Individuals with Higher Levels of Physical Activity after Stroke Show Comparable Patterns of Myelin to Healthy Older Adults

Abstract

Background: Myelin asymmetry ratios (MARs) relate and contribute to motor impairment and function after stroke. Physical activity (PA) may induce myelin plasticity, potentially mitigating hemispheric myelin asymmetries that can occur after a stroke.

Objective: The aim of this study was to determine whether individuals with higher levels of PA showed lower MAR compared to individuals with lower levels of PA.

Methods: Myelin water fraction was obtained from 5 bilateral motor regions in 22 individuals with chronic stroke and 26 healthy older adults. Activity levels were quantified with wrist accelerometers worn for a period of 72 hours (3 days). Higher and lower PA levels were defined by a cluster analysis within each group.

Results: MAR was similar regardless of PA level within the older adult group. Compared to the higher PA stroke group, lower PA stroke participants displayed greater MAR. There was no difference in MAR between the stroke and older adult higher PA groups. Within the lower PA groups, individuals with stroke showed greater MAR compared to the older adults. Arm impairment, lesion volume, age, time since stroke, and preferential arm use were not different between the PA stroke groups, suggesting that motor impairment severity and extent of brain damage did not drive differences in PA.

Conclusion: Individuals who have had a stroke and are also physically active display lower MAR (i.e., similar myelin in both hemispheres) in motor regions. High levels of PA may be neuroprotective and mitigate myelin asymmetries once a neurological insult, such as a stroke, occurs. Alternately, it is possible that promoting high levels of PA after a stroke may reduce myelin asymmetries.

Keywords: Chronic stroke; asymmetry ratios; myelin water fraction; older adults; physical activity.

Figure 1.

Mean myelin asymmetry ratios (MARs) for physical activity (PA) group in individuals who have had a stroke and older adults. There was a significant group by PA level interaction (P = .031). The low PA stroke group had greater MAR compared to the high PA stroke group (P = .032). There was no difference between the PA groups within older adults (P = .691). Within the high PA group there was no difference between the stroke and older adult group (P = .122), whereas within the low PA group, stroke had an overall greater MAR compared to older adults (P < .001). Error bars represent standard error. Circles represent individual datapoints.