Poststroke White Matter Hyperintensities and Physical Activity: A CANVAS Study Exploratory Analysis.

Area of Science:

• Neurology
• Radiology
• Rehabilitation Medicine

Background:

• White matter hyperintensities (WMHs) are linked to cognitive decline and mortality after stroke.
• Physical activity (PA) may mitigate WMH risk by improving vascular health and brain blood flow.
• The relationship between post-stroke PA and WMH progression requires further investigation.

Purpose of the Study:

• To assess the association between physical activity (PA) and white matter hyperintensities (WMH) volume at 12 months post-stroke.
• To examine the association between PA and the change in WMH volume between 3 and 12 months post-stroke.

Main Methods:

• Included 100 ischemic stroke survivors with MRI and objective PA data.
• Quantified WMH volumes using automated segmentation (Wisconsin White Matter Hyperintensities Segmentation toolbox).
• Measured moderate-to-vigorous PA (MVPA) using SenseWear® Armband; defined meeting guidelines as ≥30 min·d⁻¹.

Main Results:

• No significant association was found between MVPA and WMH volume.
• Meeting PA guidelines showed a univariable association with lower total, periventricular, and deep WMH volumes.
• Multivariable analysis revealed no association between meeting PA guidelines and WMH volume; older age predicted greater WMH volume.

Conclusions:

• Meeting PA guidelines was not independently associated with reduced WMH volume at 12 months post-stroke in multivariable analysis.
• Older age was a consistent predictor of increased WMH volume.
• PA did not show a significant association with WMH volume change between 3 and 12 months post-stroke.