Findings may support the development of an aerobic exercise training intervention for people with multiple sclerosis (MS) who present with MS-related thalamic atrophy.
Aerobic exercise training has the potential to restore function in individuals with thalamic atrophy in multiple sclerosis (MS) patients, according to a new study.
MS-related thalamic atrophy is a major biomarker for neurodegeneration and associated physical and cognitive decline in MS, “highlighting the importance of exploring ways to restore and maintain function in individuals who present with this consequence of the disease,” the Kessler Foundation said in a news release.
Aerobic exercise training is one promising approach,but little is known about its potential effects in patients with thalamic atrophy.
A new study, published in the Journal of Neurology, is the first to evaluate a brain biomarker as a potential mediator of the relationship among aerobic fitness, physical functioning, and cognitive functioning in persons with MS, Brian Sandroff, Ph.D., lead scientist and director of the Exercise Neurorehabilitation Research Laboratory at Kessler Foundation and lead author of the study, told Managed Healthcare Executive®.
Sandroff and colleagues evaluated 44 fully ambulatory individuals with MS from 3 randomized controlled trials. Outcomes included aerobic fitness (peak oxygen consumption during graded treadmill exercise), processing speed (Symbol Digit Modalities Test), walking endurance (a 6-minute walk test), and thalamic neuroimaging.
Results provided initial evidence for “strong and selective associations” among aerobic fitness, cognitive processing speed, and walking endurance in individuals with thalamic atrophy, according to Sandroff. “This study suggests that aerobic exercise training has the potential to restore function in individuals with thalamic atrophy, who are clearly at risk for progressive physical and cognitive decline,” he said.
Sandroff and colleagues previously established that having worse mobility and cognitive processing speed at baseline predicted larger improvements on those outcomes after 6 month of multi-modal exercise training in persons with MS.
“Consistent with the pattern of results from our previous work, the associations among fitness, walking endurance, and cognitive processing speed were significantly stronger in those who presented with thalamic atrophy compared with those with MS who did not,” Sandroff noted.
The findings may support the development of a subsequent aerobic exercise training intervention for improving cognitive processing speed and walking endurance as primary outcomes in persons with MS who present with MS-related thalamic atrophy, Sandroff said.
“As thalamic atrophy is considered a strong biomarker for MS neurodegeneration, such a trial would represent the first test of aerobic exercise training for restoring function, particularly cognitive processing speed and walking endurance, in those who present with objective MS-related central nervous system damage, as there have been no rehabilitation trials in MS that have targeted patients who present with brain atrophy,” Sandroff said. “This is exciting, as we can potentially optimize aerobic exercise training trials that target specific groups of people with MS to maximize the chances of restoring functions in those patients.”
The next step of research involves asking whether or not those with MS who present with thalamic atrophy demonstrate larger improvements in physical and cognitive functioning after engaging in aerobic exercise training relative to those with MS who do not present with thalamic atrophy, according to Sandroff. “If that ends up being the case, then it might suggest that it could be worthwhile to start examining thalamic atrophy from clinical MRI scans as a possible factor for prescribing exercise training to patients within comprehensive MS care settings.”
The study was supported by EMD Serono and the Eunice Kennedy Shriver National Institute of Child Health and Human Development of the National Institutes of Health.