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Abstract Details

The Insula Modulates the Effects of Aerobic Training on Cardiovascular Function and Ambulation in Multiple Sclerosis
Multiple Sclerosis
P10 - Poster Session 10 (8:00 AM-9:00 AM)
3-010
Impairment in the autonomic control of cardiovascular function is very common in pwMS. Insula is a key region related to this function with differences between left and right hemisphere. Insula lesions and atrophy are frequent in pwMS and appear to be related to cardiovascular alterations. AT targets the cardiopulmonary system and is proposed as a neuroprotective strategy in several neurological conditions.
To understand the effects of aerobic training (AT), focusing on the role of insula (differentiating in right and left) in establishing cardiovascular fitness (CF) and AT responses in people with multiple sclerosis (pwMS).

Sixty-one pwMS were randomized in two groups (MS-AT and MS-C) to perform 24 training sessions of 30-40 minutes for 2-3 times per week. MS-AT performed moderate AT, while MS-C underwent non-specific motor training. All patients had a baseline and follow-up evaluation after the training period, including assessment of maximal peak of oxygen consumption (VO2max), heart rate reserve (HRR), 6-minute walk test (6MWT) and a MRI scan to quantify lesion volumes (LV), global and regional brain atrophy. Two age- and sex-matched healthy control (HC) groups were enrolled for baseline comparison of CF and brain volumetry data.

At baseline, MS patients showed impaired values of VO2max, HRR and 6MWT (p<0.001) and a widespread pattern of atrophy compared to HC, including bilateral insula. In MS, higher left insula LV correlated to higher HRR (R=0.27, p<0.05). After training, MS-AT experienced an improvement in 6MWT compared to MS-C and this enhancement was greater in patients without insular lesions. At follow-up, MS-C showed a reduction of left anterior insula volume compared to baseline (p<0.001).

In pwMS, AT improves CF and walking capacity. It showed a neuroprotective effect, especially for the left insula that has a stronger relationship with CF, compared to the contralateral region.
Authors/Disclosures
Paolo Preziosa (Ospedale San Raffaele)
PRESENTER
Mr. Preziosa has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Bristol Myers Squibb . Mr. Preziosa has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Sanofi Genzyme. Mr. Preziosa has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Novartis. Mr. Preziosa has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Roche. Mr. Preziosa has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Merck.
Matteo Albergoni, PT (Ospedale San Raffaele SRL (VAT: IT 07636600962)) Dr. Albergoni has nothing to disclose.
Loredana Storelli Loredana Storelli has nothing to disclose.
Maria Assunta Rocca (Neuroimaging Research Unit) Maria Assunta Rocca has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Biogen, Bristol Myers Squibb, Eli Lilly, Janssen, Roche. Maria Assunta Rocca has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for AstraZaneca, Biogen, Bristol Myers Squibb, Bromatech, Celgene, Genzyme, Horizon Therapeutics Italy, Merck Serono SpA, Novartis, Roche, Sanofi and Teva. The institution of Maria Assunta Rocca has received research support from MS Society of Canada, the Italian Ministry of Health, the Italian Ministry of University and Research, and Fondazione Italiana Sclerosi Multipla.
Massimo Filippi, MD, FAAN (Ospedale San Raffaele, Neuroimaging Research Unit) Dr. Filippi has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Alexion, Almirall, Biogen, Merck, Novartis, Roche, Sanofi;. Dr. Filippi has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Alexion, Biogen, Bristol-Myers Squibb, Merck, Novartis, Roche, Sanofi, Sanofi-Aventis, Sanofi- Genzyme, Takeda. Dr. Filippi has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Bayer, Biogen, Celgene, Chiesi Italia SpA, Eli Lilly, Genzyme, Janssen, Merck-Serono, Neopharmed Gentili, Novartis, Novo Nordisk, Roche, Sanofi, Takeda, and TEVA. Dr. Filippi has received personal compensation in the range of $5,000-$9,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Springer Nature. The institution of Dr. Filippi has received research support from Biogen Idec, Merck-Serono, Novartis, Roche, the Italian Ministry of Health, the Italian Ministry of University and Research, and Fondazione Italiana Sclerosi Multipla.