Exercise in Multiple Sclerosis: Effects on Cognitive Function and Brain Connectivity (AERCONN)

Universitätsklinikum Hamburg-Eppendorf

Status

Completed

Conditions

Multiple Sclerosis

Treatments

Behavioral: Aerobic Exercise

Study type

Interventional

Funder types

Other

Identifiers

NCT02005237

031A130 (Other Grant/Funding Number)

AERCONN

Details and patient eligibility

About

Cognitive dysfunction is frequent in patients with multiple sclerosis (MS) and to date, there are no available treatments to improve cognition in this patient population. Some evidence from animal studies and small clinical trials suggest that aerobic exercise might beneficially affect cognitive function in MS. The aim of this randomized-controlled trial is to explore if an aerobic exercise training program can enhance cognition in MS. In addition, we will employ neuroimaging markers to determine if exercise alters measures of brain structure and function.

Patients will be randomly assigned to either a 3-months exercise program (bicycle ergometry, 2-3 session per week) or a waitlist control group. The primary endpoint of the study is a test of verbal learning and memory. Secondary endpoints include neuroimaging markers of functional and structural connectivity in the brain. We hypothesize that exercise will improve verbal learning and memory and beneficially affect measures of brain connectivity.

Full description

Background: Cognitive dysfunction is frequent in patients with multiple sclerosis (MS) and to date, there are no available treatments to improve cognition in this patient population. Some evidence from animal studies and small clinical trials suggest that aerobic exercise might beneficially affect cognitive function in MS.

Aims: This study aims to explore the potential of an aerobic exercise program on brain structure and function in MS in a single-blind, randomized controlled phase IIa trial. We hypothesize that exercise will improve verbal learning and memory (primary endpoint) as well as induce changes in neuroimaging markers of structural and functional central nervous system (CNS) connectivity (secondary endpoints). Tertiary outcomes will include walking ability, motor function and coordination, as well as patient-based outcomes (depression, fatigue, and health-related quality of life).

Design: This is a single-blind, randomized, controlled phase IIa trial with a parallel group design comparing 3 months of standardized aerobic exercise training (bicycle ergometry) to a waitlist control group (superiority framework). The allocation ratio of exercise to waitlist control is 1:1 with a sample size of n=60.

Enrollment

68 patients

Sex

All

Ages

18 to 65 years old

Volunteers

No Healthy Volunteers

Inclusion criteria

Relapsing-remitting multiple sclerosis according to McDonald criteria
Currently in remission
Disease duration < 10 years
Low to moderate physical disability (EDSS 0-3.5)
On stable immunotherapy (>3 months) or without any planned treatment for the next year

Exclusion criteria

Patients who are not able to understand the study concept due to severe cognitive deficits or psychiatric comorbidity
Patients currently taking psychoactive drugs
Patients unable to undergo aerobic exercise training for medical reasons
Patients with active disease or uncertain stability under current immunomodulatory therapy (as judged by the treating neurologist)
Patients with implants or body modifications (e.g. dental implants, piercings, tattoos, pacemakers etc.) which might interfere with MEG and MRI assessments
Patients unable to travel to the study center 2-3 times a week for the duration of the study