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Bartsch BL, Whitaker AA, Oloyede S, Waghmare S, Billinger SA. Feasibility of a Recumbent Stepper for Short-Interval, Low-Volume High-Intensity Interval Exercise in Stroke. J Neurol Phys Ther 2024:01253086-990000000-00069. [PMID: 38913833 DOI: 10.1097/npt.0000000000000482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/26/2024]
Abstract
BACKGROUND AND PURPOSE Studies investigating high-intensity interval exercise (HIIE) in stroke typically emphasize treadmill training. However, a literature review suggested that seated devices such as a recumbent stepper or cycle offer a promising alternative for HIIE since exercise can be prescribed using peak power output (PPO). Therefore, this would give health care professionals the ability to monitor and adapt power output for the target heart rate range. The purpose of this secondary analysis was to examine the feasibility of prescribing short-interval, low-volume HIIE using PPO in chronic stroke. METHODS We used several methods to test feasibility: (1)Acceptability: Measured by the percentage of participants who completed the entire HIIE protocol; (2) Implementation was assessed by the number of reported cardiac or serious adverse events during submaximal exercise testing and HIIE and the average percentage of participants reaching vigorous intensity, defined by the American College of Sports Medicine as at least 77% of age-predicted maximal heart rate (HR max ). RESULTS Data were available for 28 participants who were 32.2 (17.2) months post-stroke and 61.4 (11.9) years of age. Twenty-eight participants completed HIIE per protocol. No cardiac or serious adverse events occurred during the submaximal exercise test or during HIIE. The rapid switching between HIIE and recovery showed no evidence of blood pressure reaching unsafe thresholds. Average intensity during HIIE reached 76.8% HR max , which is slightly below the target of 77.0%. DISCUSSION AND CONCLUSIONS A single bout of short-interval, low-volume HIIE, prescribed using PPO, was feasible in chronic stroke. Video Abstract : Available for more insights from the authors (Supplemental Digital Content, Video, available at: http://links.lww.com/JNPT/A474 ).
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Affiliation(s)
- Bria L Bartsch
- Department of Physical Therapy, Rehabilitation Science, and Athletic Training, University of Kansas Medical Center, Kansas City, Kansas (B.L.B., S.W.); Department of Neurology, University of Kansas Medical Center, Kansas City, Kansas (B.L.B., S.O., S.W., S.A.B.); Department of Physical Medicine and Rehabilitation, Medical College of Wisconsin, Milwaukee, Wisconsin (A.A.W.); Cardiovascular Center, Medical College of Wisconsin, Milwaukee, Wisconsin (A.A.W.); University of Kansas Alzheimer's Disease Research Center, Fairway, Kansas (S.A.B.); Department of Physical Medicine and Rehabilitation, University of Kansas Medical Center, Kansas City, Kansas (S.A.B.); and Department of Cell Biology and Physiology, University of Kansas Medical Center, Kansas City, Kansas (S.A.B)
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Whitaker AA, Waghmare S, Montgomery RN, Aaron SE, Eickmeyer SM, Vidoni ED, Billinger SA. Lower middle cerebral artery blood velocity during low-volume high-intensity interval exercise in chronic stroke. J Cereb Blood Flow Metab 2024; 44:627-640. [PMID: 37708242 PMCID: PMC11197145 DOI: 10.1177/0271678x231201472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 08/18/2023] [Accepted: 08/24/2023] [Indexed: 09/16/2023]
Abstract
High-intensity interval training (HIIE) may present unique challenges to the cerebrovascular system in individuals post-stroke. We hypothesized lower middle cerebral artery blood velocity (MCAv) in individuals post-stroke: 1) during 10 minutes of HIIE, 2) immediately following HIIE, and 3) 30 minutes after HIIE, compared to age- and sex-matched controls (CON). We used a recumbent stepper submaximal exercise test to determine workloads for high-intensity and active recovery. Our low volume HIIE protocol consisted of 1-minute intervals for 10 minutes. During HIIE, we measured MCAv, mean arterial pressure (MAP), heart rate (HR), and end tidal carbon dioxide (PETCO2). We assessed carotid-femoral pulse wave velocity as a measure of arterial stiffness. Fifty participants completed the study (25 post-stroke, 76% ischemic, 32% moderate disability). Individuals post-stroke had lower MCAv during HIIE compared to CON (p = 0.03), which remained 30 minutes after HIIE. Individuals post-stroke had greater arterial stiffness (p = 0.01) which was moderately associated with a smaller MCAv responsiveness during HIIE (r = -0.44). No differences were found for MAP, HR, and PETCO2. This study suggests individuals post-stroke had a lower MCAv during HIIE compared to their peers, which remained during recovery up to 30 minutes. Arterial stiffness may contribute to the lower cerebrovascular responsiveness post-stroke.
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Affiliation(s)
- Alicen A Whitaker
- Department of Physical Therapy, Rehabilitation Science, and Athletic Training, University of Kansas Medical Center, Kansas City, KS, USA
- Department of Physical Medicine and Rehabilitation, Medical College of Wisconsin, Milwaukee, WI, USA
- Cardiovascular Center, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Saniya Waghmare
- Department of Physical Therapy, Rehabilitation Science, and Athletic Training, University of Kansas Medical Center, Kansas City, KS, USA
- Department of Neurology, University of Kansas Medical Center, Kansas City, KS, USA
| | - Robert N Montgomery
- Department of Biostatistics & Data Science, University of Kansas Medical Center, Kansas City, KS, USA
| | - Stacey E Aaron
- Department of Neurology, University of Kansas Medical Center, Kansas City, KS, USA
| | - Sarah M Eickmeyer
- Department of Physical Medicine and Rehabilitation, University of Kansas Medical Center, Kansas City, KS, USA
| | - Eric D Vidoni
- Department of Neurology, University of Kansas Medical Center, Kansas City, KS, USA
- University of Kansas Alzheimer’s Disease Research Center, Fairway, KS, USA
| | - Sandra A Billinger
- Department of Neurology, University of Kansas Medical Center, Kansas City, KS, USA
- Department of Physical Medicine and Rehabilitation, University of Kansas Medical Center, Kansas City, KS, USA
- University of Kansas Alzheimer’s Disease Research Center, Fairway, KS, USA
- Department of Cell Biology and Physiology, University of Kansas Medical Center, Kansas City, KS, USA
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Weston ME, Barker AR, Tomlinson OW, Coombes JS, Bailey TG, Bond B. Agreement between left and right middle cerebral artery blood velocity responses to incremental and constant work-rate exercise in healthy males and females. Physiol Meas 2023; 44:074001. [PMID: 37406643 DOI: 10.1088/1361-6579/ace49d] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 07/05/2023] [Indexed: 07/07/2023]
Abstract
Objective.To quantify the agreement between left and right middle cerebral artery blood velocity (MCAv) responses to incremental and constant work-rate exercise in adults.ApproachSeventeen healthy adults (23.8 ± 2.4 years, 9 females) completed a ramp incremental test to exhaustion on a cycle ergometer, three 6-minute transitions at a moderate-intensity, and three at a heavy-intensity, all on separate days. Bilateral MCAv was measured throughout using transcranial Doppler ultrasonography, with left and right MCAv data analysed separately. Data were analysed at baseline, gas exchange threshold, respiratory compensation point and exhaustion during ramp incremental exercise. MCAv responses to constant work-rate exercise were analysed using a mono-exponential model, to determine time- and amplitude-based kinetic response parameters.Main ResultsLeft and right MCAv responses to incremental and constant work-rate exercise were significantly, strongly and positively correlated (r≥ 0.61,P< 0.01). Coefficient of variation (left versus right) ranged from 7.3%-20.7%, 6.4%-26.2% and 5.9%-22.5% for ramp, moderate and heavy-intensity exercise, respectively. The relative change in MCAv from baseline was higher in the right compared to left MCAv during ramp, moderate and heavy-intensity exercise (allP< 0.05), but the effect sizes were small (d≤ 0.4). Small mean left-right differences were present during ramp incremental exercise at all time-points (<6 cm s-1; <4%), and for all kinetic parameters during moderate and heavy-intensity exercise (<3 cm s-1, <3%, <4 s).SignificanceThese findings demonstrate similarities between left and right MCAv responses to incremental and constant-work rate exercise in adults on a group-level, but also highlight individual variation in the agreement between left and right MCAv exercise responses.
