title: Exercise intensity modulates the change in cerebral blood flow following aerobic exercise in chronic stroke.
abstract: The mechanisms supporting functional improvement by aerobic exercise following stroke remain incompletely understood. This study investigated how cycling intensity and aerobic fitness influence cerebral blood flow (CBF) following a single exercise session. Thirteen community-living stroke survivors performed 20 min of semi-recumbent cycling at low and moderate intensities (40-50 and 60-70 % of heart rate reserve, respectively) as determined from an exercise stress test. CBF was quantified by arterial spin labeling MRI at baseline, as well as 30 and 50 min post-exercise. An intensity-dependent effect was observed in the right post-central and supramarginal gyri up to 50 min after exercise (uncorrected p < 0.005, cluster size ≥10). Regional CBF was increased 18 ± 17 % and reduced 8 ± 12 % following moderate- and low-intensity cycling, respectively. In contrast, CBF changes were similar between sessions in the right lentiform nucleus and mid-frontal gyrus, as well as the left temporal and parietal gyri. Aerobic fitness was directly related to posterior cingulate and thalamic CBF, and inversely related to precuneal CBF at rest (R (2) ≥ 0.75); however, no relationship between fitness and the post-exercise change in CBF was observed. Divergent changes in regional CBF were observed in the right parietal cortex following low- and moderate-intensity exercise, which suggests that intensity of prescribed exercise may be useful in optimizing rehabilitation.
authors.affiliation: Heart and Stroke Foundation Canadian Partnership for Stroke Recovery, Sunnybrook Research Institute, University of Toronto, 2075 Bayview Ave., Room M6-168, Toronto, ON, M4N 3M5, Canada, adrobert@sri.utoronto.ca.
authors.forename: Andrew D
authors.initials: AD
authors.lastname: Robertson
authors.forename: David E
authors.initials: DE
authors.lastname: Crane
authors.forename: A Saeed
authors.initials: AS
authors.lastname: Rajab
authors.forename: Walter
authors.initials: W
authors.lastname: Swardfager
authors.forename: Susan
authors.initials: S
authors.lastname: Marzolini
authors.forename: Zahra
authors.initials: Z
authors.lastname: Shirzadi
authors.forename: Laura E
authors.initials: LE
authors.lastname: Middleton
authors.forename: Bradley J
authors.initials: BJ
authors.lastname: MacIntosh
mesh_terms: D000368:Aged; D002540:Cerebral Cortex / Q000098:blood supply*; D002560:Cerebrovascular Circulation / Q000502:physiology*; D002908:Chronic Disease; D003342:Corpus Striatum / Q000098:blood supply*; D015444:Exercise / Q000502:physiology*; D005260:Female; D006801:Humans; D018810:Magnetic Resonance Angiography; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D020521:Stroke / Q000503:physiopathology*; D000071939:Stroke Rehabilitation