Trainuvimab: Impact Of High-intensity Exercise On Cognition In Multiple Sclerosis - Interim And Subgroup Analysis

Abstract

Cognitive impairment is a common symptom of Multiple Sclerosis that directly impacts patients’ quality of life. Yet, evidence of treatments is mixed. Exercise reveals high potential as a supportive non-pharmacological therapy. PURPOSE: To investigate the effects of a three-week high-intensity interval training (HIIT) on processing speed, verbal and visual-spatial memory in cognitive impaired persons with MS (pwMS). METHODS: 66 persons with relapsing-remitting (RR) or secondary-progressive (SP) MS were randomly assigned to an intervention (HIIT: 5x 1.5min intervals at 95-100% HFmax, 3x/week) or an active control group (CG: 24min continuous exercise at 65% HFmax, 3x/week). For subgroup analysis participants with cognitive impairment were identified (deviation of ≤ 1.5 SD from normative test data from at least one test). Cognitive performance was assessed pre and post to the intervention period with the Brief International Cognitive Assessment for Multiple Sclerosis (BICAMS). Potential within (pre vs. post) - and between –subject (group, MS-type) effects and their interactions were investigated by analysis of variance (ANOVA) with repeated measures. Post-hoc tests (Bonferroni) were conducted for significant main effects of within or between-subjects. RESULTS: 28 pwMS were identified as cognitively impaired. ANOVA revealed no significant interactions for any outcome and showed no significant main effects for visual-spatial memory. Significant main effects (factor time) were observed for processing speed (F (1, 24)=15.65, p=.001) and verbal memory (F(1, 24)=4.85, p=.037). In the HIIT-group participants with RRMS significantly improved processing speed over time (MD: -4.67, 95%-CI [34,41, 43,81], p=.023), whereas no changes (p=.051) were shown for participants with SPMS. No improvements were observed for the CG. Pairwise comparisons revealed no significant changes for verbal memory. CONCLUSION: Compared to the CG, HIIT shows stronger impact on processing speed for RRMS. SPMS-type showed no changes. However, results should be interpreted cautiously, as the data set reveals no significant main effects for group and MS-phenotypes. Supported by: The Swiss Multiple Sclerosis Society, the trust Grenzen überschreiten, the Stiftung für Ergotherapie and the Blumenau-Léonie Hartmann-Stiftung.