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Thalamic atrophy moderates associations among aerobic fitness, cognitive processing speed, and walking endurance in persons with multiple sclerosis

Journal of Neurology volume 269, pages 5531–5540 (2022)Cite this article

Abstract

Background and objectives

Thalamic atrophy (TA) represents a biomarker of neurodegeneration and associated dysfunction/decline in physical and cognitive functioning among persons with multiple sclerosis (MS). Aerobic fitness, as an end point of exercise training, represents a promising target for restoring function in MS, but it is unknown if such effects differ by TA. This cross-sectional study examined whether aerobic fitness was differentially associated with cognitive processing speed and walking endurance in persons with MS who present with and without TA.

Methods

44 fully ambulatory persons with MS completed a graded exercise test for measuring aerobic fitness (VO2peak) and underwent 3T MRI for measuring TA, the Symbol Digit Modalities Test (SDMT), and the 6-min walk (6MW). We performed Spearman correlations (rs) among VO2peak, SDMT, and 6MW scores overall, and in persons with and without TA. We applied Fisher’s z-test for comparing correlations based on TA status.

Results

When controlling for age, EDSS score, and global MRI measures of atrophy, VO2peak was strongly associated with SDMT scores (prs = 0.74, p < 0.01) and 6MW performance (prs = 0.77, p < 0.01) in persons with TA, whereas VO2peak was not associated with SDMT scores (prs =  − 0.01, p = 0.99) or 6MW performance (prs = 0.25, p = 0.38) in those without TA. The correlations between VO2peak and SDMT (z = 2.86, p < 0.01) and VO2peak and 6MW (z = 2.33, p = 0.02) were significantly stronger in the TA group.

Discussion

This study provides initial evidence of strong, selective associations among aerobic fitness, cognitive processing speed, and walking endurance in persons with TA as a biomarker for MS-related neurodegeneration. Such data support TA as a moderator of the association among aerobic fitness, cognitive processing speed, and walking endurance in persons with MS. Future research should carefully consider the role of TA when designing trials of aerobic exercise, cognition, and mobility in MS.

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Acknowledgements

The authors report no conflicts of interest directly or indirectly related to this manuscript. This study was supported, in part, by an investigator-initiated grant from EMD Serono, Inc. (One Technology Place, Rockland, MA 02370) and the Eunice Kennedy Shriver National Institute of Child Health and Human Development of the National Institutes of Health under Award Number R01HD091155.

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Authors and Affiliations

  1. Center for Neuropsychology and Neuroscience Research, Kessler Foundation, 1199 Pleasant Valley Way, West Orange, NJ, 07052, USA

    Brian M. Sandroff, Cristina A. F. Román, Glenn R. Wylie & John DeLuca

  2. Rutgers New Jersey Medical School, Newark, NJ, USA

    Brian M. Sandroff, Cristina A. F. Román, Glenn R. Wylie & John DeLuca

  3. University of Illinois Chicago, Chicago, IL, USA

    Robert W. Motl

  4. University of Alabama at Birmingham, Birmingham, AL, USA

    Gary R. Cutter

  5. University at Buffalo, Buffalo, NY, USA

    Ralph H. B. Benedict, Michael G. Dwyer & Robert Zivadinov

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  1. Brian M. Sandroff
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Correspondence to Brian M. Sandroff.

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Ethical standard statement

All study procedures were approved by the Institutional Review Board at the University of Illinois at Urbana-Champaign, University of Alabama at Birmingham, and Kessler Foundation.

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Sandroff, B.M., Motl, R.W., Román, C.A.F. et al. Thalamic atrophy moderates associations among aerobic fitness, cognitive processing speed, and walking endurance in persons with multiple sclerosis. J Neurol 269, 5531–5540 (2022). https://doi.org/10.1007/s00415-022-11205-9

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  • DOI: https://doi.org/10.1007/s00415-022-11205-9

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