Mixed Comparison of Different Exercise Interventions for Function, Respiratory, Fatigue, and Quality of Life in Adults With Amyotrophic Lateral Sclerosis: Systematic Review and Network Meta-Analysis

Zhu, Yining; Xu, Yining; Xuan, Rongrong; Huang, Jialu; Bíró, István; Fekete, Gusztáv; Gu, Yaodong

doi:10.3389/fnagi.2022.919059

Cited by 16 publications

(16 citation statements)

References 67 publications

(68 reference statements)

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“…at least 150 minutes per week of mild to moderate exercise, the Mediterranean diet, avoidance of smoking, and tailored lipid lowering therapies. As pointed out above, one recent meta-analysis showed beneficial effects of aerobic exercise in ALS, which is exercise on a treadmill, cycle ergometer, recumbent cycle, or with arm-leg ergometry in 2-3 training sessions/week [148]. One recent meta-analysis demonstrated ALS risk reduction through several anti-hypertensives with quite similar effects among angiotensin-converting enzyme inhibitors, beta-blockers, calcium-channel blockers, and diuretics, if taken regularly [37].…”

Section: Concluding Remarks On Vascular Rethinking In Als Managementmentioning

confidence: 93%

Brain Vascular Health in ALS Is Mediated through Motor Cortex Microvascular Integrity

Schreiber¹,

Bernal²,

Ulbrich³

et al. 2023

Preprint

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Brain vascular health appears to be of critical importance for protection against the development of amyotrophic lateral sclerosis (ALS) as well as the slowing of disease progression. ALS patients often demonstrate cardiovascular risk factors and commonly suffer from cerebrovascular disease, with evidence of pathological alterations in the small cerebral vessels. Impaired vascular brain health has detrimental effects on motor neurons as lowered vascular endothelial growth factor levels compromise endothelial cell formation, promoting blood-brain barrier leakage and inflammation. Increased turnover of neurovascular unit cells precedes their senescence, which, together with pericyte alterations, further fosters the failure of toxic metabolite removal. We here provide a comprehensive overview of the pathogenesis of impaired brain vascular health in ALS and how novel magnetic resonance imaging techniques can aid its detection. In particular, we discuss vascular patterns of blood supply to the motor cortex with the number of branches from the anterior and middle cerebral arteries acting as a novel marker of resistance and resilience against downstream effects of vascular risk and events in ALS. We outline how certain interventions adapted to patient needs and capabilities have the potential to mechanistically target the brain microvasculature towards favorable motor cortex blood supply patterns. Through this strategy, we aim to guide novel approaches to ALS management and a better understanding of ALS pathophysiology.

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Section: Concluding Remarks On Vascular Rethinking In Als Managementmentioning

confidence: 93%

Brain Vascular Health in ALS Is Mediated through Motor Cortex Microvascular Integrity

Schreiber¹,

Bernal²,

Ulbrich³

et al. 2023

Preprint

View full text Add to dashboard Cite

show abstract

“…A recent meta-analysis considering randomized controlled trials of aerobic and resistance exercise training in ALS showed that patients benefit in terms of motor function, increasing their resilience to disease [ 148 ]. However, as the majority of ALS patients suffer from progressive widespread motor symptoms, several forms of effective exercise such as aerobic training become increasingly inaccessible during the course of disease.…”

Section: Targeting Brain Vascular Health To Preserve Microvascular In...mentioning

confidence: 99%

“…This includes physical activity, i.e., at least 150 min per week of mild to moderate exercise, the Mediterranean diet, avoidance of smoking, and tailored lipid-lowering therapies. As pointed out above, one recent meta-analysis showed beneficial effects of aerobic exercise in ALS, which is exercise on a treadmill, cycle ergometer, recumbent cycle or with arm-leg ergometry in two–three training sessions/week [ 148 ]. One recent meta-analysis demonstrated ALS risk reduction through several anti-hypertensives with quite similar effects among angiotensin-converting enzyme inhibitors, beta-blockers, calcium-channel blockers and diuretics, if taken regularly [ 37 ].…”

