title: Blunted pressor and intramuscular metabolic responses to voluntary isometric exercise in multiple sclerosis.
abstract: To test the hypothesis that a lower mean arterial pressure (MAP) response during voluntary isometric exercise in multiple sclerosis (MS) is related to a dampened muscle metabolic signal, 9 MS and 11 control subjects performed an isometric dorsiflexor contraction at 30% maximal voluntary contraction until target failure (endurance time). We made continuous and noninvasive measurements of heart rate and MAP (Finapres) and of intramuscular pH and P(i) (phosphorus magnetic resonance spectroscopy) in a subset of 6 MS and 10 control subjects. Endurance times and change in heart rate were similar in MS and control subjects. The decrease in pH and increase in P(i) were less throughout exercise in MS compared with control subjects, as was the change in MAP response. Differences in muscle strength accounted for some of the difference in MAP response between groups. Cardiovascular responses during Valsalva and cold pressor tests were similar in MS and control subjects, suggesting that the blunted MAP response during exercise in MS was not due to a generalized dysautonomia. The dampened metabolic response in MS subjects was not explained by inadequate central muscle activation. These data suggest that the blunted pressor response to exercise in MS subjects may be largely appropriate to a blunted muscle metabolic response and differences in contracting muscle mass.
authors.affiliation: Department of Radiology, University of California, San Francisco, California 94121, USA. alexng@itsa.ucsf.edu
authors.forename: A V
authors.initials: AV
authors.lastname: Ng
authors.forename: H T
authors.initials: HT
authors.lastname: Dao
authors.forename: R G
authors.initials: RG
authors.lastname: Miller
authors.forename: D F
authors.initials: DF
authors.lastname: Gelinas
authors.forename: J A
authors.initials: JA
authors.lastname: Kent-Braun
mesh_terms: D000328:Adult; D001341:Autonomic Nervous System / Q000503:physiopathology; D001794:Blood Pressure / Q000502:physiology*; D016022:Case-Control Studies; D003080:Cold Temperature; D004576:Electromyography; D005260:Female; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D006863:Hydrogen-Ion Concentration; D007537:Isometric Contraction / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000378:metabolism* / Q000503:physiopathology*; D018763:Muscle Fatigue / Q000502:physiology; D018482:Muscle, Skeletal / Q000378:metabolism*; D010710:Phosphates / Q000378:metabolism; D010725:Phosphocreatine / Q000378:metabolism; D014636:Valsalva Maneuver
chemical_list: D010710:Phosphates; D010725:Phosphocreatine