The Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne, AUSTRALIA.
Turner Institute for Brain and Mental Health, Monash University, Clayton, AUSTRALIA.
Med Sci Sports Exerc. 2022 Sep 1;54(9):1401-1409. doi: 10.1249/MSS.0000000000002946. Epub 2022 Apr 25.
White matter hyperintensities (WMHs) are associated with poststroke cognitive decline and mortality. Physical activity (PA) may decrease WMH risk by reducing vascular risk factors and promoting cerebral perfusion. However, the association between poststroke PA and WMH progression remains unclear. We examined the association between PA and WMH volume 12 months after stroke, and between PA and change in WMH volume between 3 and 12 months after stroke.
We included ischemic stroke survivors from the Cognition And Neocortical Volume After Stroke cohort with available brain magnetic resonance imaging and objective PA data. Total, periventricular, and deep WMH volumes (in milliliters) were estimated with manually edited, automated segmentations (Wisconsin White Matter Hyperintensities Segmentation toolbox). Moderate-to-vigorous intensity PA (MVPA) was estimated using the SenseWear® Armband. Participants with MVPA ≥30 min·d -1 were classified as "meeting PA guidelines." We used quantile regression to estimate the associations between PA (MVPA and meeting PA guidelines) with WMH volume at 12 months and change in WMH volume between 3 and 12 months after stroke.
A total of 100 participants were included (median National Institutes of Health Stroke Scale 2; interquartile range, 1-4). MVPA was not associated with WMH volume. In univariable analysis, meeting PA guidelines was associated with lower total, periventricular, and deep WMH volumes by 3.0 mL (95% confidence interval (CI), 0.5-9.7 mL), 2.8 mL (95% CI, 0.5-7.1 mL), and 0.9 mL (95% CI, 0.1-3.0 mL), respectively. However, in multivariable analysis, meeting PA guidelines was not associated with WMH volume, and older age was associated with greater WMH volume at 12 months. PA was not associated with change in WMH volume.
Meeting PA guidelines was associated with lower WMH volume at 12 months in univariable analysis, but not in multivariable analysis. Age consistently predicted greater WMH volume.
脑白质高信号（WMHs）与卒中后认知能力下降和死亡率相关。体力活动（PA）通过降低血管危险因素和促进脑灌注，可能降低 WMH 的风险。然而，卒中后 PA 与 WMH 进展之间的关系尚不清楚。我们研究了卒中后 12 个月时 PA 与 WMH 体积之间的关系，以及卒中后 3 至 12 个月期间 PA 与 WMH 体积变化之间的关系。
我们纳入了 Cognition And Neocortical Volume After Stroke 队列中具有可用脑磁共振成像和客观 PA 数据的缺血性卒中幸存者。通过手动编辑、自动分割（威斯康星州脑白质高信号分割工具箱）估计总脑室周围和深部 WMH 体积（以毫升为单位）。使用 SenseWear®臂带估计中高强度体力活动（MVPA）。MVPA 大于等于 30 分钟/天的参与者被归类为“符合 PA 指南”。我们使用分位数回归来估计 PA（MVPA 和符合 PA 指南）与卒中后 12 个月 WMH 体积和卒中后 3 至 12 个月 WMH 体积变化之间的关系。
共纳入 100 名参与者（中位数国立卫生研究院卒中量表 2 分；四分位距，1-4 分）。MVPA 与 WMH 体积无关。在单变量分析中，符合 PA 指南与总脑室周围和深部 WMH 体积分别降低 3.0 毫升（95%置信区间[CI]，0.5-9.7 毫升）、2.8 毫升（95%CI，0.5-7.1 毫升）和 0.9 毫升（95%CI，0.1-3.0 毫升）相关。然而，在多变量分析中，符合 PA 指南与 WMH 体积无关，而年龄较大与 12 个月时 WMH 体积增加相关。PA 与 WMH 体积变化无关。
在单变量分析中，符合 PA 指南与 12 个月时的 WMH 体积降低相关，但在多变量分析中无关。年龄始终与更大的 WMH 体积相关。