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Affiliation(s)
- Max E Weston
- Children's Health and Exercise Research Centre, Public Health and Sports Sciences, Faculty of Health and Life Sciences, University of Exeter, Exeter, United Kingdom
- Physiology and Ultrasound Laboratory in Science and Exercise, School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Australia
| | - Alan R Barker
- Children's Health and Exercise Research Centre, Public Health and Sports Sciences, Faculty of Health and Life Sciences, University of Exeter, Exeter, United Kingdom
| | - Owen W Tomlinson
- Children's Health and Exercise Research Centre, Public Health and Sports Sciences, Faculty of Health and Life Sciences, University of Exeter, Exeter, United Kingdom
| | - Jeff S Coombes
- Physiology and Ultrasound Laboratory in Science and Exercise, School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Australia
| | - Tom G Bailey
- Physiology and Ultrasound Laboratory in Science and Exercise, School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Australia
- School of Nursing Midwifery and Social Work, The University of Queensland, Brisbane, Australia
| | - Bert Bond
- Children's Health and Exercise Research Centre, Public Health and Sports Sciences, Faculty of Health and Life Sciences, University of Exeter, Exeter, United Kingdom
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Mulser L, Moreau D. Effect of Acute Cardiovascular Exercise on Cerebral Blood Flow: A Systematic Review. Brain Res 2023; 1809:148355. [PMID: 37003561 DOI: 10.1016/j.brainres.2023.148355] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Revised: 03/14/2023] [Accepted: 03/21/2023] [Indexed: 04/03/2023]
Abstract
A single bout of cardiovascular exercise can have a cascade of physiological effects, including increased blood flow to the brain. This effect has been documented across multiple modalities, yet studies have reported mixed findings. Here, we systematically review evidence for the acute effect of cardiovascular exercise on cerebral blood flow across a range of neuroimaging techniques and exercise characteristics. Based on 52 studies and a combined sample size of 1,174 individuals, our results indicate that the acute effect of cardiovascular exercise on cerebral blood flow generally follows an inverted U-shaped relationship, whereby blood flow increases early on but eventually decreases as exercise continues. However, we also find that this effect is not uniform across studies, instead varying across a number of key variables including exercise characteristics, brain regions, and neuroimaging modalities. As the most comprehensive synthesis on the topic to date, this systematic review sheds light on the determinants of exercise-induced change in cerebral blood flow, a necessary step toward personalized interventions targeting brain health across a range of populations.
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Affiliation(s)
- Lisa Mulser
- School of Psychology The University of Auckland
| | - David Moreau
- School of Psychology and Centre for Brain Research The University of Auckland.
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van Bohemen SJ, Rogers JM, Boughton PC, Clarke JL, Valderrama JT, Kyme AZ. Continuous non-invasive estimates of cerebral blood flow using electrocardiography signals: a feasibility study. Biomed Eng Lett 2023; 13:185-195. [PMID: 37124110 PMCID: PMC10130316 DOI: 10.1007/s13534-023-00265-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Revised: 01/11/2023] [Accepted: 01/22/2023] [Indexed: 02/12/2023] Open
Abstract
AbstractThis paper describes a potential method to detect changes in cerebral blood flow (CBF) using electrocardiography (ECG) signals, measured across scalp electrodes with reference to the same signal across the chest—a metric we term the Electrocardiography Brain Perfusion index (EBPi). We investigated the feasibility of EBPi to monitor CBF changes in response to specific tasks. Twenty healthy volunteers wore a head-mounted device to monitor EBPi and electroencephalography (EEG) during tasks known to alter CBF. Transcranial Doppler (TCD) ultrasound measurements provided ground-truth estimates of CBF. Statistical analyses were applied to EBPi, TCD right middle cerebral artery blood flow velocity (rMCAv) and EEG relative Alpha (rAlpha) data to detect significant task-induced changes and correlations. Breath-holding and aerobic exercise induced highly significant increases in EBPi and TCD rMCAv (p < 0.01). Verbal fluency also increased both measures, however the increase was only significant for EBPi (p < 0.05). Hyperventilation induced a highly significant decrease in TCD rMCAv (p < 0.01) but EBPi was unchanged. Combining all tasks, EBPi exhibited a highly significant, weak positive correlation with TCD rMCAv (r = 0.27, p < 0.01) and the Pearson coefficient between EBPi and rAlpha was r = − 0.09 (p = 0.05). EBPi appears to be responsive to dynamic changes in CBF and, can enable practical, continuous monitoring. CBF is a key parameter of brain health and function but is not easily measured in a practical, continuous, non-invasive fashion. EBPi may have important clinical implications in this context for stroke monitoring and management. Additional studies are required to support this claim.
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Lin H, Ye Y, Wan M, Qiu P, Xia R, Zheng G. Effect of Baduanjin exercise on cerebral blood flow and cognitive frailty in the community older adults with cognitive frailty: A randomized controlled trial. J Exerc Sci Fit 2023; 21:131-137. [PMID: 36606263 PMCID: PMC9791406 DOI: 10.1016/j.jesf.2022.12.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 11/26/2022] [Accepted: 12/01/2022] [Indexed: 12/12/2022] Open
Abstract
Objectives Regular Baduanjin exercise training has been shown to be beneficial to the physical and cognitive health of older adults, but the underlying mechanisms remain to be investigated. This study examined the influence of Baduanjin on cerebral hemodynamics in community-dwelling older adults with cognitive frailty. Design Randomized controlled trial. Methods A total of 102 eligible participants were randomly allocated into the Baduanjin exercise intervention group (BEG) or usual physical activity control group (CG) for 24 weeks. Cerebral hemodynamic parameters of bilateral middle/anterior cerebral artery and basilar artery, cognitive ability and physical frailty were assessed using Transcranial Doppler (TCD), Montreal Cognitive Assessment (MoCA) and Edmonton Frailty Scale (EFS) at baseline and 24 weeks post-intervention. Results After 24 weeks intervention, the changes in peak systolic velocity (PSV), mean blood flow velocity (MBFV), and end diastolic velocity (EDV) in the right middle cerebral artery and basilar artery were better in the BEG than in the CG; the increase in MoCA scores and the decrease in EFS scores were significantly higher in the BEG than in the CG. Moreover, the interaction of exercise and time on those variables showed obvious significance. Conclusions The 24 weeks Baduanjin exercise training had a positive beneficial effect on cerebral blood flow in community-dwelling older adults with cognitive frailty. This may be a potential mechanism by which Baduanjin exercise improves the cognitive frailty in older adults. Trial registration Chinese Clinical Trial Registry, ChiCTR1800020341. Date of registration December 25, 2018, http://www.chictr.org.cn/showproj.aspx?proj=29846.
