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The Multiple Sclerosis Performance Test (MSPT): An iPad-Based Disability Assessment Tool
11:35

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Published on: June 30, 2014

Is metabolic flexibility altered in multiple sclerosis patients?

Anja Mähler1, Jochen Steiniger, Markus Bock

  • 1Experimental and Clinical Research Center, A Joint Cooperation between the Charité University Medicine Berlin and Max Delbrueck Center for Molecular Medicine, Berlin, Germany.

Plos One
|September 7, 2012
PubMed
Summary

Multiple sclerosis patients show altered fuel metabolism, with higher carbohydrate oxidation and lower lipid oxidation at rest and during exercise. This metabolic inflexibility may contribute to exercise intolerance in MS.

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Area of Science:

  • Metabolic research
  • Exercise physiology
  • Neurology

Background:

  • Metabolic flexibility, the ability to adapt fuel oxidation to availability, is crucial for energy homeostasis.
  • Multiple sclerosis (MS) is associated with muscle weakness and exercise intolerance.
  • Altered metabolic flexibility is hypothesized to contribute to exercise intolerance in MS patients.

Purpose of the Study:

  • To investigate whether altered metabolic flexibility contributes to exercise intolerance in multiple sclerosis patients.
  • To compare fuel oxidation rates and metabolic responses to glucose loading between MS patients and healthy controls.

Main Methods:

  • Studied 16 MS patients (on glatiramer) and 16 controls.
  • Measured energy expenditure, carbohydrate (COX), and lipid oxidation (LOX) via indirect calorimetry at rest and during low-grade exercise.
  • Analyzed plasma and tissue (adipose, muscle) metabolites using microdialysis.

Main Results:

  • MS patients exhibited higher resting COX and lower LOX compared to controls.
  • Adipose tissue showed higher glucose, lactate, and glycerol levels in MS patients.
  • During exercise, MS patients displayed a rapid, unstable increase in COX, falling below baseline post-exercise, unlike controls.

Conclusions:

  • MS patients do not show impaired glucose tolerance or skeletal muscle metabolic inflexibility at rest.
  • Increased adipose tissue lipolysis in MS patients may be linked to glatiramer treatment.
  • Autonomic dysfunction could underlie dysregulated thermogenesis and lipid mobilization in MS.