Exercise-Based Cardiac Rehabilitation Modulates Prefrontal Cortex Oxygenation during Submaximal Exercise Testing in Cardiovascular Disease Patients

Abstract

The purpose of this study was to investigate if prefrontal cortex (PFC) oxygenation during incremental exercise is altered among cardiovascular disease (CVD) patients who completed 6 weeks of exercise-based cardiac rehabilitation (CR). Nineteen (male = 14, female = 5; 65.5 ± 11.5 years) participants from an outpatient CR program were enrolled in the study. Each participant completed a submaximal graded treadmill evaluation at intake and again upon completion of 18 individualized CR sessions. Functional near-infrared spectroscopy (fNIRS) imaging was used to measure left- and right- PFC (LPFC and RPFC) oxygenation parameters during the submaximal exercise evaluations. Patients showed improvements in cardiorespiratory capacity (pre 5.5 ± 2.5 vs. post 6.9 ± 2.8 metabolic equivalents (METs)). A significant decrease in LPFC and RPFC oxygenation was observed during the post-CR exercise test compared to pre-CR. CVD patients enrolled in 6 weeks of CR showed significant improvements in functional capacity along with decreased cortical oxygenation during submaximal exercise. Exercise training may cause distribution of cortical resources to motor regions that support sustained exercise.

Keywords: aerobic exercise; cardiac rehabilitation; cardiovascular disease; oxygenation; prefrontal cortex.

Figure 1

Outline of the study protocol. Number of cardiac rehabilitation (CR) sessions are mean ± SD. fNIRS = functional near infrared spectroscopy.

Figure 2

Prefrontal cortex relative changes for functional near infrared spectroscopy measures during the submaximal exercise test pre- and post- cardiac rehabilitation. * significantly lower than pre-cardiac rehabilitation, p < 0.05. ∆ = change from baseline (0 μmol), O₂Hb = oxyhemoglobin (A), HHb = deoxyhemoglobin (B), tHb = total hemoglobin (C), Hbdiff = oxyhemoglobin difference (D), LPFC = left prefrontal cortex, RPFC = right prefrontal cortex. Data are mean ± SD, N = 19.