TY - JOUR
T1 - Efficacy of High-Intensity Aerobic Exercise on Brain MRI Measures in Multiple Sclerosis
AU - Langeskov-Christensen, Martin
AU - Grøndahl Hvid, Lars
AU - Nygaard, Mikkel Karl Emil
AU - Ringgaard, Steffen
AU - Jensen, Henrik Boye
AU - Nielsen, Helle Hvilsted
AU - Petersen, Thor
AU - Stenager, Egon
AU - Eskildsen, Simon Fristed
AU - Dalgas, Ulrik
N1 - Publisher Copyright:
© 2020 American Academy of Neurology.
Copyright:
This record is sourced from MEDLINE/PubMed, a database of the U.S. National Library of Medicine
PY - 2021/1/12
Y1 - 2021/1/12
N2 - OBJECTIVE: To determine whether 24 weeks of high-intensity progressive aerobic exercise (PAE) affects brain MRI measures in people with multiple sclerosis (MS). METHODS: We conducted a randomized, controlled, phase 2 trial (with a crossover follow-up) including an exercise group (supervised PAE followed by self-guided physical activity) and a waitlist group (habitual lifestyle followed by supervised PAE). Mildly to severely impaired patients with MS aged 18-65 years were randomized (1:1). The primary outcome was percentage brain volume change (PBVC) after 24 weeks, analyzed using the intention-to-treat principle. RESULTS: Eighty-six participants were recruited. PBVC did not change over the intervention period (mean between-group change +0.12%, 95% confidence interval [CI] -0.27 to 0.51, p = 0.55). In contrast, cardiorespiratory fitness (+3.5 mL O2/min/kg, 2.0 to 5.1, p < 0.01) and annualized relapse rate (0.00, 0.00-0.07 vs +0.45, 0.28 to 0.61, p < 0.01) improved in the exercise group. CONCLUSION: These findings do not support a neuroprotective effect of PAE in terms of total brain atrophy in people with MS and it did not lead to a statistically significant difference in gray matter parenchymal fraction. PAE led to improvements in cardiorespiratory fitness and a lower relapse rate. While these exploratory findings cautiously support PAE as a potential adjunct disease-modifying treatment in MS, further investigations are warranted. CLINICALTRIALSGOV IDENTIFIER: NCT02661555. CLASSIFICATION OF EVIDENCE: This study provides Level I evidence that 24 weeks of high-intensity PAE did not elicit disease-modifying effects in PBVC in people with MS. Exploratory analyses showed that PAE may reduce relapse rate.
AB - OBJECTIVE: To determine whether 24 weeks of high-intensity progressive aerobic exercise (PAE) affects brain MRI measures in people with multiple sclerosis (MS). METHODS: We conducted a randomized, controlled, phase 2 trial (with a crossover follow-up) including an exercise group (supervised PAE followed by self-guided physical activity) and a waitlist group (habitual lifestyle followed by supervised PAE). Mildly to severely impaired patients with MS aged 18-65 years were randomized (1:1). The primary outcome was percentage brain volume change (PBVC) after 24 weeks, analyzed using the intention-to-treat principle. RESULTS: Eighty-six participants were recruited. PBVC did not change over the intervention period (mean between-group change +0.12%, 95% confidence interval [CI] -0.27 to 0.51, p = 0.55). In contrast, cardiorespiratory fitness (+3.5 mL O2/min/kg, 2.0 to 5.1, p < 0.01) and annualized relapse rate (0.00, 0.00-0.07 vs +0.45, 0.28 to 0.61, p < 0.01) improved in the exercise group. CONCLUSION: These findings do not support a neuroprotective effect of PAE in terms of total brain atrophy in people with MS and it did not lead to a statistically significant difference in gray matter parenchymal fraction. PAE led to improvements in cardiorespiratory fitness and a lower relapse rate. While these exploratory findings cautiously support PAE as a potential adjunct disease-modifying treatment in MS, further investigations are warranted. CLINICALTRIALSGOV IDENTIFIER: NCT02661555. CLASSIFICATION OF EVIDENCE: This study provides Level I evidence that 24 weeks of high-intensity PAE did not elicit disease-modifying effects in PBVC in people with MS. Exploratory analyses showed that PAE may reduce relapse rate.
KW - Adult
KW - Brain/diagnostic imaging
KW - Cross-Over Studies
KW - Denmark/epidemiology
KW - Exercise/physiology
KW - Female
KW - Follow-Up Studies
KW - High-Intensity Interval Training/methods
KW - Humans
KW - Magnetic Resonance Imaging/methods
KW - Male
KW - Middle Aged
KW - Multiple Sclerosis/diagnostic imaging
KW - Treatment Outcome
U2 - 10.1212/WNL.0000000000011241
DO - 10.1212/WNL.0000000000011241
M3 - Journal article
C2 - 33262230
AN - SCOPUS:85100069665
VL - 96
SP - e203-e213
JO - Neurology
JF - Neurology
SN - 0028-3878
IS - 2
ER -