70 年代的老疗法体外反搏，能帮早期阿尔茨海默病患者改善认知吗

4 min read

• External counterpulsation (ECP) may help boost cognition in people diagnosed with early Alzheimer’s disease.
• The treatment is designed to boost blood flow.
• Doctors say more research is needed.

There are a lot of treatments in development for people with Alzheimer's disease, but new research is exploring an unusual tactic that hails back to the '70s. It's called external counterpulsation (ECP), and it's a special treatment that uses squeezable cuffs to compress the lower body.

The study, which was published in the American Journal of Alzheimer’s Disease & Other Dementias, found that patients with mild cognitive impairment or early Alzheimer's disease gained several points on cognitive scales after using ECP, suggesting it may be a promising therapy worth further investigation.

The ECP contraption looks similar to compression boots that have become trendy, with a few important differences. This device extends higher to include the butt, calves, and thighs, and also inflates and deflates with the person’s cardiac cycle. Regular compression boots do not. And, while it seems random that a tool like this might help to improve memory, neurologists who treat patients with cognitive decline and Alzheimer's disease say there may be something to this news.

Meet the experts: Clifford Segil, DO, a neurologist at Providence Saint John’s Health Center in Santa Monica, California; Liron Sinvani, MD, director of research and innovation for the Institute for Healthy Aging at Northwell Health and the Feinstein Institutes for Medical Research; and Anna Hohler, MD, regional director of Neurology for Westchester, Northwell Health, and chair of Neurology for Northern Westchester and Phelps hospitals.

What did the study find?

For the study, researchers recruited 190 people with early Alzheimer's disease to participate in a 12-month randomized controlled trial. Participants were either given three to five weekly one-hour ECP sessions for 35 treatments or a sham treatment that exerted much less pressure. After that, they received treatments twice a week through six months. Participants went through cognitive assessments at the start of the study, and also at weeks 6, 12, 18, 24, 36, and 52.

After analyzing the data, researchers discovered that people who went through the ECP treatments had improvements in cognition, including memory, attention, language, and reasoning. They also seemed to do better at doing everyday tasks like getting dressed, eating, and doing household tasks. They continued to have cognitive benefits even after they were done receiving the treatments.

However, there are “important reasons to be cautious” about the results, says Liron Sinvani, MD, director of research and innovation for the Institute for Healthy Aging at Northwell Health and the Feinstein Institutes for Medical Research, noting that the research was funded by the company that makes the ECP device used in the study, and that the lead author works for the same company.

Why might this help with memory in patients with early Alzheimer's disease?

Doctors say that one possible explanation behind these results is the boost in blood flow that comes with this compression therapy.

"External counterpulsation is thought to improve blood flow throughout the body, including to the brain," explains Anna Hohler, MD, regional director of Neurology for Westchester, Northwell Health, and chair of Neurology for Northern Westchester and Phelps hospitals. "Because reduced cerebral blood flow has been associated with cognitive decline and Alzheimer's disease, enhancing circulation may help support brain function and potentially improve memory and attention in some patients with early-stage disease."

Dr. Sinvani agrees. "The rationale for ECP makes biological sense: By improving blood flow to the brain, enhancing vascular function, reducing inflammation, and potentially improving the brain's ability to clear toxic proteins, ECP may address a critical and often overlooked piece of the Alzheimer's puzzle," she says.

In general, "what is healthy for your heart is usually healthy for your brain, and what is unhealthy for your heart is usually unhealthy for your brain," says Clifford Segil, DO, a neurologist at Providence Saint John’s Health Center in Santa Monica, California.

Will this technology come back?

That's unclear. "I think it could, and this trial makes a compelling case for why it deserves further investigation," Dr. Sinvani says. She praises ECP's non-invasive nature and well-established safety profile as being big perks of this technology. “It is essentially a passive cardiovascular workout,” she says.

"While the early findings are intriguing, larger studies are needed before this therapy can be widely recommended for Alzheimer's disease," Dr. Hohler says. "If future research confirms meaningful cognitive benefits and long-term safety, external counterpulsation could become a useful adjunctive treatment, particularly because it is noninvasive and already has an established safety record in cardiovascular care."

What other options do early Alzheimer's patients have?

There are treatment options available for people diagnosed with early Alzheimer's disease. These include FDA-approved medications to slow progression of the disease, therapies for symptoms, cognitive stimulation, physical exercise, good sleep hygiene, management of vascular risk factors, and social engagement, Dr. Hohler says.

"A comprehensive approach that combines medical treatment with healthy lifestyle interventions currently offers the best opportunity to preserve cognitive function and quality of life," she says.

Carina Hsieh, MPH, is the deputy features editor of Women’s Health. She has more than a decade’s worth of experience working in media and has covered everything from beauty, fashion, travel, lifestyle, pets, to health.

She began her career as an intern in the fashion closet at Cosmopolitan where she worked her way up to Senior Sex & Relationships Editor. While covering women’s health there, she discovered her passion for health service journalism and took a break to get her Masters in Public Health. Post-grad school, she worked as a freelance writer and as The Daily Beast’s first Beauty, Health, and Wellness Reporter.

Carina is an alum of the Fashion Institute of Technology and the Yale School of Public Health. She and her French Bulldog, Bao Bao, split their time between Brooklyn and Connecticut. She enjoys reformer Pilates, (slow) running, and smelling the fancy toiletries in boutique fitness class locker rooms.