MS is characterized by inflammation, loss of myelin (the protective sheath that covers nerve axons) and axonal degeneration in the central nervous system, leading to a loss of neural functions. Recent studies suggest that physical activity is essential for people with MS as it improves walking, balance, cognition, fatigue and depression, contributing to a better quality of life.
Previous research in the elderly also showed a link between higher levels of physical activity and improvements in neural activity. However, few studies have explored how exercise impacts the brain of MS patients.
They evaluated 153 MS patients (104 women and 49 men), with a mean age of 39.3, recruited at the Multiple Sclerosis Center, Sheba Medical Center in Israel.
Physical activity was accessed using the Godin Leisure-Time Exercise Questionnaire (GLTEQ), a self-reported measure of the frequency of strenuous (i.e., jogging), moderate (fast walking), and mild (walking) exercise.
Exercises were considered if done for at least 15 minutes each week, and the researchers tallied scores based on valid periods of weekly exercises reported. Patients who scored at least 14 points were classified as active, while those with fewer points were considered insufficiently active.
According to these GLTEQ scores, the group was divided into 77 active patients and 76 insufficiently active.
Active group participants were more frequently women (a total of 46), patients with lesser disability (an average Expanded Disability Status Scale, EDSS, score of 2) and had better cognition compared with the insufficiently active group. The active group also had better information processing speeds (average score, 97.6 vs. 89.7) and cognitive motor skills (average score, 100.2 vs. 93.1).
Lesser brain atrophy was found in active group patients, compared to inactive ones, in regions that included the right amygdala, brain stem, left and right hippocampus — all within the brain’s subcortical region that controls cognitive, affective and social functions.
When controlling for age, gender and total cranial volume, the right hippocampus remained significantly larger in the active group (4,209 vs 3,936.8 cubic millimeters or mm3), the researchers reported.
A separate analysis showed the left hippocampus was significantly different between active and insufficiently active patients, and remained so after controlling for disability scores and cognition.
“The hippocampus appears to be the most prominent subcortical region affected by physical activity in PwMS [people with MS],” the researchers wrote.
MS patients who “regularly participate in leisure-time physical activities, in accordance with basic public health recommendations, maintain their hippocampal volume, regardless of their disability and cognitive capabilities,” the team concluded.
The National MS Society made available recommendations on exercises and physical activity for all MS patients, and videos and guidelines can be found on its website. Recommendations for specialists and other healthcare providers to encourage more exercise by patients are outlined in a study available here.
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