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Updated: Sep 16, 2025

Randomized, Triple-Blind, and Parallel-Controlled Trial of Transcranial Direct Current Stimulation for Cognitive Rehabilitation after Stroke
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Modulating Brain Excitability with Cardiovascular Exercise in Chronic Stroke: A Randomized Controlled Trial.

Lynden Rodrigues1,2, Kevin Moncion3, Bernat De Las Heras1,2

  • 1School of Physical and Occupational Therapy, McGill University, Montréal QC, Canada.

Neurorehabilitation and Neural Repair
|July 10, 2025
PubMed
Summary
This summary is machine-generated.

Chronic cardiovascular exercise (CE) improves corticospinal excitability (CSE) in stroke survivors, rebalancing brain hemispheres. Exercise intensity did not significantly alter these neuroplasticity effects, suggesting CE benefits regardless of HIIT or MICT. Further research is needed for functional relevance.

Keywords:
GABAbrain excitabilitycardiovascular exerciseglutamatestroketranscranial magnetic stimulation

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Area of Science:

  • Neuroscience
  • Rehabilitation Medicine
  • Exercise Physiology

Background:

  • Corticospinal excitability (CSE) measured by transcranial magnetic stimulation (TMS) is a key indicator of neuroplasticity.
  • Previous studies show single bouts of high-intensity interval training (HIIT) and moderate-intensity continuous training (MICT) transiently improve CSE in stroke survivors.
  • The long-term effects of repeated exercise sessions and the impact of exercise intensity on CSE in stroke are not well understood.

Purpose of the Study:

  • To investigate the effects of a 12-week HIIT versus MICT cardiovascular exercise (CE) program on CSE in chronic stroke survivors.
  • To compare changes in CSE measures in both the ipsilesional (ILH) and contralesional (CLH) hemispheres using TMS.
  • To analyze the impact of exercise intensity on neuroplasticity markers in post-stroke recovery.

Main Methods:

  • A randomized controlled trial (NCT03614585) involving 56 chronic stroke survivors (>6 months post-stroke).
  • Participants were randomized into 12-week HIIT (n=28) or MICT (n=28) CE programs.
  • CSE measures, including resting motor evoked potential (MEP) amplitude, resting motor threshold (rMT), and intracortical facilitation (ICF), were assessed at baseline and post-intervention using TMS.

Main Results:

  • Overall, CE significantly increased ILH resting MEP amplitude and rebalanced interhemispheric rMT and ICF ratios.
  • Exploratory analyses revealed significant reductions in rMT and ICF, and increased resting MEP amplitude in the ILH across both groups combined.
  • No significant differences in CSE changes were observed between the HIIT and MICT groups, indicating exercise intensity did not moderate the effects.

Conclusions:

  • Chronic cardiovascular exercise, irrespective of intensity (HIIT vs. MICT), enhances excitatory CSE in the ipsilesional hemisphere and reduces interhemispheric imbalances in stroke survivors.
  • Exercise intensity does not appear to be a critical factor in modulating these exercise-induced neuroplastic changes.
  • Further research is necessary to elucidate the functional significance of these observed CSE changes in the context of post-stroke recovery.