title: Cardiorespiratory fitness, cognition and brain structure after TIA or minor ischemic stroke.
abstract: Background It is not known whether cardiorespiratory fitness is associated with better cognitive performance and brain structure in patients with a TIA or minor ischemic stroke. Aims To examine the association between cardiorespiratory fitness, cognition and brain structure in patients with a TIA and minor stroke. Methods The study population consisted of patients with a TIA or minor stroke with a baseline measurement of the peak oxygen consumption, a MRI scan of brain and neuropsychological assessment. Composite z-scores were calculated for the cognitive domains attention, memory and executive functioning. White matter hyperintensities, microbleeds and lacunes were rated visually. The mean apparent diffusion coefficient was measured in regions of interest in frontal and occipital white matter and in the centrum semiovale as a marker of white matter structure. Normalized brain volumes were estimated by use of Statistical Parametric Mapping. Results In 84 included patients, linear regression analysis adjusted for age, sex and education showed that a higher peak oxygen consumption was associated with higher cognitive z-scores, a larger grey matter volume (B = 0.15 (95% CI 0.05; 0.26)) and a lower mean apparent diffusion coefficient (B = -.004 (95% CI -.007; -.001)). We found no association between the peak oxygen consumption and severe white matter hyperintensities, microbleeds, lacunes and total brain volume. Conclusions These data suggest that cardiorespiratory fitness is associated with better cognitive performance, greater grey matter volume and greater integrity of the white matter in patients with a TIA or minor ischemic stroke. Further prospective trials are necessary to define the effect of cardiorespiratory fitness on cognition and brain structure in patients with TIA or minor stroke.
authors.affiliation: 1 Department of Neurology, OLVG West, Amsterdam, The Netherlands.|2 Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands.|3 Department of Neurology, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: H Myrthe
authors.initials: HM
authors.lastname: Boss
authors.affiliation: 1 Department of Neurology, OLVG West, Amsterdam, The Netherlands.
authors.forename: Sander M
authors.initials: SM
authors.lastname: Van Schaik
authors.affiliation: 4 Department of Radiology, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: Theo D
authors.initials: TD
authors.lastname: Witkamp
authors.affiliation: 2 Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: Mirjam I
authors.initials: MI
authors.lastname: Geerlings
authors.affiliation: 1 Department of Neurology, OLVG West, Amsterdam, The Netherlands.
authors.forename: Henry C
authors.initials: HC
authors.lastname: Weinstein
authors.affiliation: 1 Department of Neurology, OLVG West, Amsterdam, The Netherlands.
authors.forename: Renske M
authors.initials: RM
authors.lastname: Van den Berg-Vos
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001808:Blood Vessels / Q000473:pathology*; D001921:Brain / Q000473:pathology*; D000072599:Cardiorespiratory Fitness; D003071:Cognition; D015444:Exercise; D005260:Female; D006801:Humans; D002546:Ischemic Attack, Transient / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D020521:Stroke / Q000453:epidemiology*
keywords: Stroke; atrophy; cognition; exercise test; physical fitness; white matter