Efficacy of high-intensity aerobic exercise on brain MRI measures in multiple sclerosis

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaperJournal articleResearchpeer-review

  • Martin Langeskov-Christensen
  • Lars Grøndahl Hvid
  • Mikkel Karl Emil Nygaard, Denmark
  • Steffen Ringgaard
  • Henrik Boye Jensen, Brain and Nerve Diseases, Department of Neurology, Hospital Lillebaelt, 6000 Kolding, Denmark. Henrik.Boye.Jensen@rsyd.dk., Department of Regional Health Research, University of Southern Denmark, Denmark
  • Helle Hvilsted Nielsen, BRIDGE (Brain Research – Inter-Disciplinary Guided Excellence), Department of Clinical Research, University of Southern Denmark, Department of Neurobiology Research, Institute of Molecular Medicine, University of Southern Denmark, 5000 Odense C, Denmark., Department of Neurology, Odense University Hospital, Denmark., Denmark
  • Thor Petersen
  • ,
  • Egon Stenager, Department of Regional Health Research, University of Southern Denmark, Department of neurology, Soenderborg Hospital, Denmark
  • Simon Fristed Eskildsen
  • Ulrik Dalgas

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 MS patients 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% 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.

CLINICALTRIALS REGISTRATION: ClinicalTrials.gov 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.

Original languageEnglish
Pages (from-to)e203-e213
Number of pages11
Publication statusPublished - Jan 2021

    Research areas

  • Adult, Brain/diagnostic imaging, Cross-Over Studies, Denmark/epidemiology, Exercise/physiology, Female, Follow-Up Studies, High-Intensity Interval Training/methods, Humans, Magnetic Resonance Imaging/methods, Male, Middle Aged, Multiple Sclerosis/diagnostic imaging, Treatment Outcome

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ID: 201994474