Evidence map›Paper›PMID 42206736›Full record

ArticleEuropean journal of neurology2026

Association Between Physical Activity and Cryptogenic Ischemic Stroke in Young Adults: A Case-Control Study.

Shakar Kutal, Nilufer Yesilot, Tomi Sarkanen, Petra Redfors, Annika Nordanstig, Pauli Ylikotila, Marialuisa Zedde, Ulla Junttola, Lauri Tulkki, Kristina Ryliskiene and 20 more

Abstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in European journal of neurology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

30 authors.

Shakar KutalDepartment of Neurology, Helsinki University Hospital, and University of Helsinki, Helsinki, Finland.ORCID https://orcid.org/0009-0007-5483-435X
Nilufer YesilotDepartment of Neurology, Istanbul University Faculty of Medicine, Istanbul, Turkey.
Tomi SarkanenDepartment of Neurology, Tampere University Hospital, Wellbeing Services County of Pirkanmaa, and Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland.ORCID https://orcid.org/0000-0001-8815-2807
Petra RedforsDepartment of Neurology, Sahlgrenska University Hospital and Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden.
Annika NordanstigDepartment of Neurology, Sahlgrenska University Hospital and Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden.
Pauli YlikotilaDepartment of Neurology, Neurocenter, University of Turku, Turku, Finland.
Marialuisa ZeddeNeurology Unit, Azienda Unità Sanitaria Locale-IRCCS Di Reggio Emilia, Reggio Emilia, Italy.
Ulla JunttolaDepartment of Neurology, Faculty of Medicine, Neurocenter, Oulu University Hospital, Finland and Research Unit of Clinical Medicine, Oulu, Finland.
Lauri TulkkiDepartment of Neurology, Helsinki University Hospital, and University of Helsinki, Helsinki, Finland.
Kristina RyliskieneCentre of Neurology, Faculty of Medicine, Vilnius University, Vilnius, Lithuania.
Radim LicenikNorth West Anglia NHS Foundation Trust Acute Stroke Centre, Peterborough, UK.
Phillip FerdinandNeurosciences, University Hospitals of North Midlands NHS Trust, Stoke-on-Trent, UK.ORCID https://orcid.org/0000-0002-8715-2917
Dalius JatužisCentre of Neurology, Faculty of Medicine, Vilnius University, Vilnius, Lithuania.ORCID https://orcid.org/0000-0001-6159-4795
Liisa KõrvDepartment of Neurology and Neurosurgery, University of Tartu, Tartu, Estonia.
Janika KõrvDepartment of Neurology and Neurosurgery, University of Tartu, Tartu, Estonia.
Alessandro PezziniDepartment of Medicine and Surgery, Department of Emergency, Parma University Hospital, University of Parma and Stroke Care Program, Parma, Italy.ORCID https://orcid.org/0000-0001-8629-3315
Juha SinisaloDepartment of Cardiology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.ORCID https://orcid.org/0000-0002-0169-5137
Mika LehtoDepartment of Internal Medicine, Jorvi Hospital, HUS Helsinki University Hospital, and University of Helsinki, Helsinki, Finland.ORCID https://orcid.org/0000-0002-8691-5142
Eva GerdtsDepartment of Heart Disease, Haukeland University Hospital, Bergen, Norway.
Jaana AutereNeurocenter Neurology, Kuopio University Hospital, Finland and University of Eastern, Kuopio, Finland.
Ana Catarina FonsecaDepartment of Neurosciences and Mental Health (Neurology), hospital de Santa Maria-CHLN, Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal.
André PaulaDepartment of Neurosciences and Mental Health (Neurology), hospital de Santa Maria-CHLN, Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal.
Ulrike Waje-AndreassenDepartment of Neurology, Haukeland University Hospital, Bergen, Norway.
Bettina von SarnowskiDepartment of Neurology, University Medicine Greifswald, Greifswald, Germany.
Tiina SairanenDepartment of Neurology, Helsinki University Hospital, and University of Helsinki, Helsinki, Finland.
Turgut TatlisumakDepartment of Neurology, Sahlgrenska University Hospital and Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden.
Juha HuhtakangasDepartment of Neurology, Faculty of Medicine, Neurocenter, Oulu University Hospital, Finland and Research Unit of Clinical Medicine, Oulu, Finland.
Pekka JäkäläNeurocenter Neurology, Kuopio University Hospital, Finland and University of Eastern, Kuopio, Finland.ORCID https://orcid.org/0000-0002-8410-6915
Jukka PutaalaDepartment of Neurology, Helsinki University Hospital, and University of Helsinki, Helsinki, Finland.
Nicolas Martinez-MajanderDepartment of Neurology, Helsinki University Hospital, and University of Helsinki, Helsinki, Finland.ORCID https://orcid.org/0000-0001-8489-7051

Funding

Academy of Finland 286246Academy of Finland 318075Academy of Finland 322656Emil Aaltosen SäätiöHelsinki and Uusimaa Hospital District research fund TYH2014407Helsinki and Uusimaa Hospital District research fund TYH2018318Sahlgrenska University Hospitals Research Foundations ALFGBG-726821Sigrid Juséliuksen SäätiöSuomen Lääketieteen Säätiö
6 · The paper itself

Abstract

backgroundData on the association between physical activity (PA) and cryptogenic ischaemic stroke (CIS) in young adults are scarce. We investigated the relationship between PA levels and early-onset CIS, stratified by the presence of a high-risk patent foramen ovale (PFO).

methodsPatients aged 18-49 years with first-ever CIS and sex- and age-matched stroke-free controls were recruited from 19 European centres. PA was assessed using the short International Physical Activity Questionnaire and expressed as Metabolic Equivalents, categorized into percentiles (bottom 10%, 10%-25%, 25%-75% [reference], 75%-90%, top 10%). Associations between PA and CIS were analyzed using conditional logistic regression adjusted for age, education level, traditional risk factors, and non-traditional risk factors.

resultsAltogether, 533 patients (median age 41 [interquartile range 34-46]; 47.3% women) and 533 controls were included. Scoring in the top 10% of PA was independently associated with CIS: adjusted odds ratio 2.07; 95% confidence interval 1.22-3.51. Comparing patients without high-risk PFO to all controls, the top 10% PA category (1.78; 1.07-2.94) and the bottom 10% category (1.76; 1.06-2.92) were associated with CIS. No independent association was observed in patients with high-risk PFO.

conclusionsPA in the top 10% was associated with an increased risk of early-onset CIS in the overall study population. Among patients without a high-risk PFO, both the bottom 10% and top 10% of PA were consistently associated with elevated CIS risk. These findings highlight the need to better understand the mechanisms through which both low and high activity levels may predispose to stroke.

Indexed as

Brain IschemiaExerciseForamen Ovale, PatentIschemic StrokeAdolescentAdultCase-Control StudiesFemaleHumansMaleMiddle AgedRisk FactorsYoung Adultischemic strokepatent foramen ovalephysical activityrisk factorsstroke in the young

Identifiers

PMID42206736
PMCPMC13238723

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.