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This preliminary study on essentially HIIT and cardio interval training was published by the prestigious journal Lancet. Note that this is a "preprint" study, in that it is not yet peer-reviewed, but they felt the findings were strong enough to publicize early. I agree. -D
LANCET PREPRINT [see below]
Efficacy of High-Intensity Progressive Aerobic Exercise on Brain Atrophy Measures in Multiple Sclerosis: A Randomized, Controlled, Cross-Over, Phase-2 Trial
37 Pages Posted: 15 Apr 2019
Martin Langeskov-Christensen
Aarhus University - Section for Sport Science
Lars Grøndahl Hvid
Aarhus University - Section for Sport Science
Mikkel Karl Emil Nygaard
Aarhus University - Department of Clinical Medicine
Steffen Ringgaard
Aarhus University - Aarhus University Hospital
Henrik Boye Jensen
Lillebaelt Hospital
Helle Hvilsted Nielsen
University of Southern Denmark - Institute of Molecular Medicine
Thor Petersen
Aarhus University - Aarhus University Hospital
Egon Stenager
University of Southern Denmark - Department of Regional Health Research
Simon Fristed Eskildsen
Aarhus University - Department of Clinical Medicine
Ulrik Dalgas
Aarhus University - Section for Sport Science
Abstract
Background: Accelerated brain atrophy is a main determinant of the progressing disabilities clinically characterizing people with multiple sclerosis (MS). Preliminary data from animal studies and human phase 1 studies indicate a possible disease-modifying effect of physical exercise. We therefore assessed whether high-intensity progressive aerobic exercise (PAE) affects brain atrophy in MS.
Methods: We conducted a 24-week randomized, controlled, cross-over, phase 2 trial, including an exercise group (24 weeks of supervised PAE followed by self-guided physical activity) and a waitlist group (24 weeks of habitual lifestyle followed by supervised PAE). Participants were recruited at four Danish hospitals. MS patients aged 18-65 years with an Expanded Disability Status Scale score of 0-6 willing to travel to the trial and training facility were randomly assigned (1:1) by the sealed envelope principle, stratified by sex. The primary outcome was percentage brain volume change (PBVC) after 24 weeks, analyzed using an intention-to-treat linear mixed effects model.
Findings: A total of 86 participants were recruited from 28 April 2016 to 10 October 2017 (43 patients were assigned to each group). PBVC was -0·29% (SD 0·63) in the exercise group; -0·17% (0·99) in the placebo group (between-group change +0·12%, 95% CI -0·27-0·51; p=0·545). We observed higher grey matter parenchymal fraction (+1·13 percentage points, 0·00-2·26; p=0·05) and cardiorespiratory fitness (+3·5 mL O2/min/kg, 2·0-5·1; p<0·0001) and lower annualized relapse rate (p=0·0023) in the exercise group. No serious adverse events were observed.
Interpretation: These findings do not support a ‘whole brain’ neuroprotective effect of PAE (i.e. total brain atrophy) in people with MS. Oppositely, improved cardiorespiratory fitness was accompanied by a ‘regional brain’ neuroprotective effect (i.e. grey matter parenchymal fraction) and a relapse rate of zero. These findings justify recommending PAE as a possible adjunct disease-modifying treatment in MS and warrant further long-term, large-scale phase 3 investigations.
Trial Registration Number: ClinicalTrials.gov identifier: NCT02661555.
LANCET PREPRINT [see below]
Efficacy of High-Intensity Progressive Aerobic Exercise on Brain Atrophy Measures in Multiple Sclerosis: A Randomized, Controlled, Cross-Over, Phase-2 Trial
37 Pages Posted: 15 Apr 2019
Martin Langeskov-Christensen
Aarhus University - Section for Sport Science
Lars Grøndahl Hvid
Aarhus University - Section for Sport Science
Mikkel Karl Emil Nygaard
Aarhus University - Department of Clinical Medicine
Steffen Ringgaard
Aarhus University - Aarhus University Hospital
Henrik Boye Jensen
Lillebaelt Hospital
Helle Hvilsted Nielsen
University of Southern Denmark - Institute of Molecular Medicine
Thor Petersen
Aarhus University - Aarhus University Hospital
Egon Stenager
University of Southern Denmark - Department of Regional Health Research
Simon Fristed Eskildsen
Aarhus University - Department of Clinical Medicine
Ulrik Dalgas
Aarhus University - Section for Sport Science
Abstract
Background: Accelerated brain atrophy is a main determinant of the progressing disabilities clinically characterizing people with multiple sclerosis (MS). Preliminary data from animal studies and human phase 1 studies indicate a possible disease-modifying effect of physical exercise. We therefore assessed whether high-intensity progressive aerobic exercise (PAE) affects brain atrophy in MS.
Methods: We conducted a 24-week randomized, controlled, cross-over, phase 2 trial, including an exercise group (24 weeks of supervised PAE followed by self-guided physical activity) and a waitlist group (24 weeks of habitual lifestyle followed by supervised PAE). Participants were recruited at four Danish hospitals. MS patients aged 18-65 years with an Expanded Disability Status Scale score of 0-6 willing to travel to the trial and training facility were randomly assigned (1:1) by the sealed envelope principle, stratified by sex. The primary outcome was percentage brain volume change (PBVC) after 24 weeks, analyzed using an intention-to-treat linear mixed effects model.
Findings: A total of 86 participants were recruited from 28 April 2016 to 10 October 2017 (43 patients were assigned to each group). PBVC was -0·29% (SD 0·63) in the exercise group; -0·17% (0·99) in the placebo group (between-group change +0·12%, 95% CI -0·27-0·51; p=0·545). We observed higher grey matter parenchymal fraction (+1·13 percentage points, 0·00-2·26; p=0·05) and cardiorespiratory fitness (+3·5 mL O2/min/kg, 2·0-5·1; p<0·0001) and lower annualized relapse rate (p=0·0023) in the exercise group. No serious adverse events were observed.
Interpretation: These findings do not support a ‘whole brain’ neuroprotective effect of PAE (i.e. total brain atrophy) in people with MS. Oppositely, improved cardiorespiratory fitness was accompanied by a ‘regional brain’ neuroprotective effect (i.e. grey matter parenchymal fraction) and a relapse rate of zero. These findings justify recommending PAE as a possible adjunct disease-modifying treatment in MS and warrant further long-term, large-scale phase 3 investigations.
Trial Registration Number: ClinicalTrials.gov identifier: NCT02661555.
Preprints with The Lancet is part of SSRN´s First Look, a place where journals and other research experts identify content of interest prior to publication. These preprint papers are not peer-reviewed and are posted here as part of a 12-month trial. Authors have either opted in at submission to The Lancet family of journals to post their preprints on Preprints with The Lancet, or submitted directly via SSRN. The usual SSRN checks and a Lancet-specific check for appropriateness and transparency have been applied. These papers should not be used for clinical decision making or reporting of research to a lay audience without indicating that this is preliminary research that has not been peer-reviewed. For more information see the Comment published in The Lancet, or visit The Lancet´s FAQ page, and for any feedback please contact preprints@lancet.com
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