title: Cardiopulmonary fitness correlates with regional cerebral grey matter perfusion and density in men with coronary artery disease.
abstract: OBJECTIVE
  Physical activity is associated with positive effects on the brain but there is a paucity of clinical neuroimaging data in patients with coronary artery disease (CAD), a cardiovascular condition associated with grey matter loss. The purpose of this study was to determine which brain regions are impacted by cardiopulmonary fitness and with the change in fitness after 6 months of exercise-based cardiac rehabilitation.
  
  
  METHODS
  CAD patients underwent magnetic resonance imaging at baseline, and peak volume of oxygen uptake during exercise testing (VO2Peak) was measured at baseline and after 6 months of training. T1-weighted structural images were used to perform grey matter (GM) voxel-based morphometry (VBM). Pseudo-continuous arterial spin labeling (pcASL) was used to produce cerebral blood flow (CBF) images. VBM and CBF data were tested voxel-wise using VO2Peak and age as explanatory variables.
  
  
  RESULTS
  In 30 men with CAD (mean age 65±7 years), VBM and CBF identified 7 and 5 respective regions positively associated with baseline VO2Peak. These included the pre- and post-central, paracingulate, caudate, hippocampal regions and converging findings in the putamen. VO2Peak increased by 20% at follow-up in 29 patients (t = 9.6, df = 28, p<0.0001). Baseline CBF in the left post-central gyrus and baseline GM density in the right putamen predicted greater change in VO2Peak.
  
  
  CONCLUSIONS
  Perfusion and GM density were associated with fitness at baseline and with greater fitness gains with exercise. This study identifies new neurobiological correlates of fitness and demonstrates the utility of multi-modal MRI to evaluate the effects of exercise in CAD patients.
authors.affiliation: Heart and Stroke Foundation Canadian Partnership for Stroke Recovery, Sunnybrook Research Institute, Toronto, Ontario, Canada; Physical Sciences, Sunnybrook Research Institute, Toronto, Ontario, Canada; Department of Medical Biophysics, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Bradley J
authors.initials: BJ
authors.lastname: MacIntosh
authors.affiliation: Heart and Stroke Foundation Canadian Partnership for Stroke Recovery, Sunnybrook Research Institute, Toronto, Ontario, Canada; Neuropsychopharmacology Research Group, Sunnybrook Research Institute, Toronto, Ontario, Canada.
authors.forename: Walter
authors.initials: W
authors.lastname: Swardfager
authors.affiliation: Heart and Stroke Foundation Canadian Partnership for Stroke Recovery, Sunnybrook Research Institute, Toronto, Ontario, Canada.
authors.forename: David E
authors.initials: DE
authors.lastname: Crane
authors.affiliation: Neuropsychopharmacology Research Group, Sunnybrook Research Institute, Toronto, Ontario, Canada.
authors.forename: Nipuni
authors.initials: N
authors.lastname: Ranepura
authors.affiliation: Neuropsychopharmacology Research Group, Sunnybrook Research Institute, Toronto, Ontario, Canada.
authors.forename: Mahwesh
authors.initials: M
authors.lastname: Saleem
authors.affiliation: Department of Clinical Pharmacology, University of Toronto, Toronto, Ontario, Canada; Toronto Rehabilitation Institute, Toronto, Ontario, Canada.
authors.forename: Paul I
authors.initials: PI
authors.lastname: Oh
authors.affiliation: Heart and Stroke Foundation Canadian Partnership for Stroke Recovery, Sunnybrook Research Institute, Toronto, Ontario, Canada; Physical Sciences, Sunnybrook Research Institute, Toronto, Ontario, Canada; Neuropsychopharmacology Research Group, Sunnybrook Research Institute, Toronto, Ontario, Canada.
authors.forename: Bojana
authors.initials: B
authors.lastname: Stefanovic
authors.affiliation: Neuropsychopharmacology Research Group, Sunnybrook Research Institute, Toronto, Ontario, Canada; Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Nathan
authors.initials: N
authors.lastname: Herrmann
authors.affiliation: Heart and Stroke Foundation Canadian Partnership for Stroke Recovery, Sunnybrook Research Institute, Toronto, Ontario, Canada; Neuropsychopharmacology Research Group, Sunnybrook Research Institute, Toronto, Ontario, Canada; Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Krista L
authors.initials: KL
authors.lastname: Lanctôt
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002560:Cerebrovascular Circulation; D003324:Coronary Artery Disease / Q000473:pathology* / Q000503:physiopathology* / Q000534:rehabilitation; D015444:Exercise; D066128:Gray Matter / Q000473:pathology* / Q000503:physiopathology*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009929:Organ Size; D010101:Oxygen Consumption