Effects of Mindfulness and Exercise on Growth Factors, Inflammation, and Stress Markers in Chronic Stroke: The MindFit Project Randomized Clinical Trial.
Por:
Bermudo-Gallaguet A, Ariza M, Agudelo D, Camins-Vila N, Boldó M, Peters S, Sawicka AK, Dacosta-Aguayo R, Soriano-Raya JJ, Via-Garcia M, Clemente I, García-Molina A, Durà Mata MJ, Torán-Monserrat P, Erickson KI and Mataró-Serrat M
Publicada:
9 abr 2025
Ahead of Print:
9 abr 2025
Resumen:
Background/Objectives: Stroke often leads to persistent cognitive and emotional impairments, which rehabilitation may mitigate. However, the biological mechanisms underlying such improvements remain unclear. This study investigated whether supplementing computerized cognitive training (CCT) with mindfulness-based stress reduction (MBSR) or physical exercise (PE) modulated biomarkers of neuroplasticity, inflammation, and stress in patients with chronic stroke compared to CCT alone. We also explored whether biomarker changes mediated or correlated with behavioral improvements. Methods: In a three-arm, single-blind, randomized controlled trial (NCT04759950), 141 patients with chronic stroke were randomized (1:1:1) to MBSR+CCT, PE+CCT, or CCT-only for 12 weeks. Plasma levels of brain-derived neurotrophic factor (BDNF), insulin-like growth factor-1 (IGF-1), vascular endothelial growth factor (VEGF), C-reactive protein (CRP), interleukin-6 (IL-6), and cortisol were measured at baseline and post-intervention. Cognitive, mental health, mindfulness, and fitness outcomes were also assessed. Between- and within-group changes were analyzed using ANCOVA and paired t-tests. Per-protocol and complete-case analyses were conducted. Results: Among the 109 participants with =80% adherence, the only significant between-group difference was for VEGF: it remained stable in the MBSR+CCT group but declined in PE+CCT and CCT-only. Within-group analyses showed significant decreases in cortisol in MBSR+CCT and PE+CCT, while IGF-1 levels declined across all groups. In contrast, BDNF, IL-6, and CRP did not show significant changes, and biomarker changes were not significantly associated with behavioral improvements. Complete-case analysis (n = 126) yielded similar findings. Conclusions: Our findings suggest that combining MBSR or PE with CCT may modulate certain biological processes relevant to stroke recovery. MBSR may help maintain VEGF levels, which could support vascular health, while MBSR and PE may contribute to lowering cortisol levels. However, since no clear association with behavioral improvements was found, further research is needed to determine the clinical relevance of these biomarker changes in stroke recovery.
Filiaciones:
Bermudo-Gallaguet A:
Departament de Psicologia Clínica i Psicobiologia, Facultat de Psicologia, Universitat de Barcelona (UB), Passeig de la Vall d'Hebron, 171, 08035 Barcelona, Spain
Institut de Neurociències, Universitat de Barcelona, Passeig de la Vall d'Hebron, 171, 08035 Barcelona, Spain
Institut de Recerca Sant Joan de Déu Santa Rosa 39-57, 08950 Esplugues de Llobregat, Spain
Ariza M:
Departament de Psicologia Clínica i Psicobiologia, Facultat de Psicologia, Universitat de Barcelona (UB), Passeig de la Vall d'Hebron, 171, 08035 Barcelona, Spain
Agudelo D:
Departament de Psicologia Clínica i Psicobiologia, Facultat de Psicologia, Universitat de Barcelona (UB), Passeig de la Vall d'Hebron, 171, 08035 Barcelona, Spain
Camins-Vila N:
