Pilot study of exercise and cognition in progressive multiple sclerosis highlights need to assess outcomes of randomized controlled trials

East Hanover, NJ. December 16, 2021. An international team of multiple sclerosis (MS) experts reported lack of association between cognition and physical activity and cardiorespiratory fitness in a large sample of individuals with progressive MS. These findings have important implications for studies involving exercise interventions aimed at treating the cognitive effects of MS. The article, titled, “Cardiorespiratory fitness and free-living physical activity are not associated with cognition in persons with progressive multiple sclerosis: Baseline analyses from the CogEx study,” was published in Multiple Sclerosis Journal on October 1, 2021, doi: 10.1177/13524585211048397. The authors represent Canada, the United States, Italy, the UK, Denmark, and Belgium.

Article link: https://pubmed.ncbi.nlm.nih.gov/34595972/

The effects of exercise interventions on cognition are a focus of rehabilitation research in conditions associated with deficits and decline in cognition. Cognitive benefits of aerobic exercise have been reported in relapsing-remitting (non-progressive) MS and in age-related cognitive decline. One small pilot study conducted in progressive MS found an association between aerobic ergometer exercise and cardiovascular fitness, alertness, and verbal memory.

To examine these associations, the authors analyzed baseline data from the CogEx study, a multi-national, multi-arm, randomized, blinded, sham-controlled trial looking at the effects of cognitive rehabilitation and aerobic exercise training on cognition and neuroimaging findings in 240 individuals with progressive MS. They measured cardiorespiratory fitness, free-living moderate-to-vigorous physical activity, and cognitive performance.

“Neither cardiorespiratory fitness nor free living physical activity correlated with cognitive performance in this study sample,” said lead author Brian Sandroff, PhD, senior research scientist in the Center for Neuropsychology and Neuroscience Research at Kessler Foundation. “This suggests that other mechanisms of action may mediate the potential effects of aerobic training on cognition in this population. The neuroimaging data collected in this trial may help clarify these underlying mechanisms.”  

The findings have important implications for randomized controlled trials in progressive MS. “It’s clear that we need to carefully assess the outcome measures for studies of exercise and cognition in this population,” added co-author John DeLuca, PhD, Senior Vice President for Research and Training at Kessler Foundation. “Improving cognition and brain health is essential to maintaining quality of life for people with progressive MS. To achieve that, we need to expand our investigation of how exercise affects brain function.”

Relevant resource

CogEx protocol study:

Feinstein A. et al. Study protocol: improving cognition in people with progressive multiple sclerosis: a multi-arm, randomized, blinded, sham-controlled trial of cognitive rehabilitation and aerobic exercise (COGEx) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7245035/

Funding: MS Society of Canada (EGID3185)

Learn more about ongoing MS studies at Kessler Foundation at https://kesslerfoundation.org/MSresearchstudies

For further information, email ResearchStudies@KesslerFoundation.org

About Kessler Foundation

Kessler Foundation, a major nonprofit organization in the field of disability, is a global leader in rehabilitation research that seeks to improve cognition, mobility and long-term outcomes, including employment, for people with neurological disabilities caused by diseases and injuries of the brain and spinal cord. Kessler Foundation leads the nation in funding innovative programs that expand opportunities for employment for people with disabilities. For more information, visit KesslerFoundation.org.

For more information, or to interview an expert, contact: Carolann Murphy, 973.324.8382, CMurphy@KesslerFoundation.org.

Graphic: 

Title: Brian M. Sandroff, PhD

Caption: Dr. Sandroff is senior research scientist in the Center for Neuropsychology and Neuroscoenc Research at Kessler Foundation, and director of the  Exercise Neurorehabilitation Research Laboratory.