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Key Words
- ACA, anterior cerebral artery
- BA, basilar artery
- Baduanjin
- CBF, cerebral blood flow
- CF, cognitive frailty
- Cerebral blood flow
- Cognitive frailty
- EDV, end diastolic velocity
- EFS, Edmonton frailty scale
- GDS, global deterioration scale
- ITT, intention-to-treat
- MBFV, mean of blood flow velocity
- MCA, middle cerebral artery
- Mechanisms
- MoCA, Montreal cognitive assessment
- PSV, peak systolic velocity
- Randomized controlled trial
- TCD, transcranial doppler
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Affiliation(s)
- Huiying Lin
- College of Nursing and Health Management, Shanghai University of Health & Medicine Sciences, Pudong New District, Shanghai, China,College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Shangjie University Town, Fuzhou, China
| | - Yu Ye
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Shangjie University Town, Fuzhou, China
| | - Mingyue Wan
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Shangjie University Town, Fuzhou, China
| | - Pingting Qiu
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Shangjie University Town, Fuzhou, China
| | - Rui Xia
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Shangjie University Town, Fuzhou, China
| | - Guohua Zheng
- College of Nursing and Health Management, Shanghai University of Health & Medicine Sciences, Pudong New District, Shanghai, China,Corresponding author.
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Barnes JN, Burns JM, Bamman MM, Billinger SA, Bodine SC, Booth FW, Brassard P, Clemons TA, Fadel PJ, Geiger PC, Gujral S, Haus JM, Kanoski SE, Miller BF, Morris JK, O’Connell KM, Poole DC, Sandoval DA, Smith JC, Swerdlow RH, Whitehead SN, Vidoni ED, van Praag H. Proceedings from the Albert Charitable Trust Inaugural Workshop on 'Understanding the Acute Effects of Exercise on the Brain'. Brain Plast 2022; 8:153-168. [PMID: 36721393 PMCID: PMC9837736 DOI: 10.3233/bpl-220146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/18/2022] [Indexed: 12/12/2022] Open
Abstract
An inaugural workshop supported by "The Leo and Anne Albert Charitable Trust," was held October 4-7, 2019 in Scottsdale, Arizona, to focus on the effects of exercise on the brain and to discuss how physical activity may prevent or delay the onset of aging-related neurodegenerative conditions. The Scientific Program Committee (led by Dr. Jeff Burns) assembled translational, clinical, and basic scientists who research various aspects of the effects of exercise on the body and brain, with the overall goal of gaining a better understanding as to how to delay or prevent neurodegenerative diseases. In particular, research topics included the links between cardiorespiratory fitness, the cerebrovasculature, energy metabolism, peripheral organs, and cognitive function, which are all highly relevant to understanding the effects of acute and chronic exercise on the brain. The Albert Trust workshop participants addressed these and related topics, as well as how other lifestyle interventions, such as diet, affect age-related cognitive decline associated with Alzheimer's and other neurodegenerative diseases. This report provides a synopsis of the presentations and discussions by the participants, and a delineation of the next steps towards advancing our understanding of the effects of exercise on the aging brain.
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Affiliation(s)
- Jill N. Barnes
- Department of Kinesiology, University of Wisconsin-Madison, Madison, WI, USA
| | - Jeffrey M. Burns
- University of Kansas Alzheimer’s Disease Research Center, Fairway, KS, USA
| | - Marcas M. Bamman
- UAB Center for Exercise Medicine, University of Alabama, Birmingham, AL, USA
| | | | - Sue C. Bodine
- Department of Internal Medicine, Division of Endocrinology and Metabolism, University of Iowa Carver College of Medicine, Iowa City, IA, USA
| | - Frank W. Booth
- Department of Biomedical Sciences, University of Missouri, Columbia, MO, USA
| | - Patrice Brassard
- Department of Kinesiology, Faculty of Medicine, Université Laval, and Research center of the Institut universitaire de cardiologie et de pneumologie de Québec, Québec city, QC, Canada
| | - Tameka A. Clemons
- Department of Professional and Medical Education, Meharry Medical College, Nashville, TN, USA
| | - Paul J. Fadel
- Department of Kinesiology, University of Texas at Arlington, Arlington, Texas, USA
| | - Paige C. Geiger
- Department of Molecular and Integrative Physiology, University of Kansas Medical Center, Kansas City, KS, USA
| | - Swathi Gujral
- University of Pittsburgh School of Medicine, Department of Psychiatry, Pittsburgh, PA, USA
| | - Jacob M. Haus
- School of Kinesiology, University of Michigan, Ann Arbor, MI, USA
| | - Scott E. Kanoski
- Human and Evolutionary Biology Section, Department of Biological Sciences, Dornsrife College of Letters, Arts and Sciences, University of Southern California, Los Angeles, CA, USA
| | - Benjamin F. Miller
- Aging and Metabolism Research Program, Oklahoma Medical Research Foundation, Oklahoma City, OK, USA
| | - Jill K. Morris
- University of Kansas Alzheimer’s Disease Research Center, Fairway, KS, USA
| | | | - David C. Poole
- Departments of Kinesiology, Anatomy and Physiology, Kansas State University, Manhattan, KS, USA
| | | | - J. Carson Smith
- Department of Kinesiology, School of Public Health, University of Maryland, College Park, MD, USA
| | | | - Shawn N. Whitehead
- Vulnerable Brain Laboratory, Department Anatomy and Cell Biology, Schulich School of Medicine and Dentistry, Western University, London, N6A 5C1, Canada
| | - Eric D. Vidoni
- University of Kansas Alzheimer’s Disease Research Center, Fairway, KS, USA
| | - Henriette van Praag
- Stiles-Nicholson Brain Institute, Charles E. Schmidt College of Medicine, Florida Atlantic University, Jupiter FL, USA
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Vidoni ED, Morris JK, Palmer JA, Li Y, White D, Kueck PJ, John CS, Honea RA, Lepping RJ, Lee P, Mahnken JD, Martin LE, Billinger SA. Dementia risk and dynamic response to exercise: A non-randomized clinical trial. PLoS One 2022; 17:e0265860. [PMID: 35802628 PMCID: PMC9269742 DOI: 10.1371/journal.pone.0265860] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Accepted: 06/18/2022] [Indexed: 11/25/2022] Open
Abstract
Background Physical exercise may support brain health and cognition over the course of typical aging. The goal of this nonrandomized clinical trial was to examine the effect of an acute bout of aerobic exercise on brain blood flow and blood neurotrophic factors associated with exercise response and brain function in older adults with and without possession of the Apolipoprotein epsilon 4 (APOE4) allele, a genetic risk factor for developing Alzheimer’s. We hypothesized that older adult APOE4 carriers would have lower cerebral blood flow regulation and would demonstrate blunted neurotrophic response to exercise compared to noncarriers. Methods Sixty-two older adults (73±5 years old, 41 female [67%]) consented to this prospectively enrolling clinical trial, utilizing a single arm, single visit, experimental design, with post-hoc assessment of difference in outcomes based on APOE4 carriership. All participants completed a single 15-minute bout of moderate-intensity aerobic exercise. The primary outcome measure was change in cortical gray matter cerebral blood flow in cortical gray matter measured by magnetic resonance imaging (MRI) arterial spin labeling (ASL), defined as the total perfusion (area under the curve, AUC) following exercise. Secondary outcomes were changes in blood neurotrophin concentrations of insulin-like growth factor-1 (IGF-1), vascular endothelial growth factor (VEGF), and brain derived neurotrophic factor (BDNF). Results Genotyping failed in one individual (n = 23 APOE4 carriers and n = 38 APOE4 non-carriers) and two participants could not complete primary outcome testing. Cerebral blood flow AUC increased immediately following exercise, regardless of APOE4 carrier status. In an exploratory regional analyses, we found that cerebral blood flow increased in hippocampal brain regions, while showing no change in cerebellum across both groups. Among high inter-individual variability, there were no significant changes in any of the 3 neurotrophic factors for either group immediately following exercise. Conclusions Our findings show that both APOE4 carriers and non-carriers show similar effects of exercise-induced increases in cerebral blood flow and neurotrophic response to acute aerobic exercise. Our results provide further evidence that acute exercise-induced increases in cerebral blood flow may be regional specific, and that exercise-induced neurotrophin release may show a differential effect in the aging cardiovascular system. Results from this study provide an initial characterization of the acute brain blood flow and neurotrophin responses to a bout of exercise in older adults with and without this known risk allele for cardiovascular disease and Alzheimer’s disease. Trial registration Dementia Risk and Dynamic Response to Exercise (DYNAMIC); Identifier: NCT04009629.
