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Old 02-12-2019, 12:31 PM
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Default STUDY: Effect of High-Intensity Exercise on Multiple Sclerosis Function

Medicine & Science in Sports & Exercise. Publish Ahead of Print():, JAN 2019

DOI: 10.1249/MSS.0000000000001914 ,
PMID: 30707115

Issn Print: 0195-9131

Publication Date: 2019/01/30

Effect of High-Intensity Exercise on Multiple Sclerosis Function and 31P MRS Outcomes

Anna Orban; Bharti Garg; Manoj K. Sammi; Dennis N. Bourdette; William D. Rooney; Kerry Kuehl; Rebecca I. Spain

We determined if a high-intensity aerobic exercise program would be safe, improve expected fitness and clinical outcomes, and alter exploratory phosphorous magnetic resonance spectroscopy (31P MRS) outcomes in persons with multiple sclerosis (PwMS).

This open-label prospective pilot study compared 2 cohorts of ambulatory PwMS matched for age, sex and VO2max. Cohorts underwent 8-weeks of high-intensity aerobic exercise (MS-Ex, n=10) or guided stretching (MS-Ctr, n=7). Aerobic exercise consisted of four 30-minute sessions per week while maintaining >70% maximal heart rate. Changes in cardiorespiratory fitness, clinical outcomes, and 31P MRS of tibialis anterior muscle (TA) and brain were compared. Cross-sectional 31P MRS comparisons were made between all MS participants and a separate matched healthy control (HC) population.

The MS-Ex cohort achieved target increases in VO2max (mean +12.7%, p=<0.001, between-group improvement p=0.03). One participant was withdrawn for exercise-induced syncope. The MS-Ex cohort had within-group improvements in fat mass (-5.8%, p=0.04), lean muscle mass (+2.6%, p=0.02), Symbol Digit Modalities Test (+15.1%, p=0.04), and cognitive subscore of the Modified Fatigue Impact Scale (MFIS: -26%, p=0.03) while only the physical subscore of the MFIS improved in MS-Ctr (-16.1%, p=0.007). 31P MRS revealed significant within-group increases in MS-Ex participants in TA rate-constant of PCr recovery (kPCr; +31.5%, p=0.03) and ATP/PCr (+3.2%, p=0.01), and near significant between-group increases in TA kPCr (p=0.05) but no significant changes in brain 31P MRS following exercise. Cross-sectional differences existed between MS and HC brain PCr/Pi (4.61 0.44, 3.93 0.19 p=0.0019).

High-intensity aerobic exercise in PwMS improved expected cardiorespiratory and clinical outcomes but provoked one serious adverse event. 31P MRS may serve to explore underlying mechanisms by which aerobic exercise exerts cerebral benefits.
Dave Bexfield
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