Boss H Myrthe, Van Schaik Sander M, Witkamp Theo D, Geerlings Mirjam I, Weinstein Henry C, Van den Berg-Vos Renske M
1 Department of Neurology, OLVG West, Amsterdam, The Netherlands.
2 Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands.
Int J Stroke. 2017 Oct;12(7):724-731. doi: 10.1177/1747493017702666. Epub 2017 Apr 6.
Background It is not known whether cardiorespiratory fitness is associated with better cognitive performance and brain structure in patients with a TIA or minor ischemic stroke. Aims To examine the association between cardiorespiratory fitness, cognition and brain structure in patients with a TIA and minor stroke. Methods The study population consisted of patients with a TIA or minor stroke with a baseline measurement of the peak oxygen consumption, a MRI scan of brain and neuropsychological assessment. Composite z-scores were calculated for the cognitive domains attention, memory and executive functioning. White matter hyperintensities, microbleeds and lacunes were rated visually. The mean apparent diffusion coefficient was measured in regions of interest in frontal and occipital white matter and in the centrum semiovale as a marker of white matter structure. Normalized brain volumes were estimated by use of Statistical Parametric Mapping. Results In 84 included patients, linear regression analysis adjusted for age, sex and education showed that a higher peak oxygen consumption was associated with higher cognitive z-scores, a larger grey matter volume (B = 0.15 (95% CI 0.05; 0.26)) and a lower mean apparent diffusion coefficient (B = -.004 (95% CI -.007; -.001)). We found no association between the peak oxygen consumption and severe white matter hyperintensities, microbleeds, lacunes and total brain volume. Conclusions These data suggest that cardiorespiratory fitness is associated with better cognitive performance, greater grey matter volume and greater integrity of the white matter in patients with a TIA or minor ischemic stroke. Further prospective trials are necessary to define the effect of cardiorespiratory fitness on cognition and brain structure in patients with TIA or minor stroke.
目前尚不清楚短暂性脑缺血发作（TIA）或轻度缺血性卒中患者的心肺适能是否与更好的认知表现和脑结构相关。
研究TIA和轻度卒中患者的心肺适能、认知与脑结构之间的关联。
研究人群包括TIA或轻度卒中患者，他们进行了峰值耗氧量的基线测量、脑部MRI扫描和神经心理学评估。计算注意力、记忆和执行功能等认知领域的综合z分数。对白质高信号、微出血和腔隙进行视觉评分。在额叶和枕叶白质以及半卵圆中心的感兴趣区域测量平均表观扩散系数，作为白质结构的标志物。使用统计参数映射估计标准化脑体积。
在纳入的84例患者中，经年龄、性别和教育程度校正的线性回归分析显示，较高的峰值耗氧量与较高的认知z分数、较大的灰质体积（B = 0.15（95%CI 0.05；0.26））和较低的平均表观扩散系数（B = -0.004（95%CI -0.007；-0.001））相关。我们发现峰值耗氧量与严重白质高信号、微出血、腔隙和全脑体积之间无关联。
这些数据表明，TIA或轻度缺血性卒中患者的心肺适能与更好的认知表现、更大的灰质体积和更高的白质完整性相关。需要进一步的前瞻性试验来确定心肺适能对TIA或轻度卒中患者认知和脑结构的影响。