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Affiliation(s)
- Eric D. Vidoni
- Department of Neurology, University of Kansas Medical Center, Kansas City, KS, United States of America
- * E-mail:
| | - Jill K. Morris
- Department of Neurology, University of Kansas Medical Center, Kansas City, KS, United States of America
| | - Jacqueline A. Palmer
- Department of Physical Therapy, Rehabilitation Science and Athletic Training, University of Kansas Medical Center, Kansas City, KS, United States of America
| | - Yanming Li
- Department of Biostatistics and Data Science, University of Kansas Medical Center, Kansas City, KS, United States of America
| | - Dreu White
- Department of Physical Therapy, Rehabilitation Science and Athletic Training, University of Kansas Medical Center, Kansas City, KS, United States of America
| | - Paul J. Kueck
- Department of Neurology, University of Kansas Medical Center, Kansas City, KS, United States of America
| | - Casey S. John
- Department of Neurology, University of Kansas Medical Center, Kansas City, KS, United States of America
| | - Robyn A. Honea
- Department of Neurology, University of Kansas Medical Center, Kansas City, KS, United States of America
| | - Rebecca J. Lepping
- Department of Neurology, University of Kansas Medical Center, Kansas City, KS, United States of America
| | - Phil Lee
- Department of Radiology, University of Kansas Medical Center, Kansas City, KS, United States of America
| | - Jonathan D. Mahnken
- Department of Biostatistics and Data Science, University of Kansas Medical Center, Kansas City, KS, United States of America
| | - Laura E. Martin
- Department of Population Health, University of Kansas Medical Center, Kansas City, KS, United States of America
| | - Sandra A. Billinger
- Department of Neurology, University of Kansas Medical Center, Kansas City, KS, United States of America
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Weston ME, Barker AR, Tomlinson OW, Coombes JS, Bailey TG, Bond B. The effect of exercise intensity and cardiorespiratory fitness on the kinetic response of middle cerebral artery blood velocity during exercise in adults. J Appl Physiol (1985) 2022; 133:214-222. [PMID: 35708705 PMCID: PMC9291408 DOI: 10.1152/japplphysiol.00862.2021] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The aim of this study was to compare the kinetic response of middle cerebral artery blood velocity (MCAv) to moderate and heavy-intensity cycling in adults, and explore the relationship between maximal oxygen uptake (V̇O2max) and MCAv kinetics. Seventeen healthy adults (23.8±2.4 years, 9 females) completed a ramp incremental test to exhaustion on a cycle ergometer to determine V̇O2max and the gas exchange threshold (GET). Across six separate visits, participants completed three 6-minute transitions at a moderate-intensity (90% GET) and three at a heavy-intensity (40% of the difference between GET and V̇O2max). Bilateral MCAv was measured using transcranial Doppler ultrasonography and analysed using a mono-exponential model with a time delay. The time constant (τ) of the MCAv response was not different between moderate- and heavy-intensity cycling (25±10 vs. 26±8 s, P=0.82), as was the time delay (29±11 vs. 29±10 s, P=0.95). The amplitude of the exponential increase in MCAv from baseline was greater during heavy (23.9±10.0 cm.s-1, 34.1±14.4%) compared to moderate (12.7±4.4 cm.s-1, 18.7±7.5%) intensity cycling (P<0.01). Following the exponential increase, a greater fall in MCAv was observed during heavy compared to moderate-intensity exercise (9.5±6.9 vs 2.8±3.8 cm.s-1, P<0.01). MCAv after 6 minutes of exercise remained elevated during heavy compared to moderate-intensity exercise (85.2±9.6 vs. 79.3±7.7cm.s-1, P≤0.01). V̇O2max was not correlated with MCAv τ or amplitude (r=0.11-0.26, P>0.05). These data suggest that the intensity of constant-work rate exercise influences the amplitude, but not time-based, response parameters of MCAv in healthy adults, and found no relationship between cardiorespiratory fitness and MCAv kinetics.
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Affiliation(s)
- Max Edwin Weston
- Sport and Health Sciences, grid.8391.3University of Exeter, Exeter, Devon, United Kingdom
| | - Alan R Barker
- Children's Health and Exercise Research Centre, grid.8391.3University of Exeter, Exeter, Devon, United Kingdom
| | - Owen William Tomlinson
- College of Medicine and Health, grid.8391.3University of Exeter, Exeter, Devon, United Kingdom
| | - Jeff S Coombes
- Physiology and Ultrasound Laboratory in Science and Exercise (PULSE), School of Human Movement and Nutrition Sciences, grid.1003.2University of Queensland, Brisbane, Queensland, Australia
| | - Tom G Bailey
- Physiology and Ultrasound Laboratory in Science and Exercise (PULSE), School of Human Movement and Nutrition Sciences, grid.1003.2University of Queensland, Brisbane, Queensland, Australia
| | - Bert Bond
- Children's Health and Exercise Research Centre, grid.8391.3University of Exeter, Exeter, Devon, United Kingdom
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10
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Kawasaki A, Hayashi N. Playing a musical instrument increases blood flow in the middle cerebral artery. PLoS One 2022; 17:e0269679. [PMID: 35675278 PMCID: PMC9176837 DOI: 10.1371/journal.pone.0269679] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2021] [Accepted: 05/25/2022] [Indexed: 11/18/2022] Open
Abstract
Purpose Studies using functional magnetic resonance imaging and positron-emission tomography suggest that many regions of the brain are activated by such complex muscle activity. Although these studies demonstrated relative increases in blood flow in some brain regions with increased neural activity, whether or not the absolute value of cerebral blood flow increases has yet to be elucidated. It also remains unknown whether playing musical instruments affects cerebral blood flow. The aim of this study was to determine the impact of playing a musical instrument on blood flow velocity in the middle cerebral artery (MCAv) by using Doppler ultrasound to measure absolute values of arterial flow velocity. Methods Thirteen musicians performed three pieces of music with different levels of difficulty: play for the first time (FS), music in practice (PR) and already mastered (MS) on either piano or violin. MCAv was recorded continuously from 10 min before until 10 min after playing. Associations between the cerebral blood flow response and blood pressure and gas-exchange variables were examined. Results PR and MS significantly increased the MCAv. The blood pressure increased significantly in performances of all difficulty levels except for MS. There were no significant changes in exhaled gas variables during the performance. Conclusion These findings suggest that playing a musical instrument increases MCAv, and that this change is influenced by the difficulty of the performance.
