Improvement in cognitive impairment following a 12-week aerobic exercise intervention in individuals with non-cirrhotic chronic hepatitis C
Corresponding Author
Philip O’Gorman
Discipline of Physiotherapy, Trinity College, The University of Dublin, Dublin, Ireland
Correspondence
Philip O’Gorman, Discipline of Physiotherapy, Trinity Centre for Health Sciences, St James’s Hospital, Dublin, Ireland.
Search for more papers by this authorOrla Strahan
School of Psychology, Trinity College, The University of Dublin, Dublin, Ireland
Search for more papers by this authorDamien Ferguson
Academic Unit of Neurology, Trinity College, The University of Dublin, Dublin, Ireland
Department of Neurology, St James’s Hospital, Dublin, Ireland
Search for more papers by this authorAnn Monaghan
Discipline of Physiotherapy, Trinity College, The University of Dublin, Dublin, Ireland
Search for more papers by this authorMegan Kennedy
Discipline of Physiotherapy, Trinity College, The University of Dublin, Dublin, Ireland
Search for more papers by this authorCuisle Forde
Discipline of Physiotherapy, Trinity College, The University of Dublin, Dublin, Ireland
Search for more papers by this authorAshanty M. Melo
Discipline of Immunology, Trinity College, The University of Dublin, Dublin, Ireland
Search for more papers by this authorDerek G. Doherty
Discipline of Immunology, Trinity College, The University of Dublin, Dublin, Ireland
Search for more papers by this authorKelly K. O’Brien
Department of Physical Therapy, University of Toronto, Toronto, ON, Canada
Institute of Health Policy, Management and Evaluation (IHPME), University of Toronto, Toronto, ON, Canada
Rehabilitation Sciences Institute (RSI), University of Toronto, Toronto, ON, Canada
Search for more papers by this authorSusan McKiernan
Department of Clinical Medicine, Trinity College, The University of Dublin, Dublin, Ireland
Department of Hepatology, St James’s Hospital, Dublin, Ireland
Search for more papers by this authorRose Anne Kenny
The Irish Longitudinal Study on Ageing (TILDA), Trinity College, The University of Dublin, Dublin, Ireland
Mercer’s Institute for Successful Ageing, St James’s Hospital, Dublin, Ireland
Search for more papers by this authorRobert Coen
Mercer’s Institute for Successful Ageing, St James’s Hospital, Dublin, Ireland
Search for more papers by this authorColin Doherty
Academic Unit of Neurology, Trinity College, The University of Dublin, Dublin, Ireland
Department of Neurology, St James’s Hospital, Dublin, Ireland
FutureNeuro Centre for Rare and Chronic Diseases, Royal College of Surgeons in Ireland, Dublin, Ireland
Search for more papers by this authorColm Bergin
Department of Genito-Urinary Medicine and Infectious Diseases, St James’s Hospital, Dublin, Ireland
Department of Clinical Medicine, Trinity College, The University of Dublin, Dublin, Ireland
Search for more papers by this authorJohn Gormley
Discipline of Physiotherapy, Trinity College, The University of Dublin, Dublin, Ireland
Search for more papers by this authorSuzanne Norris
Department of Hepatology, St James’s Hospital, Dublin, Ireland
Department of Clinical Medicine, Trinity College, The University of Dublin, Dublin, Ireland
Search for more papers by this authorCorresponding Author
Philip O’Gorman
Discipline of Physiotherapy, Trinity College, The University of Dublin, Dublin, Ireland
Correspondence
Philip O’Gorman, Discipline of Physiotherapy, Trinity Centre for Health Sciences, St James’s Hospital, Dublin, Ireland.
