Multiple sclerosis and related disorders最新文献

{"title":"Impact of a short-term stress management protocol on physiologic biofeedback measures of stress and mood in people with multiple sclerosis","authors":"A.B. Sullivan ,&nbsp;G. Tworek ,&nbsp;A. Kane ,&nbsp;J. Fredieu ,&nbsp;T. Harvey","doi":"10.1016/j.msard.2026.106967","DOIUrl":"10.1016/j.msard.2026.106967","url":null,"abstract":"<div><h3>Background and objectives</h3><div>Stress exacerbates multiple sclerosis (MS) symptoms. We report a 10-year study examining objective and subjective measures of stress and mood in people with MS (PwMS) using a shortened and more practical form of the Stress Management Therapy for MS (SMT-MS), the Stress Management Protocol (SMP).</div></div><div><h3>Methods</h3><div>We analyzed data from PwMS who underwent a 4-session SMP at Cleveland Clinic between 2012 and 2022 (<em>N</em> = 195; 90.5 % female; 68.2 % White; average age, 44.4 years; average disease duration, 12.1 years). Subjective data were collected pre-session using the Patient Health Questionaire-9 (PHQ-9) and Generalized Anxiety Disorder (GAD). Objective data, including breathing rate (breaths per minute, BPM), pulse (beats per minute, bpm), and blood oxygen saturation (%Sp02), were collected pre- and post-SMP. Statistical models assessed data differences and within-session improvement by session, as well as differences in pre- and post-session measurements .</div></div><div><h3>Results</h3><div>Subjective and objective scores improved significantly after Session 1. Significant intrasession improvements were observed, especially during the initial sessions. Significant overall improvements were observed in PHQ-9, GAD-7, and pre-session BPM and %SpO₂. Greatest improvements in PHQ-9 and BPM were observed in patients completing 3 sessions and that %Sp0₂ were observed in patients completing 4 sessions.</div></div><div><h3>Discussion</h3><div>PwMS who participated in the SMP showed considerable improvement in outcomes within and across sessions. Our results show that a brief, 4-session SMP can improve both subjective and objective measures of stress and mood in PwMS and that PwMS are able to utilize the SMP/biofeedback tools outside of therapy, in a real-world environment.</div></div>","PeriodicalId":18958,"journal":{"name":"Multiple sclerosis and related disorders","volume":"107 ","pages":"Article 106967"},"PeriodicalIF":2.9,"publicationDate":"2026-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145939931","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of Respiratory Muscle Training on Respiratory Function and Fatigue in Multiple Sclerosis: A Systematic Review and Meta-Analysis","authors":"Yunji Chen ,&nbsp;Kun Meng ,&nbsp;Guole Jiang ,&nbsp;Xu Xiang ,&nbsp;Yang Liu ,&nbsp;Qing Yi","doi":"10.1016/j.msard.2025.106953","DOIUrl":"10.1016/j.msard.2025.106953","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the effects of respiratory muscle training (RMT) on respiratory function and fatigue in individuals with multiple sclerosis (MS).</div></div><div><h3>Methods</h3><div>In accordance with the PRISMA 2020 guidelines, a systematic search was conducted across five electronic databases (PubMed/MEDLINE, Web of Science, Cochrane Library, SPORTDiscus, Scopus) from inception through 31 August 2025. Randomized controlled trials (RCTs) and quasi-randomized controlled trials (quasi-RCTs) that enrolled adults with MS who underwent isolated RMT (inspiratory, expiratory, or combined) for a duration of ≥ 4 weeks were included. Primary outcomes included respiratory function (e.g., maximal inspiratory pressure [MIP], maximal expiratory pressure [MEP], forced expiratory volume in 1 s [FEV1], forced vital capacity [FVC]) and fatigue (evaluated using the Fatigue Severity Scale [FSS] or Modified Fatigue Impact Scale [MFIS]). Data were synthesized using random- or fixed-effects models, with results expressed as standardized mean differences (SMDs) and 95% confidence intervals (CIs).