Aerobic Exercise to Improve Brain Metabolism in MS

Multiple sclerosis (MS) is a disease of brain, spinal cord and optic nerves. Current MS therapies reduce the frequency and severity of MS flare-ups, but do not help MS in later stages of disease characterized by slow progression of disability. One obstacle to developing therapies for progressive aspects of disease is a lack of ability to measure progression and brain repair.

A new MRI technique developed by Bill Rooney, PhD, (co-investigator, OHSU Advanced Imaging Resource Center) looks at brain health by measuring levels of phosphorous. Phosphorous levels are thought to reflect energy stores produced by brain cells. The healthier the brain, the greater the energy stores seen as higher the levels of phosphorous on imaging. Dr. Rooney has shown decreased levels of phosphorous on brain MRIs from people with MS. We propose that therapies that boost brain cell health will lead to an increase in brain cell energy stores and be reflected by an increase in phosphorous levels on MRI spectroscopy.

In order to test whether improvements in brain energy stores can be seen as increased phosphorous levels, we will use a therapy known to improve energy stores in muscles and see if it also does so in the brain. We measure how much aerobic exercise increases energy stores in muscles by measuring oxygen utilization during an exercise stress test. Therefore in this study, we will see if the aerobic exercise that improves muscle energy stores (seen as an increase in oxygen utilization) corresponds to an increase in brain energy stores (seen as an increase in phosphorous levels).

Specific Aim 1. To determine if it is safe and feasible to conduct an aerobic exercise intervention in MS patients to achieve an increase in oxygen utilization by 5-15%.

Hypothesis: An MS cohort undergoing a structured aerobic exercise program will increase their aerobic capacity by 5-15% as measured by oxygen utilization testing and not experience adverse events related to the exercise program.