Introduction
Physical activity (PhA) prior to stroke has been associated with good outcomes after
the ischemic insult, but there is scarce data on the involved molecular mechanisms.
Methods
We studied consecutive acute ischemic stroke patients admitted to a single tertiary
stroke center. Prestroke PhA was evaluated with the International Physical Activity
Questionnaire (metabolic equivalent of minutes/week). We studied several circulating
angiogenic and neurogenic factors at different time points: vascular endothelial growth
factor (VEGF), granulocyte colony-stimulating factor (G-CSF), and brain-derived neurotrophic
factor (BDNF) at admission, day 7, and at 3 months. We considered good functional
outcome at 3 months (modified Rankin scale ≤ 2) as primary end point, and final infarct
volume as secondary outcome.
Results
We studied 83 patients with at least 2 time point serum determinations (mean age 69.6
years, median National Institutes of Health Stroke Scale 17 at admission). Patients
more physically active before stroke had a significantly higher increment of serum
VEGF on the seventh day when compared to less active patients. This increment was
an independent predictor of good functional outcome at 3 months and was associated
with smaller infarct volume in multivariate analyses adjusted for relevant covariates.
We did not find independent associations of G-CSF or BDNF levels neither with level
of prestroke PhA nor with stroke outcomes.
Conclusions
Although there are probably more molecular mechanisms by which PhA exerts its beneficial
effects in stroke outcomes, our observation regarding the potential role of VEGF is
plausible and in line with previous experimental studies. Further research in this
field is needed.
Key Words
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Article info
Publication history
Published online: October 28, 2016
Accepted:
October 3,
2016
Received in revised form:
August 28,
2016
Received:
May 29,
2016
Identification
DOI: https://doi.org/10.1016/j.jstrokecerebrovasdis.2016.10.004
Copyright
© 2017 National Stroke Association. Published by Elsevier Inc. All rights reserved.