</div></div><div><h3>Results</h3><div>Fifteen RCTs, comprising a total of 433 participants, were included. Meta-analysis revealed that RMT significantly enhanced respiratory muscle strength (MEP: SMD = 0.24, 95% CI: 0.03 to 0.45, <em>p</em> = 0.03; MIP: SMD = 0.45, 95% CI: 0.25 to 0.65, <em>p</em> &lt; 0.001) and pulmonary function (FEV1: SMD = 0.37, 95% CI: 0.17 to 0.58, <em>p</em> &lt; 0.001; FVC: SMD = 0.24, 95% CI: 0.04 to 0.43, <em>p</em> = 0.02). Significant reductions in fatigue were observed across all subscales of the MFIS (physical: SMD = -1.00, 95% CI: -1.53 to -0.46, <em>p</em> &lt; 0.001; cognitive: SMD = -0.54, 95% CI: -1.05 to -0.03, <em>p</em> = 0.04; psychosocial: SMD = -0.88, 95% CI: -1.41 to -0.35, <em>p</em> &lt; 0.001; total: SMD = -0.98, 95% CI: -1.52 to -0.43, <em>p</em> &lt; 0.001). However, no significant improvement was observed on the FSS (SMD = -0.39, 95% CI: -1.10 to 0.33, <em>p</em> = 0.29).</div></div><div><h3>Conclusion</h3><div>RMT may serve as an effective intervention for improving respiratory muscle strength, pulmonary function, and functional fatigue in individuals with MS. Nonetheless, its effect on perceived fatigue severity appears limited. These findings support the incorporation of RMT into MS rehabilitation programs. Further robust studies with standardized training protocols are warranted to confirm its long-term benefits.</div></div>","PeriodicalId":18958,"journal":{"name":"Multiple sclerosis and related disorders","volume":"107 ","pages":"Article 106953"},"PeriodicalIF":2.9,"publicationDate":"2026-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145939981","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Retrospective review of lymphocyte changes when switching between fumarates in patients with multiple sclerosis","authors":"Aimee Banks ,&nbsp;Autumn Zuckerman ,&nbsp;Josh DeClercq ,&nbsp;Leena Choi ,&nbsp;Katie R. Cruchelow ,&nbsp;Megan Schneider","doi":"10.1016/j.msard.2026.106968","DOIUrl":"10.1016/j.msard.2026.106968","url":null,"abstract":"<div><h3>Background</h3><div>When treating multiple sclerosis, lymphopenia is an established side effect of fumaric acids. Research demonstrating the impact of switching fumarates on lymphocyte counts is scarce. The objective of this study is to characterize the incidence and severity of lymphopenia in patients transitioning from dimethyl fumarate (DMF) to monomethyl fumarate (MMF) or diroximel fumarate (DRF).</div></div><div><h3>Methods</h3><div>A single center, retrospective review of adult medical records at the Vanderbilt Multiple Sclerosis Clinic who filled prescriptions for DMF then either DRF or MMF between January 1st, 2019 and February 28th, 2023.</div></div><div><h3>Results</h3><div>Patients who switched to DRF experienced a greater median percent change in absolute lymphocyte count (ALC) [45% decrease (IQR -95 to -14)] compared to those who switched to MMF [6% increase (IQR -4 to 17)]. Patients who switched to MMF, on average, had an ALC at follow-up 1.8 times higher than those switched to DRF (95% CI 1.4 to 2.3; <em>p</em> &lt; 0.001). Additionally, patients switched to DRF were more likely to experience grade 2 or 3 lymphopenia compared to patients switched to MMF.</div></div><div><h3>Conclusion</h3><div>Our study demonstrated that patients switched to DRF had a significantly lower ALC at follow-up and were more likely to have lymphopenia compared to patients switched to MMF.</div></div>","PeriodicalId":18958,"journal":{"name":"Multiple sclerosis and related disorders","volume":"107 ","pages":"Article 106968"},"PeriodicalIF":2.9,"publicationDate":"2026-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145939866","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Large language models in academic writing","authors":"E. Ann Yeh ,&nbsp;Michael Levy ,&nbsp;Chris Hawkes ,&nbsp;Jeannette Lechner-Scott ,&nbsp;Gavin Giovannoni","doi":"10.1016/j.msard.2025.106945","DOIUrl":"10.1016/j.msard.2025.106945","url":null,"abstract":"","PeriodicalId":18958,"journal":{"name":"Multiple sclerosis and related disorders","volume":"105 ","pages":"Article 106945"},"PeriodicalIF":2.