Resistance Training Can Slow MS Patients’ Brain Shrinkage, Clinical Trial Indicates

Resistance training like weight lifting can protect or even regenerate the nerve cells of relapsing-remitting multiple sclerosis patients, slowing the progression of the disease, according to a clinical trial.

A hallmark of MS is the brain shrinking faster than normal, and the trial (NCT01518660) indicates that resistance training can slow the shrinking or even make some brain areas grow.

The research, “Can resistance training impact MRI outcomes in relapsing-remitting multiple sclerosis?,” was published in the Multiple Sclerosis Journal.

Research has shown that physical training benefits MS patients, helping them alleviate many symptoms, including excessive fatigue and balance control problems. Recent studies suggest that exercise can have a disease-modifying role in MS. This means physical activity can be an important adjuvant, or add-on therapy, for standard-of-care regimens.

“Over the past six years, we have been pursuing the idea that physical training has effects on more than just the symptoms, and this study provides the first indications that physical exercise may protect the nervous system against the disease,” Ulrik Dalgas, an associate professor in the Department of Public Health at Aarhus University in the Netherlands, said in a news release. He was senior author of the study.

Researchers from Aarhus University, Aarhus University Hospital, the University of Southern Denmark in Odense, and the University Medical Center Hamburg-Eppendorf in Germany followed 35 patients with relapsing-remitting MS for 24 weeks.

Eighteen patients did resistance training twice a week, consisting of four lower- and two upper-body exercises. The other 17 patients struck with their normal routines.

Before and after the 24 weeks, doctors took magnetic resonance imaging scans, or MRIs, to evaluate patients’ brain structures. After the 24 weeks, the scans showed less brain shrinkage in those who had resistance training. Some of their cortical brain regions were also thicker — an indication they were growing.

“Among persons with multiple sclerosis, the brain shrinks markedly faster than normal,” Dalgas said. “Drugs can counter this development, but we saw a tendency that training further minimizes brain shrinkage in patients already receiving medication. In addition, we saw that several smaller brain areas actually started to grow in response to training.”

It is not clear why exercise benefits MS patients’ brains, nor if exercise has the same effect on all patients. Additional studies are needed to clarify its therapeutic effect, the researchers said. That knowledge could help improve current MS therapies.

“Phasing out drugs in favor of training is not realistic,” Dalgas said. “On the other hand, the study indicates that systematic physical training can be a far more important supplement during treatment than has so far been assumed. This aspect needs to be thoroughly explored.”