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Vascular Function Is Improved After an Environmental Enrichment Program: The Train the Brain-Mind the Vessel Study
Bruno RM, Stea F, Sicari R, Ghiadoni L, Taddei S, Ungar A, Bonuccelli U, Tognoni G et al.. Hypertension (Dallas, Tex. : 1979), 2018-04-09
Topic: Brain proteins, microglia and lab models
Environmental enrichment may slow cognitive decay possibly acting through an improvement in vascular function. Aim of the study was to assess the effects of a 7-month cognitive, social, and physical training program on cognitive and vascular function in patients with mild cognitive impairment. In a single-center, randomized, parallel-group study, 113 patients (age, 65-89 years) were randomized to multidomain training (n=55) or usual care (n=58). All participants underwent neuropsychological tests and vascular evaluation, including brachial artery flow-mediated dilation, carotid-femoral pulse wave velocity, carotid distensibility, and assessment of circulating hematopoietic CD34+ and endothelial progenitor cells. At study entry, an age-matched control group (n=45) was also studied. Compared with controls, patients had at study entry a reduced flow-mediated dilation (2.97±2.14% versus 3.73±2.06%; P =0.03) and hyperemic stimulus (shear rate area under the curve, 19.1±15.7 versus 25.7±15.1×10 -3 ; P =0.009); only the latter remained significant after adjustment for confounders ( P =0.03). Training improved Alzheimer disease assessment scale cognitive (training, 14.0±4.8 to 13.1±5.5; nontraining, 12.1±3.9 to 13.2±4.8; P for interaction visit×training=0.02), flow-mediated dilation (2.82±2.19% to 3.40±1.81%, 3.05±2.08% to 2.24±1.59%; P =0.006; P =0.023 after adjustment for diameter and shear rate area under the curve), and circulating hematopoietic CD34 + cells and prevented the decline in carotid distensibility (18.4±5.3 to 20.0±6.6, 23.9±11.0 to 19.5±7.1 Pa -1 ; P =0.005). The only clinical predictor of improvement of cognitive function after training was established hypertension. There was no correlation between changes in measures of cognitive and vascular function. In conclusion, a multidomain training program slows cognitive decline, especially in hypertensive individuals. This effect is accompanied by improved systemic endothelial function, mobilization of progenitor CD34 + cells, and preserved carotid distensibility. Clinical trial registration URL: http://www.clinicaltrials.gov. Unique identifier: NCT01725178.
Key findings
- Compared with controls, patients had at study entry a reduced flow-mediated dilation (2.97±2.14% versus 3.73±2.06%; P =0.03) and hyperemic stimulus (shear rate area under the curve, 19.1±15.7 versus 25.7±15.1×10 -3 ; P =0.009); only the latter remained significant after adjustment for confounders ( P =0.03).
- In conclusion, a multidomain training program slows cognitive decline, especially in hypertensive individuals.
Why it matters
A 7-month cognitive, social, and physical training programme improved cognitive scores and vascular function in people with mild cognitive impairment, especially those with hypertension. This is a multidomain lifestyle intervention for symptom improvement, not a cure or prevention.
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Study details
- Participants55
- Effect size2.14%; 2.06%; 2.19%
- Evidence strengthHigh
How this study scored 59/100
Published in a peer-reviewed journal, and it is a randomised controlled trial.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Hypertension (Dallas, Tex. : 1979)) |
| Journal's citation record | 3 / 4 | Hypertension: journal h-index 369 (OpenAlex, 2026-10-29) |
| Study design | 11 / 12 | A randomised controlled trial (from PubMed type “Randomized Controlled Trial”) |
| Strength of evidence | 5 / 5 | Rated “high” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 2 / 5 | 2018 — within 10 year(s) of the newest study here |
| Sample size | 1 / 4 | 55 participants |
| Effect reported | 2 / 3 | Effect reported as a number, without an interval or test |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomised / blinded | 1 / 2 | Randomised (as stated in the record) |
| Times cited | 3 / 7 | Cited 22 times (OpenAlex, 2026-10-10) |
| Citations per year | 1 / 5 | 2.2 citations a year over 10 year(s) since 2018 |
| Impact for its field and year | 2 / 6 | Cited 1.4× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 1 / 6 | Cited by 1 other studies in this library |
| Still being cited | 1 / 4 | Cited 4 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 1 / 4 | Last-listed author Leda Volpi: h-index 16 (OpenAlex, whole career) |
| Institution's track record | 1 / 3 | University of Pisa: institution h-index 907 (OpenAlex) |
| Multi-centre collaboration | 2 / 3 | OpenAlex lists 7 institution(s) in 1 country |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 29632101) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Total | 59 / 100 | — |
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Read the original
- DOI: 10.1161/hypertensionaha.117.10066
- PubMed: 29632101
- Original source →
- Free full text: ahajournals.org →
Full text: free to read — Unpaywall lists this copy as free to read: the link above (checked 10 Oct 2026).
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. The record's author list ends in “et al.”, so not every author is named. Check the citation against the original before you use it.
APA 7th
Bruno, R. M., Stea, F., Sicari, R., Ghiadoni, L., Taddei, S., Ungar, A., et al. (2018). Vascular Function Is Improved After an Environmental Enrichment Program: The Train the Brain-Mind the Vessel Study. Hypertension (Dallas, Tex. : 1979). https://doi.org/10.1161/hypertensionaha.117.10066
Vancouver
Bruno RM, Stea F, Sicari R, Ghiadoni L, Taddei S, Ungar A, et al. Vascular Function Is Improved After an Environmental Enrichment Program: The Train the Brain-Mind the Vessel Study. Hypertension (Dallas, Tex. : 1979). 2018. doi:10.1161/hypertensionaha.117.10066. PMID: 29632101.
BibTeX
@article{bruno2018-29632101,
author = {Bruno, R. M. and Stea, F. and Sicari, R. and Ghiadoni, L. and Taddei, S. and Ungar, A. and Bonuccelli, U. and Tognoni, G. and others},
title = {{Vascular Function Is Improved After an Environmental Enrichment Program: The Train the Brain-Mind the Vessel Study}},
journal = {Hypertension (Dallas, Tex. : 1979)},
year = {2018},
doi = {10.1161/hypertensionaha.117.10066},
pmid = {29632101},
url = {https://doi.org/10.1161/hypertensionaha.117.10066}
}
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