Department of Physiology, Radboud Institute for Health Sciences, Radboud University Medical Centre, Nijmegen, The Netherlands.
Department of Neurology, Centre for Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre, Nijmegen, The Netherlands.
Int J Stroke. 2021 Oct;16(8):962-971. doi: 10.1177/1747493020984090. Epub 2021 Jan 7.
Given the unexplored potential of physical activity to reduce the progression of cerebral small vessel disease (cSVD, the purpose of this study was to prospectively (across nine-year follow-up) examine the relation between (baseline) physical activity and the (clinical and imaging) consequences of the whole spectrum of cerebral small vessel disease.
Five hundred and three patients with cerebral small vessel disease from the RUNDMC study were followed for nine years. Physical activity was assessed using a questionnaire in 2006, 2011, and 2015. Clinical events (i.e. all-cause mortality, cerebrovascular events (by stroke subtype)) were collected with a structured questionnaire. Patients underwent magnetic resonance imaging scanning for the assessment of magnetic resonance imaging markers of cerebral small vessel disease (i.e. white matter hyperintensities, lacunes, and microbleeds) and microstructural integrity of the white matter at three timepoints.
The mean age at baseline was 66 (SD 9.0) years; 44% were women. A higher baseline physical activity level was independently associated with a lower all-cause mortality (HR: 0.69, 95%CI: 0.49-0.98, p = 0.03) and incidence of cerebrovascular disease (HR: 0.58, 95%CI: 0.36-0.96, p = 0.03). However, we found no relation between physical activity and incident lacunar stroke or progression of magnetic resonance imaging markers of cerebral small vessel disease.
Whilst regular physical activity was not related to the progression of magnetic resonance imaging markers of cerebral small vessel disease across a nine-year follow-up, results from our study prove that high levels of physical activity in patients with cerebral small vessel disease are associated with a lower all-cause mortality and lower incidence of cerebrovascular events.
鉴于体力活动在降低脑小血管疾病（cSVD）进展方面的潜力尚未得到充分探索，本研究旨在前瞻性（在 9 年随访期间）检查（基线）体力活动与脑小血管疾病整个谱的（临床和影像学）后果之间的关系。
来自 RUNDMC 研究的 503 名脑小血管疾病患者在 9 年内接受随访。使用问卷在 2006 年、2011 年和 2015 年评估体力活动。临床事件（即全因死亡率、脑血管事件（按中风亚型分类））通过结构化问卷收集。患者接受磁共振成像扫描，以评估脑小血管疾病的磁共振成像标志物（即白质高信号、腔隙和微出血）和 3 个时间点的白质微观结构完整性。
基线时的平均年龄为 66（9.0）岁；44%为女性。较高的基线体力活动水平与较低的全因死亡率（HR：0.69，95%CI：0.49-0.98，p=0.03）和脑血管病发病率（HR：0.58，95%CI：0.36-0.96，p=0.03）独立相关。然而，我们发现体力活动与腔隙性中风或脑小血管疾病磁共振成像标志物的进展之间没有关系。
虽然在 9 年的随访期间，定期体力活动与脑小血管疾病磁共振成像标志物的进展无关，但本研究的结果证明，脑小血管疾病患者高水平的体力活动与较低的全因死亡率和较低的脑血管事件发生率相关。
