Aerobic Exercise Shows Positive Effect in Multiple Sclerosis

May 29, 2020

Improvements in function may be mediated by an effect of aerobic fitness on deep gray matter brain structures.

Jessica F. Baird, PhD

Results from a study presented at the 2020 Consortium of Multiple Sclerosis Centers (CMSC) Virtual Annual Meeting suggest that the use of aerobic fitness has a positive effect on physical and cognitive function in older adults with multiple sclerosis (MS) and may be used as an approach to ameliorate the consequences of aging.1

Using a Cohen’s d model, aerobic fitness was shown to have a large effect on both walking speed (d = ­­­—0.99) and walking endurance (d = 1.51). The effect of aerobic exercise on cognitive function has been shown in previous studies for other neurological disorders and was consistent with these results as well. There was a moderate effect of aerobic fitness on cognitive function (Symbol Digit Modalities Test [SDMT], d = 0.57; California Verbal Learning Test [CVLT], d = 0.48; Brief Visuospatial Memory Test [BVMT] d = 0.67).

Results also showed that aerobic fitness had varying effects on deep gray matter (DGM) structures, with little to no effect on the thalamus (d = 0.19) and hippocampus (d = —0.01) but had moderate effect on the basal ganglia (d = 0.53).

Jessica F. Baird, PhD, post-doctoral fellow, Exercise Neuroscience Research Lab, Center for Exercise Medicine, University of Alabama at Birmingham, and colleagues concluded that improvements in function may be mediated by an effect of aerobic fitness on DGM brain structures.

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The study aimed to examine the effect of aerobic fitness on physical and cognitive function as well as improvements on DGM structures within the brain such as hippocampus, thalamus, and basal ganglia from aerobic exercise.

Researchers recruited 20 ambulatory adults, age 55 and older, with diagnosis of MS. Each patient underwent assessments of aerobic exercise using a maximal, incremental exercise test on a recumbent stepper, as well as the Timed 25-Foot Walk test for walking speed and the 6-Minute Walk to text walking endurance. Patients also underwent assessments of cognitive function using SDMT, BVMT, CVLT, and a 3-T magnetic resonance imaging (MRI) of the brain.

The study would not be the first to show positive results on cognitive function in patients with neurologic disorders. In early March 2020, recommendations published by the Huntington Study Group (HSG), suggested patients with Huntington disease (HD) should undergo aerobic exercise, resistance training and supervised gait training as part of their normal physical therapy routine.2

Another study published in September 2019 revealed that high-intensity aerobic exercise intervention, when gamified and delivered in an at-home fashion, can attenuate the symptoms of Parkinson disease (PD).3

Baird and colleagues noted that further research is warranted to comprehensively investigate the neural adaptations associated with aerobic fitness in this population.

For more coverage of CMSC 2020, click here.

REFERENCES

1. Baird JF, Bamman M, Brown C, Rinker JR, Motl RW. The effect of aerobic fitness on physical and cognitive function and brain volume in older adults with multiple sclerosis. Int J MS Care. 2020;22(2 Suppl). RHI05.

2. Quinn L, Kegelmeyer D, Kloos A, Rao AK, Busse M, Fritz N. Clinical recommendations to guide physical therapy practice for Huntington’s disease. Neurology. Published online February 4, 2020. doi:10.1212/WNL.0000000000008887

3. van der Kolk NM, de Vries NM, Kessels RPC, et al. Effectiveness of home-based and remotely supervised aerobic exercise in Parkinson's disease: a double-blind, randomised controlled trial. Lancet Neurol. Published online September 11, 2019. doi: 10.1016/S1474-4422(19)30285-6.