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Affiliation(s)
- Ai Kawasaki
- Department of Social and Human Sciences, Tokyo Institute of Technology, Tokyo, Japan
| | - Naoyuki Hayashi
- Department of Social and Human Sciences, Tokyo Institute of Technology, Tokyo, Japan.,Faculty of Sport Sciences, Waseda University, Saitama, Japan
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11
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Saito S, Washio T, Watanabe H, Katayama K, Ogoh S. Influence of cardiac output response to the onset of exercise on cerebral blood flow. Eur J Appl Physiol 2022; 122:1939-1948. [PMID: 35660969 DOI: 10.1007/s00421-022-04973-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Accepted: 05/18/2022] [Indexed: 11/03/2022]
Abstract
PURPOSE Change in cardiac output (Q) contributes to cerebral blood flow (CBF) regulation at rest and even during steady-state exercise. At the onset of cycling exercise, Q increases acutely and largely via muscle pump. The purpose of the present study was to examine whether onset exercise-induced a large increase in Q contributes to CBF regulation at the onset of exercise. METHODS In 20 young healthy participants (10 males and 10 females), Q, mean arterial pressure (MAP), and mean blood velocities of middle and posterior cerebral arteries (MCA Vm and PCA Vm) were continuously measured during light cycling exercise for 3 min. RESULTS At the onset of exercise, Q increased acutely to the peak (P < 0.001), while the CBF peak responses were not significantly higher than the values during the steady-state exercise (MCA Vm and PCA Vm; P = 0.183 and P = 0.101, respectively). The change in Q was correlated with that of MCA Vm or PCA Vm from resting baseline to the steady-state exercise (r = 0.404, P < 0.001 and r = 0.393, P < 0.001, respectively). However, the change in Q was not correlated with that of MCA Vm or PCA Vm at the onset of exercise (P = 0.853 and P = 0.893, respectively). Any sex differences in the onset response of peripheral and cerebral hemodynamics to exercise were not observed. CONCLUSION These findings suggest that the acute change in Q does not contribute to CBF regulation at the onset of exercise for protecting cerebral vasculature against a large and acute elevation in Q at the onset of exercise.
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Affiliation(s)
- Shotaro Saito
- Department of Biomedical Engineering, Toyo University, 2100 Kujirai, Kawagoe-shi, Saitama, 350-8585, Japan
| | - Takuro Washio
- Department of Biomedical Engineering, Toyo University, 2100 Kujirai, Kawagoe-shi, Saitama, 350-8585, Japan
| | - Hironori Watanabe
- Department of Biomedical Engineering, Toyo University, 2100 Kujirai, Kawagoe-shi, Saitama, 350-8585, Japan
| | - Keisho Katayama
- Research Center of Health, Physical Fitness, and Sports, Graduate School of Medicine, Nagoya University, Nagoya, Japan
| | - Shigehiko Ogoh
- Department of Biomedical Engineering, Toyo University, 2100 Kujirai, Kawagoe-shi, Saitama, 350-8585, Japan. .,Neurovascular Research Laboratory, University of South Wales, Pontypridd, UK.
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12
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Secondary Analysis of Walking Activities During the Acute Stroke Hospital Stay and Cerebrovascular Health. Cardiopulm Phys Ther J 2022; 33:130-137. [DOI: 10.1097/cpt.0000000000000196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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13
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Palmer JA, Kaufman CS, Vidoni ED, Honea RA, Burns JM, Billinger SA. Cerebrovascular response to exercise interacts with individual genotype and amyloid-beta deposition to influence response inhibition with aging. Neurobiol Aging 2022; 114:15-26. [DOI: 10.1016/j.neurobiolaging.2022.02.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 02/23/2022] [Accepted: 02/24/2022] [Indexed: 12/23/2022]
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14
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Palmer JA, Kaufman CS, Vidoni ED, Honea RA, Burns JM, Billinger SA. Sex Differences in Resilience and Resistance to Brain Pathology and Dysfunction Moderated by Cerebrovascular Response to Exercise and Genetic Risk for Alzheimer's Disease. J Alzheimers Dis 2022; 90:535-542. [PMID: 36155505 PMCID: PMC9731318 DOI: 10.3233/jad-220359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Sex as a biological variable appears to contribute to the multifactorial etiology of Alzheimer's disease. We tested sex-based interactions between cerebrovascular function and APOE4 genotype on resistance and resilience to brain pathology and cognitive executive dysfunction in cognitively-normal older adults. Female APOE4 carriers had higher amyloid-β deposition yet achieved similar cognitive performance to males and female noncarriers. Further, female APOE4 carriers with robust cerebrovascular responses to exercise possessed lower amyloid-β. These results suggest a unique cognitive resilience and identify cerebrovascular function as a key mechanism for resistance to age-related brain pathology in females with high genetic vulnerability to Alzheimer's disease.
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Affiliation(s)
- Jacqueline A. Palmer
- Department of Neurology, School of Medicine, University of Kansas Medical Center, Kansas City, KS, United States of America,University of Kansas Alzheimer’s Disease Research Center, Fairway, KS, United States of America
| | - Carolyn S. Kaufman
- Department of Molecular & Integrative Physiology, University of Kansas Medical Center, Kansas City, KS, USA
| | - Eric D. Vidoni
- University of Kansas Alzheimer’s Disease Research Center, Fairway, KS, United States of America
| | - Robyn A. Honea
- University of Kansas Alzheimer’s Disease Research Center, Fairway, KS, United States of America
| | - Jeffrey M. Burns
- University of Kansas Alzheimer’s Disease Research Center, Fairway, KS, United States of America
| | - Sandra A. Billinger
- Department of Neurology, School of Medicine, University of Kansas Medical Center, Kansas City, KS, United States of America,University of Kansas Alzheimer’s Disease Research Center, Fairway, KS, United States of America,Department of Molecular & Integrative Physiology, University of Kansas Medical Center, Kansas City, KS, USA,Correspondence: Sandra A. Billinger, PT, PhD, FAHA, , Twitter: @Sandy_REACHlab
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15
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Whitaker AA, Aaron SE, Kaufman CS, Kurtz BK, Bai SX, Vidoni ED, Montgomery RN, Billinger SA. Cerebrovascular response to an acute bout of low-volume high-intensity interval exercise and recovery in young healthy adults. J Appl Physiol (1985) 2022; 132:236-246. [PMID: 34882027 PMCID: PMC8759972 DOI: 10.1152/japplphysiol.00484.2021] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
High-intensity interval exercise (HIIT) is performed widely. However, there is a gap in knowledge regarding the acute cerebrovascular response to low-volume HIIT. Our objective was to characterize the middle cerebral artery blood velocity (MCAv) response during an acute bout of low-volume HIIT in young healthy adults. We hypothesized that MCAv would decrease below the baseline (BL), 1) during HIIT, 2) immediately following HIIT, and 3) 30 min after HIIT. As a secondary objective, we investigated sex differences in the MCAv response during HIIT. Twenty-four young healthy adults completed HIIT [12 males, age = 25 (SD = 2)]. HIIT included 10 min of 1-min high intensity (∼70% estimated maximal Watts) and active recovery (10% estimated maximal Watts) intervals on a recumbent stepper. MCAv, mean arterial pressure (MAP), heart rate (HR), and end-tidal carbon dioxide ([Formula: see text]) were recorded at BL, during HIIT, immediately following HIIT, and 30 min after HIIT. Contrary to our hypothesis, MCAv remained above BL during HIIT. MCAv peaked at minute 3 then decreased concomitantly with [Formula: see text]. MCAv was lower than BL immediately following HIIT (P < 0.001). Thirty minutes after HIIT, MCAv returned to BL (P = 0.47). Compared with men, women had a higher MCAv at BL (P = 0.001), during HIIT (P = 0.009), immediately following HIIT (P = 0.004), and 30 min after HIIT (P = 0.001). MCAv did not decrease below BL during low-volume HIIT. However, MCAv decreased below BL immediately following HIIT and returned to resting values 30 min after HIIT. MCAv also differed between sexes.NEW & NOTEWORTHY We are the first, to our knowledge, to characterize the cerebrovascular and hemodynamic response to low-volume high-intensity interval exercise (HIIT, 1-min intervals) in young healthy adults. Middle cerebral artery blood velocity (MCAv) decreased during the HIIT bout and rebounded during active recovery. Women demonstrated a significantly higher resting MCAv than men and the difference remained during HIIT. Here, we report a novel protocol and characterized the MCAv response during an acute bout of low-volume HIIT.
