This observational, longitudinal study will examine whether physical activity and other potentially modifiable lifestyle factors are associated with changes in myelin, the protective coating around nerve fibers, in older adults with multiple sclerosis (MS). Participants will undergo magnetic resonance imaging (MRI) scans to measure myelin throughout the central nervous system and will wear wrist-worn activity trackers to assess physical activity over time.
The primary aim of this study is to explore clinical variables and potentially modifiable risk factors that are associated with improved myelination (both enhanced remyelination and reduced demyelination) in older adults living with multiple sclerosis. The emphasis here will be on discovery and generation of pilot data to support further definitive longitudinal observational studies, and ultimately, clinical trials on behavioral and/or pharmaceutical interventions to prevent demyelination and promote remyelination in people living with MS. Participants will be categorized based on whether they meet or exceed the current physical activity guidelines of at least 150 minutes per week of moderate-intensity aerobic physical activity, 75 minutes per week of vigorous-intensity aerobic physical activity, or an equivalent combination. At both baseline and 6 months, MRI and clinical assessments will be obtained, and chart review will be performed. Participants will wear a wrist-worn physical activity monitor and answer monthly questionnaires (assessed via REDCap survey) throughout the study period. Linear regression will be performed to estimate the effect size of various physical activity variables (step count, sedentary time, and time spent in light/moderate/vigorous physical activity, aerobic capacity and overall strength) with 6-month change in myelination.
Study Type
OBSERVATIONAL
Enrollment
14
No intervention is administered. Participants undergo observational assessments including MRI, wearable activity monitoring, and questionnaires.
Multiple Sclerosis Center at UW Medical Center - Northwest
Seattle, Washington, United States
Quantitative MRI-derived myelin measure
Change in MRI-derived measures of myelin content within the central nervous system. Specifically, the investigators will use macromolecular proton fraction (MPF), a quantitative MRI parameter which describes the magnetization transfer effect and defined as the relative amount of protons bound to biological macromolecules with restricted molecular motion.
Time frame: Baseline and 6 months
Total step count
Total step count will measured using wrist-worn activity tracker.
Time frame: Continuously collected during the 6-month study period
Self-reported physical activity
Physical activity will be measured with the International Physical Activity Questionnaire-Short Form (IPAQ-SF). This questionnaire will ask participants about their moderate and vigorous physical activity and time spent walking, to give a total sum score of Metabolic Equivalent of Task (MET). Higher calculated (MET) scores indicate greater physical activity.
Time frame: Baseline and monthly for the 6-month study period
Multiple Sclerosis Functional Composite (MSFC)
The MSFC assesses walking function, hand function, and cognitive function and gives a composite score.
Time frame: baseline and 6 months
Low Contrast Letter Acuity
The LCLA assesses visual function
Time frame: Baseline and 6 months
Time spent in moderate-to-vigorous physical activity (MVPA)
MVPA will be measured via wrist-worn physical activity monitor
Time frame: Throughout the 6-month period
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Sedentary Time
Sedentary Time will be measured via wrist-worn fitness tracker
Time frame: Throughout the 6-month period
Self-reported sedentary time
Self-reported sedentary time will be measured with the International Physical Activity Questionnaire-Short Form (IPAQ-SF). This questionnaire will ask participants about their time spent sitting over the past 7 days, as an estimate of sedentary time.
Time frame: Baseline and monthly throughout the 6-month period