Quick Project Snapshot

Post Ischaemic Stroke Cardiovascular Exercise Study (PISCES)

Background:

Ischemic stroke (i.e., the temporary reduction in blood flow to a part of the brain leading to brain injury) and dementia (i.e., the progressive reduction in thinking skills, behaviour, mood, and the ability to live independently, due to brain volume loss) are the two leading causes of death, disability, and reduced quality of life in our society, and research suggests that the former is a major risk factor for the latter. For this reason, it is important to understand how to protect the brain after ischaemic stroke.

Exercise is a simple, yet effective, method of improving cardiovascular health. We will examine if exercise after stroke can protect against brain atrophy and cognitive decline.

Results from this study will provide information on the relationship between stroke, physical activity, brain health, and dementia. Our findings will establish whether exercise after stroke can prevent brain atrophy, cognitive impairment, and general cardiovascular disease, or at the very least, minimise their occurrence. A prescribed and tailored exercise programme could offer a simple and economically viable solution to patient care.

The investigators involved in this study have both the research and clinical experience in the fields of stroke, dementia, neuroimaging, neuropsychology, and prescribed exercise to ensure both scientific rigor and participant safety.

Aims:

The aim of this project is to determine whether aerobic exercise after stroke can help to preserve brain volume and function, as well as general physical and psychological well-being.

We hypothesise that participants who undertake prescribed aerobic exercise (i.e., tailored exercise that increases heart rate and breathing) after  stroke will have preserved brain volume and neurocognitive performance, higher mood levels, and better end-organ disease state (i.e., fewer recurrent strokes, improved blood pressure, reduced cardiovascular disease) compared to participants who do not undertake aerobic exercise.

Methods:

This is a pilot study where we will recruit ischaemic  stroke participants within two months of their events.

At two months post-stroke, participants will be randomly allocated to one of two exercise groups:

  • Very low intensity activity, or
  • Aerobic activity.

Both exercise programmes will follow an eight week course.

In total, there will be three assessment time points:

  1. Two months post-stroke: The baseline assessment before exercise intervention;
  2. Four months post-stroke: Immediately after exercise intervention; and
  3. 12 months post-stroke.

We will measure the following at each time-point: brain volume, using the latest neuroimaging techniques, cognitive function, cardiovascular state, mood levels, general body fitness, and select blood biomarkers.

Progress:

The project has received ethics approval and is about to start participant recruitment.

Clinical Cognitive Neuroscience Laboratory

In the Clinical Cognitive Neuroscience Laboratory, we study network degeneration following brain injury (e.g., ischaemic stroke) and have a particular interest in vascular contributions to cognitive impairment both in aging and in a range of neurodegenerative diseases, such as Alzheimer’s disease (AD). The latter is the most common cause of dementia in the western world and is associated with profound impairments in cognition and activities of daily living. Our research seeks to investigate neuroimaging correlates of cognitive decline; the effects of post-stroke exercise interventions on brain volume and cognitive function; and the accuracy and accessibility of imaging modalities in the diagnosis of dementia.  The ultimate goal of our research is to increase our understanding of two of the major causes of death, disability, and reduced quality of life in our society: dementia and stroke. Our team is headed by Associate Professor Amy Brodtmann, stroke and cognitive neurologist, Director of the Eastern Cognitive Disorders Clinic, and Heart Foundation Research Fellow.

We are collaborating with dementia and stroke researchers, clinicians, and neuroscientists, in Australia, and overseas, including Professor Martin Dichgans and Dr Marco During of the DEMDAS study in Munich Germany, Professor Charles DeCarli at the University of California Davis in the US, and Professor Vladimir Hachinski at the University of Western Ontario, Canada. These researchers are experts in their respective fields.

Our primary interest is to understand whether stroke and ischaemic brain injury cause neurodegeneration. This is currently being investigated in one of our major research projects, the NHMRC-funded, Cognition and Neocortical Volume After Stroke (CANVAS) Study, which is now in its fifth year of data collection.  In this study, stroke participants undergo an MRI scan and cognitive assessment within a few weeks of their events, and again, 3 months, 1 year, 3 years, and 5 years later. By comparing their results with a healthy, age-matched control group with no history of stroke or dementia, we can determine whether brain volume change is associated with post-stroke dementia and elucidate potential causal mechanisms, including genetic markers, amyloid deposition and vascular risk factors.

Another interest of our lab is to examine the association between exercise and rates of brain volume loss and cognitive decline after stroke.  In the Post Ischaemic Stroke Cardiovascular Exercise Study (PISCES), we seek to determine whether aerobic exercise after stroke is associated with preservation of brain volume and function, cognition, and greater physical and psychological well-being. One of the most important elements of this research study is its translatable novelty – our data will contribute to an applicable intervention-based approach.

All Projects by this Lab

Network disruptions following brain infarction: cognition, behaviour and regional brain volume changeIs stroke neurodegenerative? A longitudinal study of changes in brain volume and cognition after stroke (CANVAS: Cognition And Neocortical Volume After Stroke)Evaluating Imaging Methods in Dementia (TIMID)Motor Speech Disorders in Degenerative Brain DiseaseBereavement and Grief in Neurodegenerative Disease (BAGINS)Post Ischaemic Stroke Cardiovascular Exercise Study (PISCES)

Melbourne Dementia Research Centre

The Melbourne Dementia Research Centre (MDRC) is a joint collaboration between the University of Melbourne and The Florey Institute of Neuroscience and Mental Health and has a charter to transform research in Dementia.

The Centre seeks to achieve real outcomes for people living with dementia by developing new and better diagnostics, and discovering novel treatment possibilities.

The MDRC is a truly multidisciplinary hub of research that spans from basic laboratory research all the way through to human clinical trials.

Through its network of global collaborators, the MDRC exists at the forefront of the latest developments in the field.

The Centre is led by Professor Ashley Bush, a world leader in dementia research and Australia’s most highly cited neuroscientist. Director Bush is supported by the Leadership Board comprising Professor Patricia Desmond, Associate Professor Amy Brodtmann, and Dr. Scott Ayton.

All Labs that operate in this Division

Clinical Cognitive Neuroscience LaboratoryOxidation Biology UnitVascular Neurodegeneration Research Laboratory