Blood-brain barrier (BBB) and neurotrophic factors seemingly have an important role in multiple sclerosis pathology. Physical activity may influence blood-brain barrier function and levels of neurotrophic factors, and such effects might be moderated by body weight status. This study investigated the effect of exercise training on markers of blood-brain barrier permeability and neurotrophic factors as a function of weight status in multiple sclerosis patients. Sixty three persons with relapsing remitting multiple sclerosis who were normal weight (n: 33) or overweight (n: 33) were randomly assigned into groups of exercise (normal weight training, n: 18; overweight training group, n: 18) or no exercise (normal weight control, n: 15; overweight control group, n: 15). The intervention consisted of 8 weeks (3 days per week) of cycling undertaken at 60-70% peak power. Resting blood concentrations of s100 calcium-binding protein B (s100b) and neuron-specific enolase as BBB permeability markers, neurotrophic factors and cytokines (Interleukin-10 and tumor necrosis factor alpha) were evaluated before and after the intervention. There were significant weight, training, and interaction effects on brain-derived neurotrophic factor and platelet-derived growth factor; however, ciliary neurotrophic factor and nerve growth factor did not demonstrate any effect. Brain-derived neurotrophic factor and platelet-derived growth factor were significantly increased from pre-post in normal weight exercise. Significant weight, training, and interaction effects were found for s100b. In detail, s100b was significantly increased from pre-post in normal weight exercise. In contrast, neuron-specific enolase and cytokines did not demonstrate any effect. Generally, Exercise training may alter markers of BBB permeability and neurotrophic factor status in normal weight persons with multiple sclerosis; however, overweight participants may be more resistant to these effects of exercise.

Background and purpose Multiple sclerosis (MS) is a demyelinating and neurodegenerative disease of the central nervous system (CNS) that can be tracked through biomarkers of disease status. We investigated the effects of exercise on MS biomarkers associated with CNS status including imaging, blood–brain barrier (BBB) function and neurotrophic factors. Methods We conducted open‐dated searches of Scopus, Medline, EMBASE and the Cochrane Library. We included studies written in English describing interventions of exercise that measured one or more of the biomarkers associated with MS published up to October 2018. Results We located a total of 3012 citations through searches in electronic databases. Of these, 16 studies were eligible for review; six studies focused on magnetic resonance imaging (MRI) markers, nine studies focused on neurotrophic factors and three studies focused on BBB function markers. It is of note that two studies included both neurotrophic factor and BBB function markers and are therefore included across categories of biomarkers in this review. The existing evidence from MRI studies confirmed that exercise training can improve CNS integrity and function. There is evidence of a positive effect of exercise training on modulation of BBB permeability markers and brain‐derived neurotrophic factor. Conclusions Exercise successfully improves MRI outcomes and peripheral biomarkers (i.e. brain‐derived neurotrophic factor) in people with MS. This suggests that exercise can be recommended as an adjuvant therapy for MS treatment. This conclusion is tempered by some methodological limitations including small sample sizes and high drop‐out rates in the reviewed studies.

Research regarding the effects of exercise training on cytokines and adipokines in MS is in its infancy, but exercise represents an adjuvant therapy in MS, and future studies are essential for clarifying the role of exercise on cytokines and adipokines in MS.

The aim of the present study was to investigate the effects of different forms of caffeine administration on physical performance during a simulated wrestling tournament. In a double-blind and randomized experiment, twelve male freestyle wrestlers competed in a simulated wrestling tournament (5 wrestling matches consisting of 2 × 3-min wrestling rounds) following the ingestion of: a placebo, a high-dose of caffeine (10 mg/kg), a moderate-dose caffeine (4 mg/kg), a repeated-dose caffeine (2 mg/kg before each match to a total of 10 mg/kg) or a selective caffeine administration based on performance decrement previously measured (6.16 ± 1.58 mg/kg). The Pittsburgh Wrestling Performance Test (PWPT) was measured before each match to assess physical performance. In comparison to the placebo, the high dose of caffeine only reduced PWPT time before the first match (56.8 ± 2.0 vs. 52.9 ± 1.8 s; p < .05). The moderate dose of caffeine did not affect PWPT performance during the tournament. Both, the repeated dose and the selective administration of caffeine reduced PWPT time with respect to the placebo in the third (66.7 ± 1.8 vs. 63.1 ± 1.4 s; p < .05) and fourth matches (72.3 ± 2.4 vs. 65.9 ± 1.3 s; p < .05). However, only the selective dose of caffeine reduced PWPT time before the fifth match (62.7 ± 3.0 vs. 56.3 ± 2.0; p < .05). The dosage and administration of caffeine affect the ergogenic effects obtained following the ingestion of this substance. An individualized protocol to provide caffeine when physical performance is expected to be reduced might improve wrestling performance during the latter stages of a tournament.

The results from this study confirm that exercise is an effective therapeutic intervention for improving fatigue, depression and functional parameters, independent of initial weight status, in persons with MS.