Search for more papers by this authorOrla Strahan
School of Psychology, Trinity College, The University of Dublin, Dublin, Ireland
Search for more papers by this authorDamien Ferguson
Academic Unit of Neurology, Trinity College, The University of Dublin, Dublin, Ireland
Department of Neurology, St James’s Hospital, Dublin, Ireland
Search for more papers by this authorAnn Monaghan
Discipline of Physiotherapy, Trinity College, The University of Dublin, Dublin, Ireland
Search for more papers by this authorMegan Kennedy
Discipline of Physiotherapy, Trinity College, The University of Dublin, Dublin, Ireland
Search for more papers by this authorCuisle Forde
Discipline of Physiotherapy, Trinity College, The University of Dublin, Dublin, Ireland
Search for more papers by this authorAshanty M. Melo
Discipline of Immunology, Trinity College, The University of Dublin, Dublin, Ireland
Search for more papers by this authorDerek G. Doherty
Discipline of Immunology, Trinity College, The University of Dublin, Dublin, Ireland
Search for more papers by this authorKelly K. O’Brien
Department of Physical Therapy, University of Toronto, Toronto, ON, Canada
Institute of Health Policy, Management and Evaluation (IHPME), University of Toronto, Toronto, ON, Canada
Rehabilitation Sciences Institute (RSI), University of Toronto, Toronto, ON, Canada
Search for more papers by this authorSusan McKiernan
Department of Clinical Medicine, Trinity College, The University of Dublin, Dublin, Ireland
Department of Hepatology, St James’s Hospital, Dublin, Ireland
Search for more papers by this authorRose Anne Kenny
The Irish Longitudinal Study on Ageing (TILDA), Trinity College, The University of Dublin, Dublin, Ireland
Mercer’s Institute for Successful Ageing, St James’s Hospital, Dublin, Ireland
Search for more papers by this authorRobert Coen
Mercer’s Institute for Successful Ageing, St James’s Hospital, Dublin, Ireland
Search for more papers by this authorColin Doherty
Academic Unit of Neurology, Trinity College, The University of Dublin, Dublin, Ireland
Department of Neurology, St James’s Hospital, Dublin, Ireland
FutureNeuro Centre for Rare and Chronic Diseases, Royal College of Surgeons in Ireland, Dublin, Ireland
Search for more papers by this authorColm Bergin
Department of Genito-Urinary Medicine and Infectious Diseases, St James’s Hospital, Dublin, Ireland
Department of Clinical Medicine, Trinity College, The University of Dublin, Dublin, Ireland
Search for more papers by this authorJohn Gormley
Discipline of Physiotherapy, Trinity College, The University of Dublin, Dublin, Ireland
Search for more papers by this authorSuzanne Norris
Department of Hepatology, St James’s Hospital, Dublin, Ireland
Department of Clinical Medicine, Trinity College, The University of Dublin, Dublin, Ireland
Search for more papers by this authorAbstract
Cognitive impairment occurs in 30%–50% of patients with non-cirrhotic chronic hepatitis C virus (HCV) infection. Exercise is beneficial in preventing and treating cognitive impairment and cardiometabolic abnormalities in many chronic inflammatory diseases, but there are few studies investigating the impact of exercise in HCV infection. The study aimed to assess the effect of a 12-week aerobic exercise intervention on cognition and extrahepatic manifestations in individuals with HCV. In this nonrandomized controlled pilot study, individuals with HCV participated in a 12-week aerobic exercise intervention. Outcome measures included cognition (Montreal Cognitive Assessment [MOCA], Trail Making Test A & B [TMT-A; TMT-B], Digit Symbol Test [DST]), cardiorespiratory fitness (estimated 
), physical activity (accelerometry), anthropometry, quality of life (depression; fatigue; sleep quality) and biochemical markers. Outcomes were assessed at baseline (T0), intervention completion (T1) and 12 weeks after intervention completion (T2). Thirty-one patients completed the study (exercise group n = 13, control group n = 18). In the exercise group, cognition improved at T1 in the TMT-A (31% mean improvement, p = 0.019), TMT-B (15% mean improvement, p = 0.012) time and MOCA (14% mean improvement, p ≤ 0.001). These improvements were not maintained at T2. Depression (p = 0.038), sleep quality (p = 0.002), fatigue (p = 0.037) and estimated 
(7.8 mL kg−1 min−1 [22%] mean increase, p = 0.004) also improved at T1. In conclusion, this study demonstrates the benefits of a 12-week aerobic exercise intervention in improving cognition, quality of life and cardiorespiratory fitness in individuals with HCV. Larger studies are needed to confirm these findings and strategies for continued exercise engagement in individuals with HCV are warranted for sustained benefits.
Open Research
DATA AVAILABILITY STATEMENT
Data availability statement: All data are available upon reasonable request from the authors.
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