Impact of cognitive-aerobic exercise training on brain-derived neurotrophic factor, dual-tasking abilities, and mood state in individuals with multiple sclerosis.

Abstract

Objectives: Multiple sclerosis (MS) is a chronic neurological disorder characterized by demyelination and neurodegeneration, leading to various physical, cognitive, and emotional challenges. Dual-task (DT) training, involving performing mental and physical tasks simultaneously, addresses the complex interaction between motor and cognitive functions.

Purpose: Given the extensive physical, cognitive, and mood-related issues in this population, this study aimed to examine the effects of combined aerobic-cognitive training (Brythonic) and aerobic training on brain-derived neurotrophic factor (BDNF), DT performance, and mood state in MS patients.

Methods: Thirty patients (22 women and 8 men) with relapsing-remitting multiple sclerosis (RRMS) and an expanded disability status scale (EDSS) score below four were randomly assigned to three groups: aerobic-cognitive training (Brythonic), aerobic training, and control. The training groups participated in 10 weeks of home-based online training, with two sessions per week. Each session included a 10-minute warmup, 15 to 35 min of exercise, and a 5-minute cool-down. The Brythonic group performed aerobic movements while reciting motivational words, forming a complete positive sentence over ten weeks. The aerobic group performed the same movements without cognitive tasks. Serum BDNF levels, DT performance, and profile of mood states (POMS) were measured before and after the 10-week training period. A two-way ANOVA with repeated measures was used to analyze differences between and within groups, with a significance level of P ≤ 0.05.

Results: BDNF levels significantly increased in the Brythonic group (P = 0.048) and significantly decreased in the control group compared to baseline. In the DT test, the Brythonic group showed significant improvements in the number of correct answers and DT values compared to the aerobic and control groups. The Brythonic group also had a significantly reduced response time compared to the control group. Additionally, selective speed significantly increased in both training groups. In the POMS test, the Brythonic group showed significant improvements in all items except depression compared to the control group. Within the Brythonic group, all items significantly improved from baseline.

Conclusion: This study demonstrated that combining motivational words with aerobic movements significantly impacts BDNF levels, DT performance, and mood states. Adding mental exertion to physical activity appears beneficial for patients with MS. Future studies should re-examine these findings with a larger patient cohort.