Aerobic Exercise Promising for Restoring Function in Individuals with Multiple Sclerosis

Multiple Sclerosis (MS) is a chronic inflammatory, autoimmune, and neurodegenerative disease of the central nervous system (CNS). MS affects approximately 2.5 million people worldwide. High prevalence of MS is seen in northern parts of Europe and North America.

Multiple sclerosis (MS) is a potentially disabling disease of the brain and spinal cord (central nervous system).

In MS, the immune system attacks the protective sheath (myelin) that covers nerve fibers and causes communication problems between your brain and the rest of your body. Eventually, the disease can cause permanent damage or deterioration of the nerves.

It is characterized by demyelination and neuronal loss that is induced by attack of autoreactive T cells to the myelin sheath and endogenous remyelination failure, leading to functional neurological disability. Its very complex pathogenesis is not completely understood. 

MS-related thalamic atrophy is a major biomarker for neurodegeneration and associated physical and cognitive decline, highlighting the importance of exploring ways to restore and maintain function in individuals who present with this consequence of the disease. Aerobic exercise training is one promising approach, but little is known about its potential effects in individuals who present with thalamic atrophy.

Exercise can restore function in thalamic atrophy 

The team conducted a cross-sectional study to examine the associations among aerobic fitness, cognitive processing speed, and walking endurance in individuals with and without thalamic atrophy. Subjects comprised 44 fully ambulatory individuals with MS from three randomized controlled trials. Outcomes included aerobic fitness (peak oxygen consumption during graded treadmill exercise), processing speed (Symbol Digit Modalities Test), walking endurance (6-min walk test), and thalamic neuroimaging.

Results provided initial evidence for strong and selective associations among aerobic fitness, cognitive processing speed, and walking endurance in individuals with thalamic atrophy, according to lead author Dr. Sandroff. “This study suggests that aerobic exercise training has the potential to restore function in individuals with thalamic atrophy, who are clearly at risk for progressive physical and cognitive decline,” he stated. “To explore the impact on outcomes, we need to develop randomized controlled trials of aerobic exercise training in the subgroup presenting with thalamic atrophy.”

SOURCE:

Brian M. Sandroff, Robert W. Motl, Cristina A. F. Román, Glenn R. Wylie, John DeLuca, Gary R. Cutter, Ralph H. B. Benedict, Michael G. Dwyer, Robert Zivadinov. Thalamic atrophy moderates associations among aerobic fitness, cognitive processing speed, and walking endurance in persons with multiple sclerosis. Journal of Neurology, 2022; 269 (10): 5531 DOI: 10.1007/s00415-022-11205-9

https://www.mayoclinic.org/diseases-conditions/multiple-sclerosis/symptoms-causes/syc-20350269

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