title: Reported Prestroke Physical Activity Is Associated with Vascular Endothelial Growth Factor Expression and Good Outcomes after Stroke.
abstract: BACKGROUND
  Physical activity (PhA) prior to stroke has been associated with good outcomes after the ischemic insult, but there is scarce data on the involved molecular mechanisms.
  
  
  METHODS
  We studied consecutive acute ischemic stroke patients admitted to a single tertiary stroke center. Prestroke PhA was evaluated with the International Physical Activity Questionnaire (metabolic equivalent of minutes/week). We studied several circulating angiogenic and neurogenic factors at different time points: vascular endothelial growth factor (VEGF), granulocyte colony-stimulating factor (G-CSF), and brain-derived neurotrophic factor (BDNF) at admission, day 7, and at 3 months. We considered good functional outcome at 3 months (modified Rankin scale  ≤ 2) as primary end point, and final infarct volume as secondary outcome.
  
  
  RESULTS
  We studied 83 patients with at least 2 time point serum determinations (mean age 69.6 years, median National Institutes of Health Stroke Scale 17 at admission). Patients more physically active before stroke had a significantly higher increment of serum VEGF on the seventh day when compared to less active patients. This increment was an independent predictor of good functional outcome at 3 months and was associated with smaller infarct volume in multivariate analyses adjusted for relevant covariates. We did not find independent associations of G-CSF or BDNF levels neither with level of prestroke PhA nor with stroke outcomes.
  
  
  CONCLUSIONS
  Although there are probably more molecular mechanisms by which PhA exerts its beneficial effects in stroke outcomes, our observation regarding the potential role of VEGF is plausible and in line with previous experimental studies. Further research in this field is needed.
authors.affiliation: Department of Neuroscience, Hospital Germans Trias i Pujol, Universidad Autónoma Barcelona (UAB), Badalona, Barcelona, Spain. Electronic address: elenacancio@gmail.com.
authors.forename: Elena
authors.initials: E
authors.lastname: López-Cancio
authors.affiliation: Department of Neuroscience, Hospital Germans Trias i Pujol, Universidad Autónoma Barcelona (UAB), Badalona, Barcelona, Spain.
authors.forename: Ana Clara
authors.initials: AC
authors.lastname: Ricciardi
authors.affiliation: Clinical Neurosciences Research Laboratory, Department of Neurology, Hospital Clínico Universitario, Health Research Institute of Santiago de Compostela (IDIS), University of Santiago de Compostela, Santiago de Compostela, Spain.
authors.forename: Tomás
authors.initials: T
authors.lastname: Sobrino
authors.affiliation: Department of Biostatistics, Universitat Politècnica de Catalunya, Barcelona, Spain.
authors.forename: Jordi
authors.initials: J
authors.lastname: Cortés
authors.affiliation: Department of Neuroscience, Hospital Germans Trias i Pujol, Universidad Autónoma Barcelona (UAB), Badalona, Barcelona, Spain.
authors.forename: Natalia Pérez
authors.initials: NP
authors.lastname: de la Ossa
authors.affiliation: Department of Neuroscience, Hospital Germans Trias i Pujol, Universidad Autónoma Barcelona (UAB), Badalona, Barcelona, Spain.
authors.forename: Mónica
authors.initials: M
authors.lastname: Millán
authors.affiliation: Department of Neuroscience, Hospital Germans Trias i Pujol, Universidad Autónoma Barcelona (UAB), Badalona, Barcelona, Spain.
authors.forename: María
authors.initials: M
authors.lastname: Hernández-Pérez
authors.affiliation: Department of Neuroscience, Hospital Germans Trias i Pujol, Universidad Autónoma Barcelona (UAB), Badalona, Barcelona, Spain.
authors.forename: Meritxell
authors.initials: M
authors.lastname: Gomis
authors.affiliation: Department of Neuroscience, Hospital Germans Trias i Pujol, Universidad Autónoma Barcelona (UAB), Badalona, Barcelona, Spain.
authors.forename: Laura
authors.initials: L
authors.lastname: Dorado
authors.affiliation: Department of Neuroscience, Hospital Germans Trias i Pujol, Universidad Autónoma Barcelona (UAB), Badalona, Barcelona, Spain.
authors.forename: Lucía
authors.initials: L
authors.lastname: Muñoz-Narbona
authors.affiliation: Clinical Neurosciences Research Laboratory, Department of Neurology, Hospital Clínico Universitario, Health Research Institute of Santiago de Compostela (IDIS), University of Santiago de Compostela, Santiago de Compostela, Spain.
authors.forename: Francisco
authors.initials: F
authors.lastname: Campos
authors.affiliation: Department of Neurology, Hospital Clínico, University of Valladolid, Valladolid, Spain.
authors.forename: Juan F
authors.initials: JF
authors.lastname: Arenillas
authors.affiliation: Department of Neuroscience, Hospital Germans Trias i Pujol, Universidad Autónoma Barcelona (UAB), Badalona, Barcelona, Spain.
authors.forename: Antoni
authors.initials: A
authors.lastname: Dávalos
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood; D001921:Brain / Q000000981:diagnostic imaging; D002545:Brain Ischemia / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000628:therapy; D019208:Brain-Derived Neurotrophic Factor / Q000097:blood; D015444:Exercise / Q000502:physiology; D005260:Female; D016179:Granulocyte Colony-Stimulating Factor / Q000097:blood; D006801:Humans; D008297:Male; D015999:Multivariate Analysis; D000066829:Neuroprotection / Q000502:physiology; D020127:Recovery of Function / Q000502:physiology*; D057566:Self Report; D020521:Stroke / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000628:therapy; D013997:Time Factors; D016896:Treatment Outcome; D042461:Vascular Endothelial Growth Factor A / Q000097:blood*
chemical_list: D015415:Biomarkers; D019208:Brain-Derived Neurotrophic Factor; C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A; D016179:Granulocyte Colony-Stimulating Factor; C579455:BDNF protein, human
keywords: Functional recovery; physical activity; stroke; vascular growth factors