Systematic Review on Exercise Training as a Neuroplasticity-Inducing Behavior in Multiple Sclerosis

Area of Science:

• Neuroscience
• Rehabilitation Medicine
• Exercise Physiology

Background:

• Exercise training is linked to functional gains in multiple sclerosis (MS).
• Neuroplasticity is a proposed mechanism, but direct evidence is needed.
• Central nervous system changes must explain functional adaptations from exercise in MS.

Purpose of the Study:

• To systematically review studies on exercise, neuroimaging, and functional outcomes in MS.
• To evaluate evidence for exercise as a neuroplasticity-inducing behavior in MS.
• To assess studies against a conceptual model for exercise-induced neuroplasticity.

Main Methods:

• Comprehensive literature search for exercise interventions in MS with neuroimaging and functional outcomes.
• Included randomized controlled trials, pre/post designs, and quasi-experimental studies.
• Data extraction by four reviewers on participant/intervention characteristics, outcomes, and bias.

Main Results:

• Only 10 papers (8 interventions) met eligibility criteria for neuroplasticity inferences.
• Evidence is mixed regarding exercise-induced neuroplasticity in persons with MS.
• A small number of studies sufficiently examined hypothesized mechanisms of action.

Conclusions:

• A significant lack of evidence supports exercise-induced neuroplasticity in MS.
• Future research should investigate specific neural changes from targeted exercise prescriptions.
• Understanding mechanisms is crucial for optimizing exercise interventions for functional gains in MS.