High-Intensity Interval Exercise and Cerebrovascular Health: Curiosity, Cause, and Consequence

Abstract

Exercise is a uniquely effective and pluripotent medicine against several noncommunicable diseases of westernised lifestyles, including protection against neurodegenerative disorders. High-intensity interval exercise training (HIT) is emerging as an effective alternative to current health-related exercise guidelines. Compared with traditional moderate-intensity continuous exercise training, HIT confers equivalent if not indeed superior metabolic, cardiac, and systemic vascular adaptation. Consequently, HIT is being promoted as a more time-efficient and practical approach to optimize health thereby reducing the burden of disease associated with physical inactivity. However, no studies to date have examined the impact of HIT on the cerebrovasculature and corresponding implications for cognitive function. This review critiques the implications of HIT for cerebrovascular function, with a focus on the mechanisms and translational impact for patient health and well-being. It also introduces similarly novel interventions currently under investigation as alternative means of accelerating exercise-induced cerebrovascular adaptation. We highlight a need for studies of the mechanisms and thereby also the optimal dose-response strategies to guide exercise prescription, and for studies to explore alternative approaches to optimize exercise outcomes in brain-related health and disease prevention. From a clinical perspective, interventions that selectively target the aging brain have the potential to prevent stroke and associated neurovascular diseases.

Effects of two-week high-intensity interval training on cognition in adolescents – a randomized controlled pilot study

“…Possible mechanisms how HIT may improve cognition include increased blood flow into the brain, increased synthesis of brain-derived growth factors, improved insulin sensitivity, and improved neural processing and synaptic plasticity [7,15,16,27]. Furthermore, there are also possible mechanisms which may explain the decreased cognition in our study.…”

“…Furthermore, a single bout of HIT have been found to improve cognitive control in adults [14] and the results of some studies suggest positive effects of HIT on cognition and brain oxygenation [15,16]. The aim of the study was to investigate the effects of a 2-week HIT on cognition in adolescents.…”

Efficacy of Age-Specific High-Intensity Stretch-Shortening Contractions in Reversing Dynapenia, Sarcopenia, and Loss of Skeletal Muscle Quality

“…Interestingly, it is high-intensity, strenuous exercise that has been reported to be effective for treating numerous chronic diseases ranging from diabetes and heart disease to cerebrovascular and pulmonary disease [77,79] and may even be a more favorable intervention compared to pharmacological agents in specific cases such as stroke [80]. The interest in exercise as a means for prevention and/or intervention is not a new concept; however, more recently, interest in its efficacy and evidence for its pluripotency has led to the now global initiative known as "Exercise is Medicine ® (EIM)" from leading agencies, associations, and centers such as the American College of Sports Medicine, the American Medical Association, and the Centers for Disease Control, as well as enjoying support from the Surgeon General of the United States.…”

The role of exercise in mitigating subcortical ischemic vascular cognitive impairment

“…Exercise training dramatically increases eNOS expression in endothelial cells, likely because of the increased shear stress caused by high cardiac output in sustained exercise. Direct shear-stress-mediated effects on the vascular endothelium may therefore be a possible mechanism by which exercise can mitigate SVD (Bolduc et al 2013;Lucas et al 2015).…”

“…Exercise training dramatically increases eNOS expression in endothelial cells, likely because of the increased shear stress caused by high cardiac output in sustained exercise. Direct shear-stress-mediated effects on the vascular endothelium may therefore be a possible mechanism by which exercise can mitigate SVD (Bolduc et al 2013;Lucas et al 2015).Animal studies investigating both peripheral and coronary vasculature suggest that aerobic training enhances eNOS, and NO production and bioactivity (Green et al 2004). For example, short-term exercise training in rats increased endothelial NO synthesis in skeletal muscle and muscle arterioles and increased vasodilator responses (Sun et al 1994).…”