TY - JOUR
T1 - Effect of High-Intensity Exercise on Multiple Sclerosis Function and Phosphorous Magnetic Resonance Spectroscopy Outcomes
AU - Orban, Anna
AU - Garg, Bharti
AU - Sammi, Manoj K.
AU - Bourdette, Dennis N.
AU - Rooney, William D.
AU - Kuehl, Kerry
AU - Spain, Rebecca I.
N1 - Publisher Copyright:
© 2019 by the American College of Sports Medicine.
PY - 2019/7/1
Y1 - 2019/7/1
N2 - Purpose 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). Methods This open-label prospective pilot study compared two cohorts of ambulatory PwMS matched for age, sex and V-O2max. Cohorts underwent 8 wk of high-intensity aerobic exercise (MS-Ex, n = 10) or guided stretching (MS-Ctr, n = 7). Aerobic exercise consisted of four 30-min sessions per week while maintaining ≥70% maximal HR. Changes in cardiorespiratory fitness, clinical outcomes, and 31P MRS of tibialis anterior (TA) muscle and brain were compared. Cross-sectional 31P MRS comparisons were made between all MS participants and a separate matched healthy control population. Results The MS-Ex cohort achieved target increases in V-O2max (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 One participant was withdrawn for exercise-induced syncope.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 (-26%; P = 0.03), whereas only the physical subscore of the Modified Fatigue Impact Scale 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 phosphocreatine (PCr) recovery (+31.5%; P = 0.03) and adenosine triphosphate/PCr (+3.2%; P = 0.01), and near significant between-group increases in TA PCr recovery rate constant (P = 0.05) but no significant changes in brain 31P MRS after exercise. Cross-sectional differences existed between MS and healthy control brain PCr/inorganic phosphate (4.61 ± 0.44, 3.93 ± 0.19; P = 0.0019). Conclusions High-intensity aerobic exercise in PwMS improved expected cardiorespiratory and clinical outcomes but provoked one serious adverse event. The 31P MRS may serve to explore underlying mechanisms by which aerobic exercise exerts cerebral benefits.
AB - Purpose 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). Methods This open-label prospective pilot study compared two cohorts of ambulatory PwMS matched for age, sex and V-O2max. Cohorts underwent 8 wk of high-intensity aerobic exercise (MS-Ex, n = 10) or guided stretching (MS-Ctr, n = 7). Aerobic exercise consisted of four 30-min sessions per week while maintaining ≥70% maximal HR. Changes in cardiorespiratory fitness, clinical outcomes, and 31P MRS of tibialis anterior (TA) muscle and brain were compared. Cross-sectional 31P MRS comparisons were made between all MS participants and a separate matched healthy control population. Results The MS-Ex cohort achieved target increases in V-O2max (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 (-26%; P = 0.03), whereas only the physical subscore of the Modified Fatigue Impact Scale 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 phosphocreatine (PCr) recovery (+31.5%; P = 0.03) and adenosine triphosphate/PCr (+3.2%; P = 0.01), and near significant between-group increases in TA PCr recovery rate constant (P = 0.05) but no significant changes in brain 31P MRS after exercise. Cross-sectional differences existed between MS and healthy control brain PCr/inorganic phosphate (4.61 ± 0.44, 3.93 ± 0.19; P = 0.0019). Conclusions High-intensity aerobic exercise in PwMS improved expected cardiorespiratory and clinical outcomes but provoked one serious adverse event. The 31P MRS may serve to explore underlying mechanisms by which aerobic exercise exerts cerebral benefits.
KW - AEROBIC EXERCISE
KW - CLINICAL TRIAL
KW - COGNITION
KW - MULTIPLE SCLEROSIS
KW - PHOSPHORUS MR SPECTROSCOPY
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U2 - 10.1249/MSS.0000000000001914
DO - 10.1249/MSS.0000000000001914
M3 - Article
C2 - 31205251
AN - SCOPUS:85067340657
SN - 0195-9131
VL - 51
SP - 1380
EP - 1386
JO - Medicine and science in sports and exercise
JF - Medicine and science in sports and exercise
IS - 7
ER -