A panel of experts in multiple sclerosis (MS) research recommends a structured approach to studying mechanisms of exercise training to improve outcomes in multiple sclerosis (MS). In a review article, “Focusing on the neural mechanisms of the benefits of exercise in multiple sclerosis,” (doi: 10.1016/j.msard.2024.105633) published in Multiple sclerosis and related disorders on April 16, 2024, emphasize the value of adopting an experimental medicine framework to optimize the development, evaluation, and implementation of exercise interventions in MS rehabilitation.
MS is a chronic and often disabling disease of the central nervous system (CNS) that impairs motor and cognitive function, affecting millions of people worldwide. Although pharmacological treatments are effective in preventing MS relapses, they are not designed to improve functions adversely affected by the disease. Exercise has been recognized as an effective intervention with the potential to improve the neurological symptoms of MS. However, its potential has not been fully exploited due to inconsistent methodologies in the field of exercise science and a lack of understanding of the underlying mechanisms.
“By understanding how exercise affects CNS function in MS, we can design and optimize interventions that improve mobility, cognition, and quality of life,” said lead author Brian M. Sandroff, PhD, assistant director of the Center for Neuropsychology and of Neuroscience Research at the Kessler Foundation, and director of the Center’s Neurorehabilitation Research Laboratory.
In the article, Sandroff and colleagues review the current literature on exercise training in MS and outline an experimental medicine framework as a pathway to accelerate progress in the field to better integrate exercise training into MS rehabilitation protocols. This framework involves four main steps: identifying CNS targets for intervention, selecting outcomes that reflect CNS targets, developing interventions that modulate those targets, and conducting robust clinical trials to precisely determine the extent to which changes in CNS targets are the reason for the exercise. -related improvements in clinical outcomes.
Adopting this framework and collaborating across disciplines enhances communication between basic research and clinical applications, helping practitioners translate findings into real-world therapeutic interventions. This systematic approach will increase our progress towards evidence-based protocols, ultimately enhancing the rehabilitation outcomes of exercise for people with MS.”
Brian M. Sandroff, PhD, assistant director of the Center for Neuropsychology and Neuroscience Research at the Kessler Foundation
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Journal Reference:
Sandroff, BM, et al. (2024). Focusing on the Neural Mechanisms of Exercise Benefits in Multiple Sclerosis. Multiple sclerosis and related disorders. doi.org/10.1016/j.msard.2024.105633.