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Affiliation(s)
- Alicen A. Whitaker
- 1Department of Physical Therapy, Rehabilitation Science, and Athletic Training, University of Kansas Medical Center, Kansas City, Kansas
| | - Stacey E. Aaron
- 1Department of Physical Therapy, Rehabilitation Science, and Athletic Training, University of Kansas Medical Center, Kansas City, Kansas
| | - Carolyn S. Kaufman
- 2Department of Molecular and Integrative Physiology, University of Kansas Medical Center, Kansas City, Kansas
| | - Brady K. Kurtz
- 1Department of Physical Therapy, Rehabilitation Science, and Athletic Training, University of Kansas Medical Center, Kansas City, Kansas
| | - Stephen X. Bai
- 3Department of Physical Medicine and Rehabilitation, University of Kansas Medical Center, Kansas City, Kansas
| | - Eric D. Vidoni
- 4University of Kansas Alzheimer’s Disease Research
Center, Fairway, Kansas
| | - Robert N. Montgomery
- 5Department of Biostatistics & Data Science, University of Kansas Medical Center, Kansas City, Kansas
| | - Sandra A. Billinger
- 1Department of Physical Therapy, Rehabilitation Science, and Athletic Training, University of Kansas Medical Center, Kansas City, Kansas,2Department of Molecular and Integrative Physiology, University of Kansas Medical Center, Kansas City, Kansas,3Department of Physical Medicine and Rehabilitation, University of Kansas Medical Center, Kansas City, Kansas,4University of Kansas Alzheimer’s Disease Research
Center, Fairway, Kansas,6Department of Neurology, University of Kansas Medical Center, Kansas City, Kansas
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16
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Olivo G, Nilsson J, Garzón B, Lebedev A, Wåhlin A, Tarassova O, Ekblom MM, Lövdén M. Higher VO 2max is associated with thicker cortex and lower grey matter blood flow in older adults. Sci Rep 2021; 11:16724. [PMID: 34408221 PMCID: PMC8373929 DOI: 10.1038/s41598-021-96138-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Accepted: 08/04/2021] [Indexed: 02/07/2023] Open
Abstract
VO2max (maximal oxygen consumption), a validated measure of aerobic fitness, has been associated with better cerebral artery compliance and measures of brain morphology, such as higher cortical thickness (CT) in frontal, temporal and cingular cortices, and larger grey matter volume (GMV) of the middle temporal gyrus, hippocampus, orbitofrontal cortex and cingulate cortex. Single sessions of physical exercise can promptly enhance cognitive performance and brain activity during executive tasks. However, the immediate effects of exercise on macro-scale properties of the brain’s grey matter remain unclear. We investigated the impact of one session of moderate-intensity physical exercise, compared with rest, on grey matter volume, cortical thickness, working memory performance, and task-related brain activity in older adults. Cross-sectional associations between brain measures and VO2max were also tested. Exercise did not induce statistically significant changes in brain activity, grey matter volume, or cortical thickness. Cardiovascular fitness, measured by VO2max, was associated with lower grey matter blood flow in the left hippocampus and thicker cortex in the left superior temporal gyrus. Cortical thickness was reduced at post-test independent of exercise/rest. Our findings support that (1) fitter individuals may need lower grey matter blood flow to meet metabolic oxygen demand, and (2) have thicker cortex.
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Affiliation(s)
- Gaia Olivo
- Department of Psychology, University of Gothenburg, Haraldsgatan 1, 413 14, Göteborg, Sweden. .,Aging Research Center (ARC), Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institutet, Stockholm, Sweden.
| | - Jonna Nilsson
- Aging Research Center (ARC), Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institutet, Stockholm, Sweden.,The Swedish School of Sport and Health Sciences, Stockholm, Sweden
| | - Benjamín Garzón
- Department of Psychology, University of Gothenburg, Haraldsgatan 1, 413 14, Göteborg, Sweden.,Aging Research Center (ARC), Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institutet, Stockholm, Sweden
| | - Alexander Lebedev
- Aging Research Center (ARC), Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institutet, Stockholm, Sweden.,Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Anders Wåhlin
- Department of Radiation Sciences, Umeå University, Umeå, Sweden.,Umeå Center for Functional Brain Imaging (UFBI), Umeå University, Umeå, Sweden
| | - Olga Tarassova
- The Swedish School of Sport and Health Sciences, Stockholm, Sweden
| | - Maria M Ekblom
- The Swedish School of Sport and Health Sciences, Stockholm, Sweden.,Department of Neuroscience, Karolinska Institutet, Stockhom, Sweden
| | - Martin Lövdén
- Department of Psychology, University of Gothenburg, Haraldsgatan 1, 413 14, Göteborg, Sweden.,Aging Research Center (ARC), Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institutet, Stockholm, Sweden
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17
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Sakamoto R, Katayose M, Yamada Y, Neki T, Kamoda T, Tamai K, Yamazaki K, Iwamoto E. High-but not moderate-intensity exercise acutely attenuates hypercapnia-induced vasodilation of the internal carotid artery in young men. Eur J Appl Physiol 2021; 121:2471-2485. [PMID: 34028613 DOI: 10.1007/s00421-021-04721-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Accepted: 05/15/2021] [Indexed: 10/21/2022]
Abstract
PURPOSE Exercise-induced increases in shear rate (SR) across different exercise intensities may differentially affect hypercapnia-induced vasodilation of the internal carotid artery (ICA), a potential index of cerebrovascular function. We aimed to elucidate the effects of exercise intensity on ICA SR during exercise and post-exercise hypercapnia-induced vasodilation of the ICA in young men. METHODS Twelve healthy men completed 30 min of cycling at moderate [MIE; 65 ± 5% of age-predicted maximal heart rate (HRmax)] and high (HIE; 85 ± 5% HRmax) intensities. Hypercapnia-induced vasodilation was induced by 3 min of hypercapnia (target end-tidal partial pressure of CO2 + 10 mmHg) and was assessed at pre-exercise, 5 min and 60 min after exercise. Doppler ultrasound was used to measure ICA diameter and blood velocity during exercise and hypercapnia tests. RESULTS SR was not altered during either exercise (interaction and main effects of time; both P > 0.05). ICA conductance decreased during HIE from resting values (5.1 ± 1.3 to 3.2 ± 1.0 mL·min-1·mmHg-1; P < 0.01) but not during MIE (5.0 ± 1.3 to 4.0 ± 0.8 mL·min-1·mmHg-1; P = 0.11). Consequently, hypercapnia-induced vasodilation declined immediately after HIE (6.9 ± 1.7% to 4.0 ± 1.4%; P < 0.01), but not after MIE (7.2 ± 2.1% to 7.3 ± 1.8%; P > 0.05). Sixty minutes after exercise, hypercapnia-induced vasodilation returned to baseline values in both trials (MIE 8.0 ± 3.1%; HIE 6.4 ± 2.9%; both P > 0.05). CONCLUSION The present study showed blunted hypercapnia-induced vasodilation of the ICA immediately after high-intensity exercise, but not a moderate-intensity exercise in young men. Given that the acute response is partly linked to the adaptive response in the peripheral endothelial function, the effects of aerobic training on cerebrovascular health may vary depending on exercise intensity.
