Carotid Artery Hemodynamics During Competitive Gaming: Feasibility and Preliminary Findings from a Pilot Crossover Study of a 6 Min Walking Break

Background/Objectives: Competitive esports players spend prolonged periods seated while performing under sustained cognitive demand, creating conditions that may adversely affect cerebrovascular function. Internal carotid artery (ICA) blood flow is a major determinant of cerebral perfusion and may be particularly relevant to the cognitive demands of competitive gaming. To date, no study has evaluated ICA hemodynamics during competitive gaming or the feasibility of repeated Doppler ultrasound assessment in this setting. Therefore, this pilot study aimed to (1) determine the feasibility of measuring ICA hemodynamics during competitive gaming and (2) generate preliminary data on the effects of a 6 min walking break on ICA blood flow velocity and volume. Methods: Eleven competitive esports players (20.8 ± 2.1 years; 9 male) completed two 2 h gaming sessions using a randomized crossover design: uninterrupted gaming (continuous condition) and gaming interrupted by a 6 min walking break at 60 min (walking condition). Doppler ultrasound measurements of left ICA blood flow velocity, blood flow volume, and vessel diameter were obtained at baseline and every 30 min. Heart rate and blood pressure were also assessed. Feasibility outcomes included recruitment, protocol adherence, and Doppler measurement success. Results: Fourteen participants were screened. Eleven (79%) met the eligibility criteria and completed both study visits, resulting in 100% protocol adherence. Doppler ultrasound acquisition was successful in 107 of 110 planned measurements (97.3%). Baseline ICA hemodynamics were similar between conditions. Repeated-measures analyses demonstrated no significant condition × time interactions for ICA mean blood flow velocity, blood flow volume, or vessel diameter. Under the walking condition, change in ICA blood flow volume was −41.0 ± 102.4 mL/min immediately before the walking break at 60 min, −5.9 ± 132.2 mL/min at 90 min, and −43.7 ± 75.9 mL/min at 120 min; however, between-condition differences were not statistically significant. Conclusions: Repeated Doppler ultrasound assessment of ICA hemodynamics during competitive gaming was feasible and well-tolerated. ICA blood flow volume demonstrated a preliminary temporal pattern following the walking break, but no significant post-intervention between-condition differences were detected. These pilot findings provide estimates of variability and effect magnitude to inform adequately powered studies of movement breaks during prolonged gaming.