Abstract

We investigated if a five-year supervised exercise intervention with moderate-intensity continuous training (MICT) or high-intensity interval training (HIIT) versus control; physical activity according to national guidelines, attenuated the growth of white matter hyperintensities (WMH). We hypothesized that supervised exercise, in particular HIIT, reduced WMH growth. Older adults from the general population participating in the RCT Generation 100 Study were scanned at 3T MRI at baseline (age 70–77), and after 1-, 3- and 5-years. At each follow-up, cardiorespiratory fitness was measured with ergospirometry, and physical activity plus clinical data collected. Manually delineated total WMH, periventricular (PWMH), deep (DWMH), and automated total white matter hypointensity volumes were obtained. No group by time interactions were present in linear mixed model analyses with the different WMH measurements as outcomes. In the combined exercise (MICT&HIIT) group, a significant group by time interaction was uncovered for PWMH volume, with a larger increase in the MICT&HIIT group. Cardiorespiratory fitness at the follow-ups or change in cardiorespiratory fitness over time were not associated with any WMH measure. Contrary to our hypothesis, taking part in MICT or HIIT over a five-year period did not attenuate WMH growth compared to being in a control group following national physical activity guidelines.

Highlights

  • White matter hyperintensities (WMH), known as leukoaraiosis, are the most common finding on brainmagnetic resonance imaging (MRI) in persons aged 50 and older [1, 2]

  • Intervention studies with more intense exercise aimed at maximizing cardiovascular fitness, longer intervention periods with several follow-ups to monitor change over time in both WMH and fitness, and objective measures of cardiovascular fitness, i.e., peak oxygen uptake (VO2peak) measured during ergospirometry, are suggested to resolve the current conundrum [17, 25, 26]

  • In a sub-study of the randomized controlled trial (RCT) Generation 100 Study in adults born between 1936 and 1942 [27, 28], we investigated the evolution of WMH on brain MRI acquired at 3T at baseline, and after one, three, and five years of supervised exercise with either moderate-intensity continuous training (MICT) or highintensity interval training (HIIT) compared to a control group that followed the Norwegian national recommendations for physical activity

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Summary

Introduction

White matter hyperintensities (WMH), known as leukoaraiosis, are the most common finding on brainMRI in persons aged 50 and older [1, 2]. Two systematic reviews found physical activity to be associated with less WMH [17, 18], and the effect appeared prominent in older adults [19, 20]. Both participating in physical activity and aerobic exercise training can improve cardiorespiratory fitness, which is suggested as a central mechanism for the effect of training on the brain [21]. Since physical activity appears to limit WMH growth most effectively in older adults, this group is a highly relevant target group for exercise intervention studies

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