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Affiliation(s)
- Rintaro Sakamoto
- Department of Physical Therapy, Graduate School of Health Sciences, Sapporo Medical University, Sapporo, Japan
| | - Masaki Katayose
- School of Health Science, Sapporo Medical University, Sapporo, Japan
| | - Yutaka Yamada
- Department of Physical Therapy, Graduate School of Health Sciences, Sapporo Medical University, Sapporo, Japan
| | - Toru Neki
- School of Health Science, Sapporo Medical University, Sapporo, Japan
| | - Tatsuki Kamoda
- School of Health Science, Sapporo Medical University, Sapporo, Japan
| | - Katsuyuki Tamai
- School of Health Science, Sapporo Medical University, Sapporo, Japan
| | - Kotomi Yamazaki
- School of Health Science, Sapporo Medical University, Sapporo, Japan
| | - Erika Iwamoto
- School of Health Science, Sapporo Medical University, Sapporo, Japan.
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18
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Alwatban MR, Aaron SE, Kaufman CS, Barnes JN, Brassard P, Ward JL, Miller KB, Howery AJ, Labrecque L, Billinger SA. Effects of age and sex on middle cerebral artery blood velocity and flow pulsatility index across the adult lifespan. J Appl Physiol (1985) 2021; 130:1675-1683. [PMID: 33703940 DOI: 10.1152/japplphysiol.00926.2020] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Reduced middle cerebral artery blood velocity (MCAv) and flow pulsatility are contributors to age-related cerebrovascular disease pathogenesis. It is unknown whether the rate of changes in MCAv and flow pulsatility support the hypothesis of sex-specific trajectories with aging. Therefore, we sought to characterize the rate of changes in MCAv and flow pulsatility across the adult lifespan in females and males as well as within specified age ranges. Participant characteristics, mean arterial pressure, end-tidal carbon dioxide, unilateral MCAv, and flow pulsatility index (PI) were determined from study records compiled from three institutional sites. A total of 524 participants [18-90 yr; females 57 (17) yr, n = 319; males 50 (21) yr, n = 205] were included in the analysis. MCAv was significantly higher in females within the second (P < 0.001), fifth (P = 0.01), and sixth (P < 0.01) decades of life. Flow PI was significantly lower in females within the second decade of life (P < 0.01). Rate of MCAv decline was significantly greater in females than males (-0.39 vs. -0.26 cm s-1·yr, P = 0.04). Rate of flow PI rise was significantly greater in females than males (0.006 vs. 0.003 flow PI, P = 0.01). Rate of MCAv change was significantly greater in females than males in the sixth decade of life (-1.44 vs. 0.13 cm s-1·yr, P = 0.04). These findings indicate that sex significantly contributes to age-related differences in both MCAv and flow PI. Therefore, further investigation into cerebrovascular function within and between sexes is warranted to improve our understanding of the reported sex differences in cerebrovascular disease prevalence.NEW & NOTEWORTHY We present the largest dataset (n = 524) pooled from three institutions to study how age and sex affect middle cerebral artery blood velocity (MCAv) and flow pulsatility index (PI) across the adult lifespan. We report the rate of MCAv decline and flow PI rise is significantly greater in females compared with in males. These data suggest that sex-specific trajectories with aging and therapeutic interventions to promote healthy brain aging should consider these findings.
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Affiliation(s)
- Mohammed R Alwatban
- Department of Physical Therapy and Rehabilitation Science, University of Kansas Medical Center, Kansas City, Kansas.,Abiomed, Inc., Danvers, Massachusetts
| | - Stacey E Aaron
- Department of Physical Therapy and Rehabilitation Science, University of Kansas Medical Center, Kansas City, Kansas
| | - Carolyn S Kaufman
- Department of Molecular and Integrative Physiology, University of Kansas Medical Center, Kansas City, Kansas
| | - Jill N Barnes
- Bruno Balke Biodynamics Laboratory, Department of Kinesiology, University of Wisconsin-Madison, Madison, Wisconsin
| | - Patrice Brassard
- Department of Kinesiology, Faculty of Medicine, Université Laval, Quebec, Canada.,Research Center of the Institut Universitaire de Cardiologie et de Pneumologie de Québec-Université Laval, Quebec, Canada
| | - Jaimie L Ward
- Department of Physical Therapy and Rehabilitation Science, University of Kansas Medical Center, Kansas City, Kansas
| | - Kathleen B Miller
- Bruno Balke Biodynamics Laboratory, Department of Kinesiology, University of Wisconsin-Madison, Madison, Wisconsin
| | - Anna J Howery
- Bruno Balke Biodynamics Laboratory, Department of Kinesiology, University of Wisconsin-Madison, Madison, Wisconsin
| | - Lawrence Labrecque
- Department of Kinesiology, Faculty of Medicine, Université Laval, Quebec, Canada.,Research Center of the Institut Universitaire de Cardiologie et de Pneumologie de Québec-Université Laval, Quebec, Canada
| | - Sandra A Billinger
- Department of Physical Therapy and Rehabilitation Science, University of Kansas Medical Center, Kansas City, Kansas.,Department of Molecular and Integrative Physiology, University of Kansas Medical Center, Kansas City, Kansas.,Department of Physical Medicine and Rehabilitation, University of Kansas Medical Center, Kansas City, Kansas.,Department of Neurology, University of Kansas Medical Center, Kansas City, Kansas
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19
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Billinger SA, Whitaker AA, Morton A, Kaufman CS, Perdomo SJ, Ward JL, Eickmeyer SM, Bai SX, Ledbetter L, Abraham MG. Pilot Study to Characterize Middle Cerebral Artery Dynamic Response to an Acute Bout of Moderate Intensity Exercise at 3- and 6-Months Poststroke. J Am Heart Assoc 2021; 10:e017821. [PMID: 33496192 PMCID: PMC7955449 DOI: 10.1161/jaha.120.017821] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Accepted: 12/09/2020] [Indexed: 01/02/2023]
Abstract
Background The primary aim of this study was to characterize the middle cerebral artery blood velocity (MCAv) dynamic response to an acute bout of exercise in humans at 3- and 6-months poststroke. As a secondary objective, we grouped individuals according to the MCAv dynamic response to the exercise bout as responder or nonresponder. We tested whether physical activity, aerobic fitness, and exercise mean arterial blood pressure differed between groups. Methods and Results Transcranial Doppler ultrasound measured MCAv during a 90-second baseline followed by a 6-minute moderate intensity exercise bout. Heart rate, mean arterial blood pressure, and end-tidal CO2 were additional variables of interest. The MCAv dynamic response variables included the following: baseline, time delay, amplitude, and time constant. Linear mixed model revealed no significant differences in our selected outcomes between 3- and 6-months poststroke. Individuals characterized as responders demonstrated a faster time delay, higher amplitude, and reported higher levels of physical activity and aerobic fitness when compared with the nonresponders. No between-group differences were identified for baseline, time constant, or exercise mean arterial blood pressure. In the nonresponders, we observed an immediate rise in MCAv following exercise onset followed by an immediate decline to near baseline values, while the responders showed an exponential rise until steady state was reached. Conclusions The MCAv dynamic response profile has the potential to provide valuable information during an acute exercise bout following stroke. Individuals with a greater MCAv response to the exercise stimulus reported statin use and regular participation in exercise.
