A new study suggests children with multiple sclerosis (MS) who exercise regularly may have a less active disease. The research is published in the August 12, 2015, online issue of Neurology.
“Up to three-quarters of children with MS experience depression, tiredness, or memory and thinking impairment,” said study author E. Ann Yeh, MD, with The Hospital for Sick Children (SickKids) in Toronto, Associate Professor at the University of Toronto in Toronto, Ontario, Canada and a member of the American Academy of Neurology. “Our research is important since little is known regarding how lifestyle behaviors may affect the disease.”
For the study, 31 children with MS and 79 who had experienced a single inflammatory neurologic event were given questionnaires about tiredness, depression and how often they exercised. Of those, 60 were also given MRI brain scans to measure brain volume and the amount and type of MS lesions they had.
Only 45 percent of the children with MS reported participating in any strenuous physical activity, compared to 82 percent of the other children. The children with MS who took part in strenuous physical activity were more likely to have a lower overall volume (amount) of lesions in the brain that indicate disease activity, or T2 lesions, than the children with MS who did not do strenuous activity. Those who did strenuous activity had a median of 0.46 cm3 of T2 lesions, compared to 3.4 cm3 for those with no strenuous activity. Also, those with strenuous activity had a median of 0.5 relapses per year, compared to 1 per year for those with no strenuous activity. The children with MS also had higher levels of tiredness and depression compared to the other children studied. There were no differences in whole brain volumes. The results were the same after researchers adjusted for the severity of the children’s disease.
“These findings add to the possibility that physical activity may have a beneficial effect on the health of the brain,” said Yeh.
Yeh noted that the study does not determine a cause-and-effect relationship between physical activity and disease activity in MS, but only shows an association between the two.
Funding: The study was supported by the MS Society of Canada, Canadian Multiple Sclerosis Scientific Research Foundation and SickKids Foundation.
Source: Michelle Uher – AAN
Image Source: The image is in the public domain
Original Research: Abstract for “Lower physical activity is associated with higher disease burden in pediatric multiple sclerosis” by Stephanie A. Grover, Berengere Aubert-Broche, Dumitru Fetco, D. Louis Collins, Douglas L. Arnold, Marcia Finlayson, Brenda L. Banwell, Robert W. Motl, and E. Ann Yeh in Neurology. Published online August 10 2015 doi:10.1212/WNL.0000000000001939
Abstract
Lower physical activity is associated with higher disease burden in pediatric multiple sclerosis
Objective: To evaluate the association between physical activity (PA) and multiple sclerosis (MS) disease activity, depression, and fatigue in a cohort of children with MS and monophasic acquired demyelinating syndrome (mono-ADS).
Methods: In this cross-sectional study of consecutive patients attending a specialized pediatric MS clinic, we administered the PedsQL Multidimensional Fatigue Scale, Center for Epidemiological Studies Depression Scale, and Godin Leisure-Time Exercise Questionnaire. Quantitative MRI analysis was performed to obtain whole brain and T2 lesion volume in a subset of participants (n = 60).
Results: A total of 110 patients (79 mono-ADS; 31 MS; 5–18 years; M:F 1:1.2) were included. Patients with MS reported less strenuous (33.21 ± 31.88 metabolic equivalents [METs] vs 15.97 ± 22.73 METs, p = 0.002) and total (44.48 ± 39.35 METs vs 67.28 ± 59.65 METs; p = 0.0291) PA than those with mono-ADS. Patients with MS who reported greater amounts of moderate PA METs had fewer sleep/rest fatigue symptoms (r = −0.4). Participation in strenuous PA was associated with smaller T2 lesion volumes (r = −0.66) and lower annualized relapse rate (r = −0.66). No associations were found between total brain volume and participation in PA.
Conclusions: Children with MS are less physically active than children with mono-ADS. Reasons for this are unclear, but may be related to ongoing disease activity, perceived limitations, or symptoms such as depression or fatigue. Children with MS reporting higher levels of strenuous PA had lower T2 lesion volumes and lower relapse rates, suggesting a potential protective effect of strenuous PA in this population. Further longitudinal studies are needed to establish the relationship of PA to MS symptoms and disease activity in this population.
“Lower physical activity is associated with higher disease burden in pediatric multiple sclerosis” by Stephanie A. Grover, Berengere Aubert-Broche, Dumitru Fetco, D. Louis Collins, Douglas L. Arnold, Marcia Finlayson, Brenda L. Banwell, Robert W. Motl, and E. Ann Yeh in Neurology. Published online August 10 2015 doi:10.1212/WNL.0000000000001939
