While a large number of patients with multiple sclerosis develop disabling deficiencies in mobility and cognition, these researchers from the Kessler Foundation (New Jersey) need to clarify the conceptual framework of the role and the practice of exercise in the overall management of the disease. Their work, presented in the journal Neurorehabilitation and Neural Repair, proposes a systematic approach, named PRIMERS (PRocessing, Integration of Multisensory Exercise-Related Stimuli) to examine the relationship between exercise and neuroplasticity in patients with multiple sclerosis.
Much research explores the effects of exercise in different groups of patients with different diseases, or the benefits of exercise for brain and neurological health, but little attention is paid to the neural mechanisms that underlie tend positive changes in mobility and cognition in this group of patients. “It seems,” the researchers write, “that the focus is not on physical activity, particularly on the adaptive neuroplasticity of the central nervous system.”
Understand to better rehabilitate: the idea and the objective was therefore to provide a conceptual framework to, initially, allow scientists to systematically examine the effects of exercise on brain connectivity, brain structure and the molecular/cellular mechanisms within this group of MS patients. Examination and a better understanding of these effects and the underlying processes could indeed then allow the development of new strategies for rehabilitation care.
A new conceptual framework? The authors propose a new conceptual framework, PRIMERS, which describes central nervous system adaptations in response to exercise that produce via activity-dependent neuroplasticity. This conceptual framework paves the way for the systematic examination of the effects of exercise in terms of improvements in mobility and cognition in the general population but more specifically in patients with multiple sclerosis. Finally, their work suggests that exercise can be considered a factor in neuro-rehabilitation in these patients.
Exercise is a minimally invasive and inexpensive therapy that relieves both types of symptoms and can affect both mobility and cognition, says Dr. John DeLuca, vice president of research at the Kessler Foundation and co- author of the study. So the team set out to learn more about how the activity drives these improvements.
“ Rethinking how we think about exercise in our long-term management plans for people with multiple sclerosis and other neurological conditions is our first step. The use of the “PRIMERS” framework will make it possible to accelerate therapeutic progress by integrating contributions from neuroscience, neurophysiology and neurorehabilitation ”.
