P60. Direct and long term influence of cardiovascular training on cognition in subacute stroke patients

Introduction Rehabilitation of cognitive deficits has been voted ‘#1 research priority’ for patients suffering from stroke ( Saunders et al., 2014 ). Aerobic fitness training may modulate cognitive performance either by enhancing neuroplasticity or by increasing brain oxygenation. The majority of studies in this area have focused on motor function; its effect on cognitive performance is not well understood yet. The current study therefore aims to evaluate the influence of aerobic fitness intervention on cognitive functions in subacute stroke patients, and tries to elucidate the mechanisms underlying this effect. Methods The endpoint-blinded multicenter trial Physical Activity in Subacute Stroke ( Floel et al., 2014 ) (NCT01953549) randomized 194 patients (5–45 days post stroke, Barthel-Index ⩽ 65) to receive either a 4 week aerobic fitness intervention (PHYS) or a relaxation program (RELAX) of equal length. 100 patients additionally received an MRI pre and post intervention (Biomarkers and Perfusion – Training-Induced changes after Stroke (BAPTISe), NCT01954797). Image acquisition included T1 MPRAGE (1 mm isovoxel), Resting State fMRI (3 × 3v4 mm × 150 scans, TR = 2.3 s) and DTI (64 directions plus 9 × B0, 2.3 mm isovoxel). Cognition was assessed via neuropsychological tests (MoCA, Trail Making Test Part A & B (TMT)) in all patients pre and post intervention and 6 months poststroke. Statistical modeling accounted for age, functional ambulation and center effects. Results In 70/190 BAPTISe patients (60 PHYS, 49 RELAX, median 70 yrs, median NIHSS 9), T1-weighted images were available for Baseline and post intervention. Mean (standard deviation) Hippocampus volume was 3.5 (0.6) mm3 for the left and 3.6 (0.5) mm3 for the right hemisphere respectively. MoCA sum score and TMT A and B changed significantly ( p 0.001 ) between pre and post intervention across groups, but did not differ significantly between groups. 6 months post-stroke PHYS group showed a significant better outcome in MoCA sum score ( p 0.01 ) compared to the RELAX group. Further analyses on mechanisms underlying this findings are ongoing. Discussion Aerobic fitness training during the rehabilitation phase of subacute stroke patients shows some indication of improving cognitive recoverys but not immediately following the intervention. Analyses on underlying mechanisms including lesion location and lesion volume are ongoing, and will be presented on the DGKN 2018.