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145918027","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Therapeutic plasma exchange for MOG antibody-associated disease attacks: a systematic review and meta-analysis","authors":"Roger Santana de Araujo ,&nbsp;Guilherme Diogo Silva ,&nbsp;Thiago Trajano ,&nbsp;Edgar Carnero Contentti ,&nbsp;Juan Ignacio Rojas ,&nbsp;Carolin Schwake ,&nbsp;Ilya Ayzenberg ,&nbsp;Douglas Kazutoshi Sato ,&nbsp;Mateus Boaventura de Oliveira ,&nbsp;Tarso Adoni ,&nbsp;Dagoberto Callegaro ,&nbsp;Samira Luisa Apóstolos-Pereira","doi":"10.1016/j.msard.2025.106962","DOIUrl":"10.1016/j.msard.2025.106962","url":null,"abstract":"<div><h3>Introduction</h3><div>Myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) attacks are usually treated with corticosteroids, but therapeutic plasma exchange (TPE) may provide additional benefits.</div></div><div><h3>Objective</h3><div>To assess the response to TPE in MOGAD attacks.</div></div><div><h3>Methods</h3><div>We performed a systematic review and meta-analysis of observational studies reporting outcomes of MOGAD attacks treated with TPE, searching PubMed, Embase, and Scopus from inception to November 24, 2024. The primary outcome was recovery at last follow-up, classified as complete, partial, or none. Secondary analysis explored predictors of response through meta-regression on aggregated data.</div></div><div><h3>Results</h3><div>Forty-nine studies comprising 475 attacks were included. Most patients were female (56 %), presenting mainly with optic neuritis (60 %) or myelitis (37.7 %). TPE was combined with intravenous methylprednisolone in 93 % and with intravenous immunoglobulin in 11.8 %. The pooled complete recovery rate was 30 % (95 % CI 22–40, I² = 74 %), and the overall response rate (complete or partial) was 90 % (95 % CI 82–94, I² = 59.9 %). Meta-regression indicated a slightly better response in brainstem syndrome (p=0.023) and a poorer response in cerebral syndrome (p=0.044), with no significant correlation between complete recovery and age, sex, other clinical syndromes, or use as first-line therapy.</div></div><div><h3>Conclusion</h3><div>TPE is associated with high overall response rates in MOGAD attacks. Randomized trials are needed to confirm efficacy and define prognostic factors.</div></div>","PeriodicalId":18958,"journal":{"name":"Multiple sclerosis and related disorders","volume":"107 ","pages":"Article 106962"},"PeriodicalIF":2.9,"publicationDate":"2025-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145939982","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Epstein-Barr virus in multiple sclerosis pathogenesis: The path towards mechanistically faithful models","authors":"Kathryn Mizzi ,&nbsp;Ruben J. Cauchi","doi":"10.1016/j.msard.2025.106952","DOIUrl":"10.1016/j.msard.2025.106952","url":null,"abstract":"<div><div>Multiple Sclerosis (MS) is a chronic, disabling autoimmune disease of the central nervous system (CNS). While its aetiology is multifactorial, compelling evidence now implicates Epstein-Barr virus (EBV) as a primary aetiological agent. This review summarises the extensive epidemiological and mechanistic data supporting a causal link between EBV infection and MS. Epidemiological studies demonstrate that EBV infection confers &gt;30-fold increased risk for MS, with seroconversion preceding the onset of neuroaxonal damage. The leading proposed mechanism is molecular mimicry, where antibodies and T cells targeting the EBV nuclear antigen 1 (EBNA1) cross-react with CNS proteins, such as GlialCAM, initiating autoimmune-mediated demyelination. This process is modulated by synergistic interactions with genetic risk factors, and environmental factors like smoking and adolescent obesity. A critical evaluation of the experimental models used to investigate this connection