However, it has become evident that physical activity not only improves motor symptoms but also has high impact on cognition in both (elderly) healthy brain and neurodegenerative alterations in the CNS. Nutrition also has been reported to exert positive effects on brain function.
Animal studies indicate an increased endogenous plasticity as the underlying mechanism in terms of activation of neuronal precursor cells in different brain areas, leading to improved brain function.
First experimental studies in humans also show that physical activity and balanced nutrition increase the release of neurotrophic factors in the brain, increase the volume of grey matter in learning- and memory-associated brain regions and improve cognitive function. This phenomenon opens up noninvasive causal therapeutic options in neurodegenerative disorders and during aging-associated cognitive decline by inducing changes in lifestyle. This option could provide a socioeconomically and ethically reasonable treatment for neurodegenerative disorders.
The presented article summarizes the current knowledge from animal experiments and studies in humans. It provides an overview of potential cellular and molecular candidate mechanisms and discusses novel translational clinical studies and first clinical applications.
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Steiner, B., Witte, V. & Flöel, A. Lebensstil und Kognition. Nervenarzt 82, 1566–1577 (2011). https://doi.org/10.1007/s00115-011-3353-0
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DOI: https://doi.org/10.1007/s00115-011-3353-0