Institut Nacional d'Educació Física de Catalunya (INEFC), Universitat de Barcelona (UB), 08038 Barcelona, Spain
Boldó M:
Servei de Rehabilitació, Hospital Universitari Germans Trias i Pujol, Campus Can Ruti, 08916 Badalona, Spain
Institut de Recerca Germans Trias i Pujol (IGTP), Campus Can Ruti, 08916 Badalona, Spain
Peters S:
Departament de Psicologia Clínica i Psicobiologia, Facultat de Psicologia, Universitat de Barcelona (UB), Passeig de la Vall d'Hebron, 171, 08035 Barcelona, Spain
Sawicka AK:
Applied Cognitive Neuroscience Lab, Department of Neurophysiology, Neuropsychology and Neuroinformatics, Medical University of Gdansk, 80-210 Gdansk, Poland
Dacosta-Aguayo R:
Institut de Recerca Germans Trias i Pujol (IGTP), Campus Can Ruti, 08916 Badalona, Spain
Unitat de Suport a la Recerca Metropolitana Nord, Fundació Institut Universitari per a la Recerca a l'Atenció Primària de Salut Jordi Gol i Gurina, 08303 Mataró, Spain
Soriano-Raya JJ:
Departament de Psicologia Clínica i Psicobiologia, Facultat de Psicologia, Universitat de Barcelona (UB), Passeig de la Vall d'Hebron, 171, 08035 Barcelona, Spain
Institut de Neurociències, Universitat de Barcelona, Passeig de la Vall d'Hebron, 171, 08035 Barcelona, Spain
Via-Garcia M:
Departament de Psicologia Clínica i Psicobiologia, Facultat de Psicologia, Universitat de Barcelona (UB), Passeig de la Vall d'Hebron, 171, 08035 Barcelona, Spain
Institut de Neurociències, Universitat de Barcelona, Passeig de la Vall d'Hebron, 171, 08035 Barcelona, Spain
Institut de Recerca Sant Joan de Déu Santa Rosa 39-57, 08950 Esplugues de Llobregat, Spain
Clemente I:
Departament de Psicologia Clínica i Psicobiologia, Facultat de Psicologia, Universitat de Barcelona (UB), Passeig de la Vall d'Hebron, 171, 08035 Barcelona, Spain
Institut de Neurociències, Universitat de Barcelona, Passeig de la Vall d'Hebron, 171, 08035 Barcelona, Spain
Institut de Recerca Sant Joan de Déu Santa Rosa 39-57, 08950 Esplugues de Llobregat, Spain
García-Molina A:
Institut de Recerca Germans Trias i Pujol (IGTP), Campus Can Ruti, 08916 Badalona, Spain
Institut Guttmann, Universitat Autònoma de Barcelona, 08916 Badalona, Spain
Durà Mata MJ:
Servei de Rehabilitació, Hospital Universitari Germans Trias i Pujol, Campus Can Ruti, 08916 Badalona, Spain
Institut de Recerca Germans Trias i Pujol (IGTP), Campus Can Ruti, 08916 Badalona, Spain
Torán-Monserrat P:
Institut de Recerca Germans Trias i Pujol (IGTP), Campus Can Ruti, 08916 Badalona, Spain
Unitat de Suport a la Recerca Metropolitana Nord, Fundació Institut Universitari per a la Recerca a l'Atenció Primària de Salut Jordi Gol i Gurina, 08303 Mataró, Spain
Grup de REcerca Multidisciplinar en Salut i Societat (GREMSAS), 08303 Mataró, Spain
Department of Medicine, Faculty of Medicine, Universitat de Girona, 17003 Girona, Spain
Erickson KI:
Advent Health Research Institute, Neuroscience, Orlando, FL 32803, USA
Department of Psychology, University of Pittsburgh, Pittsburgh, PA 15260, USA
Mataró-Serrat M:
Departament de Psicologia Clínica i Psicobiologia, Facultat de Psicologia, Universitat de Barcelona (UB), Passeig de la Vall d'Hebron, 171, 08035 Barcelona, Spain
Institut de Neurociències, Universitat de Barcelona, Passeig de la Vall d'Hebron, 171, 08035 Barcelona, Spain
Institut de Recerca Sant Joan de Déu Santa Rosa 39-57, 08950 Esplugues de Llobregat, Spain
Green Submitted, Green Published, gold
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