FROM NEUROLOGY
Physical activity in children with multiple sclerosis is associated with lower disease activity and fewer symptoms, both of which appear to accrue with greater levels of activity, according to findings from a cross-sectional study of 110 consecutive patients attending a specialized pediatric MS clinic,
Stephanie A. Grover and her colleagues at the Hospital for Sick Children in Toronto found that self-reported physical activity was significantly greater on average for the 79 children with monophasic acquired demyelinating syndrome (mono-ADS; age range 5-18 years) than for the 31 patients with multiple sclerosis (MS; age range 11-18 years). While greater amounts of moderate physical activity in MS patients was negatively correlated with severity of sleep/rest fatigue symptoms as well as general fatigue, strenuous levels of physical activity had an even greater negative correlation with total T2 lesion volumes and annualized relapse rates.
The differences in physical activity between mono-ADS and MS patients was not because of between-group differences in severity of clinical disability, sex, or age.
The “cross-sectional study design does not allow determination of causality” to know whether less physical activity worsens fatigue and depression or whether fatigue and depression contribute to reduced physical activity, noted Dr. Maria A. Rocca and her colleagues in an editorial accompanying the report, but it agrees with findings from adults with MS.
The generalized effect of regular physical exercise on reducing fatigue and depression – which occurred in one-fifth of MS patients in this study – might occur through an “effect on structural MRI measures of white matter architecture integrity as well as increased volume of specific gray matter structures, including the hippocampus,” Dr. Rocca and her associates wrote, as well as lessening chronic low-grade inflammation.
“A strong message from this study is that implementing physical activity may represent an easy approach that could favorably influence disease outcome in the long term,” Dr. Rocca and her coauthors concluded.
You can read the full study in Neurology (2015 Aug. 12 doi: 10.1212/WNL.0000000000001939), as well as the editorial (Neurology 2015 Aug. 12 doi: 10.1212/WNL.0000000000001941) .
