CEMEREM, APHM La Timone, 264 Rue Saint-Pierre, 13385, Marseille, France.
CNRS, CRMBM, UMR 7339, Aix-Marseille Univ, Marseille, France.
J Neurol. 2023 Oct;270(10):4876-4888. doi: 10.1007/s00415-023-11806-y. Epub 2023 Jun 21.
Neurodegeneration leads to continuous accumulation of disability in progressive Multiple Sclerosis (MS). Exercise is considered to counteract disease progression, but little is known on the interaction between fitness, brain networks and disability in MS.
The aim of this study to explore functional and structural brain connectivity and the interaction between fitness and disability based on motor and cognitive functional outcomes in a secondary analysis of a randomised, 3-month, waiting group controlled arm ergometry intervention in progressive MS.
We modelled individual structural and functional brain networks based on magnetic resonance imaging (MRI). We used linear mixed effect models to compare changes in brain networks between the groups and explore the association between fitness, brain connectivity and functional outcomes in the entire cohort.
We recruited 34 persons with advanced progressive MS (pwMS, mean age 53 years, females 71%, mean disease duration 17 years and an average walking restriction of < 100 m without aid). Functional connectivity increased in highly connected brain regions of the exercise group (p = 0.017), but no structural changes (p = 0.817) were observed. Motor and cognitive task performance correlated positively with nodal structural connectivity but not nodal functional connectivity. We also found that the correlation between fitness and functional outcomes was stronger with lower connectivity.
Functional reorganisation seems to be an early indicator of exercise effects on brain networks. Fitness moderates the relationship between network disruption and both motor and cognitive outcomes, with growing importance in more disrupted brain networks. These findings underline the need and opportunities associated with exercise in advanced MS.
神经退行性变导致进行性多发性硬化症（MS）的残疾不断累积。运动被认为可以对抗疾病进展，但对于 MS 患者的健康状况、大脑网络和残疾之间的相互作用知之甚少。
本研究旨在探索功能和结构大脑连接，并基于运动和认知功能结果，在一项针对进展性 MS 的随机、3 个月、等待组对照手臂测力计干预的二次分析中，研究健康状况与残疾之间的相互作用。
我们基于磁共振成像（MRI）构建了个体的结构和功能大脑网络。我们使用线性混合效应模型来比较组间大脑网络的变化，并探索整个队列中健康状况、大脑连接和功能结果之间的关联。
我们招募了 34 名患有晚期进展性 MS（pwMS，平均年龄 53 岁，女性占 71%，平均病程 17 年，平均无辅助步行距离<100 米）的患者。运动组的高连接大脑区域的功能连接增加（p=0.017），但未观察到结构变化（p=0.817）。运动和认知任务表现与节点结构连接呈正相关，但与节点功能连接无关。我们还发现，健康状况与功能结果之间的相关性随着连接性的降低而增强。
功能重组似乎是运动对大脑网络影响的早期指标。健康状况调节了网络中断与运动和认知结果之间的关系，在连接性更差的大脑网络中，这种关系变得越来越重要。这些发现强调了在晚期 MS 中进行运动的必要性和机会。
