Exercise trains the brain after stroke


By Mardi Chapman

19 Sep 2019

A/Prof Amy Brodtmann

Exercise training can slow or stop brain atrophy after a stroke, according to preliminary data presented at the Stroke Society of Australasia 2019 ASM in Canberra last week.

The Post Ischaemic Stroke Cardiovascular Exercise Study (PISCES) study will follow 100 ischaemic stroke survivors with baseline and sequential MRI measures of total brain and hippocampal volume, said Associate Professor Amy Brodtmann a stroke and cognitive neurologist  from the Florey Institute of Neuroscience and Mental Health.

Findings from a planned fidelity analysis on a smaller number of patients included a 2.9% growth in hippocampal volume on the side of the brain damaged by the stroke compared to historical controls, she told the meeting.

Exercise seems to have slowed or stopped the atrophy on the opposite side of the brain while possibly leading to new neuron growth on the side of the lesions, said Professor Brodtmann.

“In the people who aren’t getting exercise, the hippocampi shrink. In the people who are getting exercise, the hippocampi actually look like they are growing. They are getting larger. But that is only preliminary in the first subjects.”

“With more research, MRI scans could help us understand how exercise protects the brain after stroke. The study will help us pinpoint the intensity and frequency that is needed to improve brain function after a stroke.”

She told the limbic the hippocampus was an important memory structure in the brain, which has been shown to shrink over time in stroke and in many dementia syndromes.

“So we compared the results of our intervention, which is exercise, to these historical controls.”

Professor Brodtmann said exercise with the aim of improving fitness was not a usual component of stroke rehab however the RCT will compare aerobic and resistance exercise with balance and stretching exercise.

A safety analysis showed the intervention was not doing any unsuspected harm.

The study is the first to use MRI to precisely track the level of neuron regeneration following exercise programs.

The Phase 2b study is expected to complete in two years.

While the exercise in the current trial is being delivered in a hospital setting, future studies would look at exercise delivered in the community.

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