Tuesday, September 12, 2017

Banish Cog Fog

This MS news will knock you off your feet.
By the end of this blog post, some of you are really going to hate me. I won’t take it personally. After all, there is some good news with the bad news. Sorta like hearing that you get free hot dogs (yeah!) … but that you have to eat a dozen of them, buns and all, in ten minutes. Clearly, if your name is not Joey Chestnut (his record is 70), you might be in big trouble. And if you can manage to gag them all down, it’s gonna hurt bigly.

Long story short, last month more research was released investigating the benefits of high intensity interval training (HIIT) and multiple sclerosis. In the randomized clinical trial, MS researchers pitted high intensity cardio exercise (3x per week for 20 minutes with five 3-minute exercise intervals at 80% of peak oxygen uptake) against a traditional exercise program (5x per week for 30 minutes at a constant 65% effort).

Some of the results were predictable. Both parties, 60 MS volunteers in total, saw “significant” benefit with executive functions, even though the trial was only three weeks long. Fantastic! But then researchers found that the benefits of the two exercise programs diverged dramatically. Compared to conventional training, only HIIT “significantly improved verbal memory” among participants.

You're gonna have to sweat.
(Additionally, “secondary outcomes indicated significant improvements in peak oxygen uptake—VO2-peak—and a significant reduction in matrix metalloproteinases—MMP-2” also in the HIIT group only. I would need to go to med school to find out exactly what this all means, but it sounds hella promising even if I don’t know how to pronounce it.)

How many approved medications are out there to improve cognitive performance in MS? Zero. How many dietary supplements have been shown to aid cognition in MSers? Zero. How many types of exercise routines have been shown—in study after study after study—to reduce cog fog in MS? One.

And this is where the total suckage of this post settles into focus. Brisk walking, cleaning your house, yoga, mowing your lawn, striding on your elliptical, Sunday bike rides with your kids, leisurely laps in the pool, even spirited bedroom escapades (go crazy, gang!) are all fine and dandy for your health and your MS. Do these activities. But unless you are seriously rocking the cardio, none of these efforts are going to significantly improve or protect your cognitive function with this disease.

Channel your favorite GOT bad ass.
As most of you are aware, cognitive issues are among the most disabling of all MS symptoms (along with fatigue, which researchers have found may also decrease with HIIT, but that is for another post). Problems with memory, attention, comprehension, reasoning, decision making, and more can be devastating and not only can lead to a forced early retirement, but also can affect relationships, the ability to drive safely, or the capacity to follow all the characters and plotlines in Game of Thrones. (Okay, trying to put all the pieces together in GOT is mostly hopeless no matter how well your brain works…I just threw that in for a test.)

Now before you charge forward and embark on a serious HIIT routine, talk to your doctor or neuro first. Better yet, also see a trainer and get hands-on instruction. When you do this, you need to do it right. And know that it is not going to be easy, but at least each session is going to be over with fast.

Jump in with abandon. No regrets.
Keeping your brain healthy is a big deal. No, a huge deal. Wait, wait, more of a HUGE FRIGGIN MEGA DEAL. And you have the power to do something about it, a rarity with this disease when many of our arrows, frustratingly, seem to fall just short. Take advantage of this opportunity. Don’t delay. Jump in and get started. You and that magnificent brain of yours will not regret it.


My Odd Sock said...

$%&@#!!! I exercise daily but don't have the mojo to get my heart rate that high. Am I wasting my time? Just working to keep my strength.
Maybe if I did sudoku at a high-altitude.
I've lost my mind.

Dave Bexfield said...

Ha, MOS, of course exercise is fantastic. But to make it super fantastic, yeah, you need to get your ticker really ticking. Not so sure about sudoku unless you are doing it while kickboxing.

Lisa Hammel said...

Did the type of training matter? i.e., ok to do both high and low intensity intervals on a stationary bike versus running or ?

Dave Bexfield said...

Lisa, the abstract wasn't specific, but I would presume any type of high intensity interval would work. That means sprints on the bike or sprints while running. I frequently do HIIT seated on my walker. You just have to go all out, for at least 20-30 seconds. Again, it's best to talk to a trainer.

D. Murray said...

Im Lucky enough (or unlucky) to do 3 HIIT session a week, two on the cycle (Spint Les Mills) and 1 weights ( GRIT les mills). Personally Hiit sessions give you such a high (also feel sick at the same time) Im not sure if they improve my brain in a function kind of way. Im definitly stuffed in a BIG way afterwards!
However I will do what I can while I can still so it as you never know when and how its going to be taken away.

Dave Bexfield said...

Well, you are typing this D., so something is working in your favor. Keep getting stuffed (although auto correct suggested "stoned for what it's worth").

Karen said...

For those who can read research papers, here is the link to the full article https://www.researchgate.net/publication/319188083_High-intensity_interval_exercise_improves_cognitive_performance_and_reduces_matrix_metalloproteinases-2_serum_levels_in_persons_with_multiple_sclerosis_A_randomized_controlled_trial

Anonymous said...

I have found immense benefits from just doing even a simple 10 min work out with high intensity intervals, 4x per week. I jog about 2 minutes to small hill, run up it as fast as I can, which takes about 20 seconds. Walk down. Do that a minimum of 3 times and then jog back. The shortness of the exercise means that I will do this even if it is at the end of the day and I am feeling like I just don't have the time or energy. But I really can't say no to 10 minutes. I find that I have notable decreasing MS symptoms up to 4x per week and then it flattens after that. I got the idea from this article in the NY Times: https://well.blogs.nytimes.com/2016/04/27/1-minute-of-all-out-exercise-may-equal-45-minutes-of-moderate-exertion/?mcubz=3&_r=0

Anonymous said...

Dave, How do you do HIIT seated on your walker?

momnmore said...

I stumbled upon your blog, and I have really enjoyed reading it! I really wish you HADN'T stumbled upon the study for high intensity interval training ( although congrats on meeting your distance goal you set for yourself;) Anyway, right now I DON't have the energy to consider trying it, but I do have the trainer to talk to, so it will happen for me...anyway, keep on keeping on!

Dave Bexfield said...

Thanks for the link, Karen! Anon, awesome. Other Anon, details to come (traveling). And MnM, sorry, I have more news after talking to a leading MS researcher. More soon!

yorkie92 said...

I have yet to find a way to keep my temperature down. My hypothalamus is effed so have trouble managing changes. Even with strategically placed fans etc you cannot avoid an increase in body temperature which, in my case, can trigger a paroxysmal attack which bears all the hallmarks of a stroke and is a wretched nuisance, especially if I end up being carted off to hospital.

Dave Bexfield said...

Yorkie, yikes. There are potentially some solutions but they involve working out in a meat locker, moving to Antarctica, or pumping iron in the hospital gym. Hmm. I suppose you've tried cooling vests, etc?