Objective

A large proportion of stroke patients experience cognitive impairment. Previous studies found that handgrip training can improve cognitive dysfunction after stroke through an unknown mechanism. In this study, we aimed to examine the influence of handgrip training on the cognition of patients with acute mild ischemic stroke and explore the mechanism using an advanced post-processing method for magnetic resonance imaging.

Methods

Seventy-six patients with acute mild ischemic stroke were recruited for this study and randomly divided into a grip training group (n = 37) and a control group (n = 39). Both groups of patients also received standardized treatment for stroke in the acute phase and for secondary prevention, as well as conventional physical therapy after stroke. Grip strength, global cognitive function, and the local and global efficiencies of white matter networks derived from diffusion tensor images were measured before and after the 12-week training period.

Results

In the within-group comparisons, grip training significantly improved the grip strength (3.52 [3.09–3.96], p = 0.02), Montreal Cognitive Assessment (MoCA) (2.27 [1.68–2.86], p = 0.05), and local, but not global, efficiency of the brain white matter network (0.03 [0.02–0.03], p = 0.02) in the experimental group. In contrast, these parameters were not statistically different over the same period in the control group. In the between-groups comparisons, the improvement of grip strength (2.71 [2.20–3.21], p = 0.01), MoCA (1.17 [0.39–1.95], p = 0.05), and local efficiency (0.02 [0.01–0.03], p = 0.01) showed statistically significant differences after the intervention, but not the absolute value of them, neither at the base line nor after the intervention.

Conclusions

Our results indicate that grip training can improve cognitive function by increasing the local efficiency of brain white matter connectivity. This suggests that white matter remodeling is a potential physiological mechanism connecting grip training and cognition improvement.

中文翻译：

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握力训练可改善轻度急性缺血性卒中患者的握力、认知和脑白质

客观的

很大一部分中风患者会出现认知障碍。先前的研究发现，握力训练可以通过一种未知的机制改善中风后的认知功能障碍。在这项研究中，我们旨在研究握力训练对急性轻度缺血性卒中患者认知的影响，并使用先进的磁共振成像后处理方法探索其机制。

方法

本研究招募了 76 名急性轻度缺血性卒中患者，随机分为握力训练组（n = 37）和对照组（n = 39）。两组患者还接受了卒中急性期和二级预防的标准化治疗，以及卒中后的常规物理治疗。在 12 周训练期前后测量了握力、全局认知功能以及源自扩散张量图像的白质网络的局部和全局效率。

结果

在组内比较中，握力训练显​​着提高了握力（3.52 [3.09-3.96]，p = 0.02），蒙特利尔认知评估（MoCA）（2.27 [1.68-2.86]，p = 0.05）和局部，但不是全局的，实验组中脑白质网络的效率（0.03 [0.02-0.03]，p = 0.02）。相比之下，这些参数在对照组的同一时期没有统计学差异。在组间比较中，握力（2.71 [2.20–3.21]，p = 0.01）、MoCA（1.17 [0.39–1.95]，p = 0.05）和局部效率（0.02 [0.01–0.03]）的改善， p = 0.01）在干预后显示出统计学上的显着差异，但不是它们的绝对值，无论是在基线还是干预后。

结论

我们的研究结果表明，握力训练可以通过提高大脑白质连接的局部效率来改善认知功能。这表明白质重塑是连接握力训练和认知改善的潜在生理机制。