Section: Concluding Remarks On Vascular Rethinking In Als Managementmentioning

confidence: 99%

Brain Vascular Health in ALS Is Mediated through Motor Cortex Microvascular Integrity

Schreiber

Bernal

Ulbrich

et al. 2023

Cells

View full text Add to dashboard Cite

Brain vascular health appears to be critical for preventing the development of amyotrophic lateral sclerosis (ALS) and slowing its progression. ALS patients often demonstrate cardiovascular risk factors and commonly suffer from cerebrovascular disease, with evidence of pathological alterations in their small cerebral blood vessels. Impaired vascular brain health has detrimental effects on motor neurons: vascular endothelial growth factor levels are lowered in ALS, which can compromise endothelial cell formation and the integrity of the blood–brain barrier. Increased turnover of neurovascular unit cells precedes their senescence, which, together with pericyte alterations, further fosters the failure of toxic metabolite removal. We here provide a comprehensive overview of the pathogenesis of impaired brain vascular health in ALS and how novel magnetic resonance imaging techniques can aid its detection. In particular, we discuss vascular patterns of blood supply to the motor cortex with the number of branches from the anterior and middle cerebral arteries acting as a novel marker of resistance and resilience against downstream effects of vascular risk and events in ALS. We outline how certain interventions adapted to patient needs and capabilities have the potential to mechanistically target the brain microvasculature towards favorable motor cortex blood supply patterns. Through this strategy, we aim to guide novel approaches to ALS management and a better understanding of ALS pathophysiology.

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“…In predisposed patients, very intense physical activity may simultaneously act on changing cortical plasticity in the motor cortex and in stressing muscles. The role of physical exercise in ALS was recently pointed out in a work by Julian et al [52] that demonstrated that ALS shares polygenic risk genetic factors with several conditions, among which moderate to high levels of exercise. Transcriptomic analysis corroborated this result, revealing that genes whose expression resulted altered in acute exercise were enriched with known ALS risk genes (including C9ORF72), and with ALS-associated variants of unknown significance [6].…”

Section: Treatment Of Fatigue and The Role Of Exercise In Als Patientsmentioning

confidence: 99%

Muscle fatigue and exercise-related biomarkers in amyotrophic lateral sclerosis

Bianchi

Becattini

Chico

et al. 2023

Explor Neuroprot Ther

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Amyotrophic lateral sclerosis (ALS) is a devastating neurodegenerative disorder affecting motor neurons. The complex etiopathogenetic mechanism of ALS can lead to extensive alterations, including cortical changes, neuroinflammation, and changes in muscular structure. These ALS-derived alterations may contribute to fatigue, a symptom severely impacting patients’ quality of life that is commonly associated with muscular exercise. Intriguingly, muscular exercise can be at once a promoter of motor neuron degeneration in predisposed patients as well as an effective non-pharmacological treatment of ALS. To fully disclose its therapeutic potential, muscular exercise must be tailored to patients’ phenotypes, balancing potential benefits and risks that are unique to each ALS case. Biomarkers of muscular fatigue, with their potential for insight into inflammation and oxidation, can be used to ensure that the intensity of physical activity remains below the threshold level beyond which exercise might become harmful. In this review, the authors explore the concept of fatigue in ALS patients, focusing on fatigue generation, definition, detection, quantification, and treatment. The study discusses the most important fatigue biomarkers, putting them in relation to the mechanism of fatigue generation and with monitoring of muscular exercise as a possible treatment of fatigue.

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Mixed Comparison of Different Exercise Interventions for Function, Respiratory, Fatigue, and Quality of Life in Adults With Amyotrophic Lateral Sclerosis: Systematic Review and Network Meta-Analysis

Cited by 16 publications

References 67 publications

Brain Vascular Health in ALS Is Mediated through Motor Cortex Microvascular Integrity

Brain Vascular Health in ALS Is Mediated through Motor Cortex Microvascular Integrity

Brain Vascular Health in ALS Is Mediated through Motor Cortex Microvascular Integrity

Muscle fatigue and exercise-related biomarkers in amyotrophic lateral sclerosis

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