is presented. <em>In vitro</em> systems using patient-derived cells have confirmed dysregulated immune responses to EBV antigens, while <em>in vivo</em> models – ranging from murine experimental autoimmune encephalomyelitis (EAE) and humanised mice to non-human primate models with homologous γ-herpesviruses – have been instrumental in demonstrating the role of EBV in breaking immune tolerance and driving neuroinflammation. Despite their utility, each model possesses limitations, underscoring the need for next-generation model systems that more accurately recapitulate the complex interplay between the virus, host genetics, and the CNS environment. Future research focused on refining these models is crucial for developing targeted EBV-based therapeutics, such as vaccines or antiviral agents, to prevent or treat MS.</div></div>","PeriodicalId":18958,"journal":{"name":"Multiple sclerosis and related disorders","volume":"107 ","pages":"Article 106952"},"PeriodicalIF":2.9,"publicationDate":"2025-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145934373","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A comparative study of gait pattern characteristics between individuals with multiple sclerosis and healthy individuals during anticipatory postural adjustment and gait initiation: A scoping review","authors":"Narges Jahantigh Akbari ,&nbsp;Fatemeh Ehsani ,&nbsp;Marzieh Mortezaejad ,&nbsp;Mohammad Yousefi ,&nbsp;Khorshid Bijari","doi":"10.1016/j.msard.2025.106949","DOIUrl":"10.1016/j.msard.2025.106949","url":null,"abstract":"<div><div>Individuals diagnosed with multiple sclerosis (MS) are known to face more challenging situations, such as gait initiation (GI), compared to healthy individuals. This provides a deeper insight into the mechanisms that govern dynamic postural control. A search was conducted across several databases, including PubMed, Cochrane, ScienceDirect, Web of Science, Scopus, ProQuest, and Google Scholar. Studies of any design were included if they satisfied the following criteria: the experimental group consisted of individuals with MS or clinically isolated syndrome, the control group included healthy individuals or MS patients, and the studies examined gait patterns across various parameters, such as the center of pressure (COP), center of mass, and anticipatory postural adjustments, while also assessing the gait initiation phase. Utilizing the modified Downs and Black checklist, nine articles were selected for the final analysis. The results indicated deceleration, a reduction in posterior COP displacement, and an increase in COP during anterior GI. Compared with healthy controls, individuals with MS exhibited greater instability during balance recovery and in kinetic parameters of the stance limb. Furthermore, a delay and reduction in muscle activity were noted in individuals with MS who had a history of falls, in contrast to non-falling MS patients and healthy individuals.</div></div>","PeriodicalId":18958,"journal":{"name":"Multiple sclerosis and related disorders","volume":"107 ","pages":"Article 106949"},"PeriodicalIF":2.9,"publicationDate":"2025-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145940036","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiorespiratory fitness in young and newly diagnosed patients with multiple sclerosis: A cross-sectional study","authors":"Tomáš Adamec ,&nbsp;Tomáš Hudeček ,&nbsp;Dalibor Pastucha ,&nbsp;Pavel Hradílek ,&nbsp;Adéla Kondé ,&nbsp;Anna Šilarová","doi":"10.1016/j.msard.2025.106950","DOIUrl":"10.1016/j.msard.2025.106950","url":null,"abstract":"<div><h3>Background</h3><div>Cardiorespiratory fitness (CRF) is impaired in patients with multiple sclerosis (MS) regardless of age, but evidence is limited among young and newly diagnosed patients. The aim of the study is to assess CRF using a maximal exercise test on a treadmill and to examine the relationships between CRF, physical activity level, fatigue, depression, and quality of life (QoL) in young patients newly diagnosed with MS.