Effect of High-Intensity Exercise on Multiple Sclerosis Function and Phosphorous Magnetic Resonance Spectroscopy Outcomes

Research output: Contribution to journalArticle

Abstract

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 One participant was withdrawn for exercise-induced syncope.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.

Original languageEnglish (US)
Pages (from-to)1380-1386
Number of pages7
JournalMedicine and science in sports and exercise
Volume51
Issue number7
DOIs
StatePublished - Jul 1 2019

Fingerprint

Phosphocreatine
Multiple Sclerosis
Magnetic Resonance Spectroscopy
Exercise
Fatigue
Brain
Muscles
Syncope
Adenosine Triphosphate
Fats
Phosphates
Prospective Studies
Population

Keywords

  • AEROBIC EXERCISE
  • CLINICAL TRIAL
  • COGNITION
  • MULTIPLE SCLEROSIS
  • PHOSPHORUS MR SPECTROSCOPY

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine
  • Physical Therapy, Sports Therapy and Rehabilitation

Cite this

@article{1878cb4e8ceb4380a23963a8c57b5197,
title = "Effect of High-Intensity Exercise on Multiple Sclerosis Function and Phosphorous Magnetic Resonance Spectroscopy Outcomes",
abstract = "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.",
keywords = "AEROBIC EXERCISE, CLINICAL TRIAL, COGNITION, MULTIPLE SCLEROSIS, PHOSPHORUS MR SPECTROSCOPY",
author = "Anna Orban and Bharti Garg and Manoj Sammi and Dennis Bourdette and William Rooney and Kerry Kuehl and Rebecca Spain",
year = "2019",
month = "7",
day = "1",
doi = "10.1249/MSS.0000000000001914",
language = "English (US)",
volume = "51",
pages = "1380--1386",
journal = "Medicine and Science in Sports and Exercise",
issn = "0195-9131",
publisher = "Lippincott Williams and Wilkins",
number = "7",

}

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

AU - Bourdette, Dennis

AU - Rooney, William

AU - Kuehl, Kerry

AU - Spain, Rebecca

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

UR - http://www.scopus.com/inward/record.url?scp=85067340657&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85067340657&partnerID=8YFLogxK

U2 - 10.1249/MSS.0000000000001914

DO - 10.1249/MSS.0000000000001914

M3 - Article

C2 - 31205251

AN - SCOPUS:85067340657

VL - 51

SP - 1380

EP - 1386

JO - Medicine and Science in Sports and Exercise

JF - Medicine and Science in Sports and Exercise

SN - 0195-9131

IS - 7

ER -