Physical activity may contribute to brain health in multiple sclerosis: An MR volumetric and spectroscopy study

Abstract

Background and Purpose: Physical activity may represent a disease-modifying therapy in persons with multiple sclerosis (pwMS). To date, there is limited research regarding mechanisms based on brain imaging for understanding the beneficial effects of physical activity in pwMS. This study examined the relationship between physical activity levels and thalamic and hippocampal volumes and brain metabolism in pwMS. Methods:The sample of 52 pwMS (37.3 ± 9.6 years of age; 35 females, 17 males) underwent a combination of volumetric magnetic resonance imaging and magnetic resonance spectroscopy. Current and lifetime physical activity were assessed using actigraphy and the adapted version of the Historical Activity Questionnaire, respectively.Results: Positive associations were observed between both actigraphy and selfreported levels of moderate-to-vigorous physical activity (MVPA) and thalamic and hippocampal volumes. Regarding brain metabolism, actigraphy and self-reported levels of MVPA were positively associated with higher hippocampal and thalamic levels of Nacetylaspartate/creatine ratio (NAA/Cr: marker of neural integrity and cell energy state). Conclusions:This study provides novel evidence for a positive association between physical activity and thalamic and hippocampal volume and metabolism in pwMS. These findings support the hypothesis that physical activity, particularly MVPA, may serve as a disease-modifying treatment by improving brain health in pwMS.

Towards new perspectives: A scoping review and meta‐synthesis to redefine brain health for multiple sclerosis

“…Of the 169 studies retrieved for full text review, 70 key evidence sources were included for charting. This included 34 peer‐reviewed (49%) [10–12, 35–64] studies and 36 grey literature (51%) [65–100] evidence sources (Figure 1) [10–12, 35–100]. A list of the included sources is reported in the charting matrix (Tables S2 and S3).…”

“…Forty evidence sources (57%) defined, described and/or cited a definition of brain health [10–12, 35, 37, 38, 41, 43, 45, 49–52, 54–57, 59–63, 66–68, 71, 72, 74, 75, 78, 79, 81, 82, 86, 90–92, 94, 99, 100]. Of these, 18 (45%) authors provided their own theoretical statements, reflecting the content and use of the concept brain health in the MS literature [10, 38, 45, 49–52, 54, 57, 59, 61, 63, 71, 79, 81, 91, 92, 100]. At times, multiple themes were reflected in a single definition.…”

“…At times, multiple themes were reflected in a single definition. It was common for brain health to be used as an umbrella term to describe brain structure, function or pathology ( n = 11, 28%) in the context of MS [38, 49–52, 54, 57, 61, 63, 82, 90]. The four themes, with exemplary definitions of how brain health was used, are described below.…”

“…Nineteen (48%) definitions of brain health alluded to anatomical or structural properties of the brain to describe the impact(s) of disease‐related pathology on overall brain health [11, 12, 37, 38, 43, 49–52, 54, 57, 59, 61, 63, 68, 78, 82, 88, 90]. This included nerve cells, neuronal loss, brain and lesion volume, brain atrophy, metabolites, and inflammation.…”

“…News articles were the most common grey literature evidence source (n = 13, 19%) [65,68,71,74,76,80,84,89,91,93,[96][97][98] followed by web pages about brain health (n = 7, 10%) [72, 73, 86-88, 92, 100]. Cross-sectional studies were the most common design from peer-reviewed literature sources (n = 11, 16%) [12,37,38,43,49,50,52,53,58,60,62] and only 6% (n = 4) of included evidence sources reported studies of experimental design, including randomized (n = 3) [40,45,48] and non-randomized (n = 1) trials [39]. Twenty-five peer-reviewed evidence sources included participant characteristics totalling 4520 adults diagnosed with MS, of whom 64% were women.…”