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Affiliation(s)
- Sandra A. Billinger
- Department of Physical Therapy and Rehabilitation ScienceUniversity of Kansas Medical CenterKansas CityKS
- Department of Physical Medicine and RehabilitationUniversity of Kansas Medical CenterKansas CityKS
- Department of NeurologyUniversity of Kansas Medical CenterKansas CityKS
- Department of Molecular and Integrative PhysiologyUniversity of Kansas Medical CenterKansas CityKS
| | - Alicen A. Whitaker
- Department of Physical Therapy and Rehabilitation ScienceUniversity of Kansas Medical CenterKansas CityKS
| | - Allegra Morton
- Department of Physical Therapy and Rehabilitation ScienceUniversity of Kansas Medical CenterKansas CityKS
| | - Carolyn S. Kaufman
- Department of Physical Therapy and Rehabilitation ScienceUniversity of Kansas Medical CenterKansas CityKS
- Department of Molecular and Integrative PhysiologyUniversity of Kansas Medical CenterKansas CityKS
| | - Sophy J. Perdomo
- Department of Physical Therapy and Rehabilitation ScienceUniversity of Kansas Medical CenterKansas CityKS
- Department of MedicineUniversity of PittsburghPA
| | - Jaimie L. Ward
- Department of Physical Therapy and Rehabilitation ScienceUniversity of Kansas Medical CenterKansas CityKS
| | - Sarah M. Eickmeyer
- Department of Physical Medicine and RehabilitationUniversity of Kansas Medical CenterKansas CityKS
| | - Stephen X. Bai
- Department of Physical Medicine and RehabilitationUniversity of Kansas Medical CenterKansas CityKS
| | - Luke Ledbetter
- Department of Diagnostic RadiologyUniversity of Kansas Medical CenterKansas CityKS
- Department of Radiological SciencesDavid Geffen School of MedicineUniversity of California Los AngelesLos AngelesCA
| | - Michael G. Abraham
- Department of NeurologyUniversity of Kansas Medical CenterKansas CityKS
- Department of Interventional RadiologyUniversity of Kansas Medical CenterKansas CityKS
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20
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Whitaker AA, Alwatban M, Freemyer A, Perales-Puchalt J, Billinger SA. Effects of high intensity interval exercise on cerebrovascular function: A systematic review. PLoS One 2020; 15:e0241248. [PMID: 33119691 PMCID: PMC7595421 DOI: 10.1371/journal.pone.0241248] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Accepted: 10/11/2020] [Indexed: 12/23/2022] Open
Abstract
High intensity interval exercise (HIIE) improves aerobic fitness with decreased exercise time compared to moderate continuous exercise. A gap in knowledge exists regarding the effects of HIIE on cerebrovascular function such as cerebral blood velocity and autoregulation. The objective of this systematic review was to ascertain the effect of HIIE on cerebrovascular function in healthy individuals. We searched PubMed and the Cumulative Index to Nursing and Allied Health Literature databases with apriori key words. We followed the Preferred Reporting Items for Systematic Reviews. Twenty articles were screened and thirteen articles were excluded due to not meeting the apriori inclusion criteria. Seven articles were reviewed via the modified Sackett’s quality evaluation. Outcomes included middle cerebral artery blood velocity (MCAv) (n = 4), dynamic cerebral autoregulation (dCA) (n = 2), cerebral de/oxygenated hemoglobin (n = 2), cerebrovascular reactivity to carbon dioxide (CO2) (n = 2) and cerebrovascular conductance/resistance index (n = 1). Quality review was moderate with 3/7 to 5/7 quality criteria met. HIIE acutely lowered exercise MCAv compared to moderate intensity. HIIE decreased dCA phase following acute and chronic exercise compared to rest. HIIE acutely increased de/oxygenated hemoglobin compared to rest. HIIE acutely decreased cerebrovascular reactivity to higher CO2 compared to rest and moderate intensity. The acute and chronic effects of HIIE on cerebrovascular function vary depending on the outcomes measured. Therefore, future research is needed to confirm the effects of HIIE on cerebrovascular function in healthy individuals and better understand the effects in individuals with chronic conditions. In order to conduct rigorous systematic reviews in the future, we recommend assessing MCAv, dCA and CO2 reactivity during and post HIIE.
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Affiliation(s)
- Alicen A. Whitaker
- Department of Physical Therapy and Rehabilitation Science, University of Kansas Medical Center, Kansas City, KS, United States of America
| | - Mohammed Alwatban
- Department of Physical Therapy and Rehabilitation Science, University of Kansas Medical Center, Kansas City, KS, United States of America
| | - Andrea Freemyer
- Department of Physical Therapy and Rehabilitation Science, University of Kansas Medical Center, Kansas City, KS, United States of America
| | - Jaime Perales-Puchalt
- University of Kansas Alzheimer’s Disease Center, Fairway, KS, United States of America
- Department of Neurology, University of Kansas Medical Center, Kansas City, KS, United States of America
| | - Sandra A. Billinger
- Department of Physical Therapy and Rehabilitation Science, University of Kansas Medical Center, Kansas City, KS, United States of America
- Department of Neurology, University of Kansas Medical Center, Kansas City, KS, United States of America
- Department of Physical Medicine and Rehabilitation, University of Kansas Medical Center, Kansas City, KS, United States of America
- * E-mail:
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Walsh EI, Smith L, Northey J, Rattray B, Cherbuin N. Towards an understanding of the physical activity-BDNF-cognition triumvirate: A review of associations and dosage. Ageing Res Rev 2020; 60:101044. [PMID: 32171785 DOI: 10.1016/j.arr.2020.101044] [Citation(s) in RCA: 51] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Revised: 02/06/2020] [Accepted: 03/10/2020] [Indexed: 12/17/2022]
Abstract
Physical activity has received substantial research attention due to its beneficial impact on cognition in ageing, particularly via the action of brain-derived neurotrophic factor (BDNF). It is well established that physical activity can elevate circulating levels of BDNF, and that BDNF has neurotrophic, neuroprotective and cognitively beneficial properties. Yet, practical implementation of this knowledge is limited by a lack of clarity on context and dose-effect. Against a shifting backdrop of gradually diminishing physical and cognitive capacity in normal ageing, the type, intensity, and duration of physical activity required to elicit elevations in BDNF, and more importantly, the magnitude of BDNF elevation required for detectable neuroprotection remains poorly characterised. The purpose of this review is to provide an overview of the association between physical activity, BDNF, and cognition, with a focus on clarifying the magnitude of these effects in the context of normative ageing. We discuss the implications of the available evidence for the design of physical activity interventions intended to promote healthy cognitive ageing.
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