Exercise and Cognitive Function in Multiple Sclerosis
Summary
Multiple sclerosis (MS) is an immune-mediated disorder of the central nervous system characterised by demyelination and neurodegeneration, often accompanied by cognitive impairment affecting processing speed, memory and executive function. Accumulating evidence indicates that structured exercise interventions—from moderate continuous training to high-intensity interval training (HIIT)—can support cognitive health in MS by promoting neuroplasticity, modulating inflammatory pathways and enhancing brain network integration. Neuroimaging studies reveal that regular physical activity is associated with increased functional and structural connectivity in critical regions such as the hippocampus, thalamus and cortical hubs. Moreover, exercise may alleviate fatigue and mood disturbances, indirectly bolstering cognitive performance. However, trial outcomes remain heterogeneous, reflecting variations in exercise modality, intensity, duration and participant characteristics. Recent work emphasises the need for mechanistic biomarkers, standardised cognitive end points and individualised approaches that account for baseline cognitive status. Integrating exercise into comprehensive MS management holds promise for preserving independence and quality of life on a global scale.
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Exercise and Cognitive Function in Multiple Sclerosis publication trend
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Technical terms
Neuroplasticity: The capacity of the central nervous system to reorganise structure and function in response to training or injury.
Functional connectivity: Statistical dependence between neuronal activity in distinct brain regions, typically measured by resting-state MRI to assess network integrity.
High-intensity interval training (HIIT): An exercise protocol alternating short bursts of near-maximal effort with periods of active recovery.
Neuroimaging biomarker: A measurable indicator obtained from imaging techniques that reflects neurological structure or function related to disease or intervention effects.
References
- The MoxFo initiative—Mechanisms of action: Biomarkers in multiple sclerosis exercise studies. Multiple Sclerosis Journal (2023).
- Neuroimaging Technology in Exercise Neurorehabilitation Research in Persons with MS: A Scoping Review. Sensors (2023).
- Aerobic Exercise Induces Functional and Structural Reorganization of CNS Networks in Multiple Sclerosis: A Randomized Controlled Trial. Frontiers in Human Neuroscience (2020).
- Cognitive Impairment Impacts Exercise Effects on Cognition in Multiple Sclerosis. Frontiers in Neurology (2021).
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