Study on Leisure Time Physical Activity and ICAS

A new study published in the Journal of Stroke highlights the role of leisure time physical activity not only in secondary stroke prevention of intracranial arterial stenosis (ICAS), but also its benefits for asymptomatic ICAS. The study suggests that intracranial arterial stenosis (ICAS) that is ≥70% asymptomatic has the strongest association with leisure time physical activity (LTPA).

Although beneficial in secondary stroke prevention of intracranial artery stenosis, it is unknown if leisure-time physical exercise also improves ICAS or extracranial carotid stenosis patients who are asymptomatic (ECAS). In order to ascertain the association between LTPA and ECAS and ICAS in a stroke-free, racially and ethnically diverse group, Dixon Yang and colleagues undertook this study.

Participants from the Northern Manhattan Study's magnetic resonance imaging sub-study, of which 1274 underwent LTPA tests at enrolment, were included in this cross-sectional study. LTPA was ordinarily expressed as model-based cluster analysis (LTPA-cluster) and constantly as metabolic equivalent score (MET-score), both based on the identical LTPA tests. Using carotid intima-media thickness and the amount of carotid plaques, ECAS was assessed sonographically. ICAS was determined using a time-of-flight magnetic resonance angiography and was classified as having a stenosis of ≥50% or ≥70% or more. With confounders taken into account, regression models were used to assess the relationship between LTPA and ECAS and ICAS.

Key Findings

• The mean MET-score for the 1274 subjects that were included was 10±16, and 60% of them were in an LTPA-cluster with any activity.
• The mean carotid intima-media thickness was 0.97±0.09 mm among individuals who underwent carotid ultrasonography (n=1234), and 56% of patients had at least one carotid plaque detected.
• 8% of individuals with a magnetic resonance angiograph (n=1211) and 5% of those with a high-density ICAS (≥70%) had ICAS.
• MET-score was connected to ≥70% of ICAS but not to ECAS measures for ICAS.
• The connection between ≥70% ICAS and LTPA was repeated when MET-score was substituted with LTPA-clusters.

In conclusion, this well-planned population-based imaging research demonstrated the advantages of doing enough exercise during downtime for persons with atherosclerotic disease, particularly for those with severe cerebral atherosclerosis.

Reference

Yang, D., Liu, M., Willey, J. Z., Khasiyev, F., Tom, S. E., Rundek, T., Cheung, Y. K., Wright, C. B., Sacco, R. L., Elkind, M. S. V., & Gutierrez, J. (2022). Physical Activity Is Inversely Associated With Severe Intracranial Stenosis in Stroke-Free Participants of NOMAS. In Stroke. Ovid Technologies (Wolters Kluwer Health). https://doi.org/10.1161/strokeaha.122.039660