</div></div><div><h3>Methods</h3><div>This cross-sectional study analyzed baseline data from a sample of 43 patients with MS who completed a maximal exercise test on a treadmill, measurement of body composition, and answered the Beck Depression Inventory second edition, modified Fatigue Impact Scale, and 36-item Short Form Survey QoL.</div></div><div><h3>Results</h3><div>CRF was significantly lower among patients newly diagnosed with MS (aged 20–45 years) compared to normative values (paired Wilcoxon test, <em>p</em> &lt; 0.001). The median absolute differences between normative values and patients’ maximal oxygen uptake (VO₂max) was 8.5 ml/kg/min (interquartile range [IQR]: 2.4–13.4 ml/kg/min), and the median relative differences was 28.3 % (IQR: 7.1–53.9 %). VO₂max significantly negatively correlated with fatigue (r_S = -0.37, <em>p</em> = 0.013), but not depression (r_S = -0.01, <em>p</em> = 0.971). Significant positive correlations were found between VO₂max and multiple subscales of QoL, including physical functioning (r_S = 0.50, <em>p</em> = 0.001), social functioning (r_S = 0.41, <em>p</em> = 0.007), pain (r_S = 0.41, <em>p</em> = 0.006), and role limitations due to physical health (r_S = 0.31, <em>p</em> = 0.047).</div></div><div><h3>Conclusion</h3><div>Young patients with newly diagnosed MS already exhibit substantially reduced CRF compared with normative values. Lower VO₂max is associated with higher fatigue and poorer physical and social aspects of QoL. These findings highlight the need for interventions aimed at improving CRF as an integral component of rehabilitation programs.</div></div>","PeriodicalId":18958,"journal":{"name":"Multiple sclerosis and related disorders","volume":"107 ","pages":"Article 106950"},"PeriodicalIF":2.9,"publicationDate":"2025-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145885831","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Understanding adherence and its impact on function in a six-month step exergame intervention for people with multiple sclerosis","authors":"Jeff Wen Han Thng ,&nbsp;Daina L Sturnieks ,&nbsp;Phu Hoang ,&nbsp;Stephen R Lord ,&nbsp;Jasmine C Menant","doi":"10.1016/j.msard.2025.106948","DOIUrl":"10.1016/j.msard.2025.106948","url":null,"abstract":"<div><h3>Objectives</h3><div>To identify predictors of adherence to a six-month home-based step exergame intervention to prevent falls and determine the effects of adherence on physical, cognitive and psychological function outcomes in people with MS.</div></div><div><h3>Methods</h3><div>This is a secondary analysis of a multi-site randomised controlled trial of a six-month home-based step exergame intervention versus usual care in 469 people with MS. Intervention participants were asked to undertake step exergame training for 120 min/week. Adherence was captured by the step exergame system. Participants’ baseline characteristics were examined as predictors of adherence. Higher adherers to the intervention were compared to the control group in physical, cognitive and psychological outcome measures.</div></div><div><h3>Results</h3><div>Older age, lower body mass index, site location and fewer depressive symptoms were independent significant predictors of improved adherence to the step exergame intervention. Compared to control participants (<em>n</em> = 228), high adherers (≥100 min/week) (<em>n</em> = 71) reported fewer symptoms of fatigue following the intervention. In a sub-sample of participants who undertook physical and cognitive tests, 25 high adherers made significantly fewer errors in the Stroop stepping test compared to 104 controls.</div></div><div><h3>Conclusion</h3><div>People with MS who were older, had a lower body mass index, and reported fewer depressive symptoms were more likely to adhere to a step exergame intervention to prevent falls. Higher adherers demonstrated clinically meaningful benefits, including reduced fatigue and improved performance on a cognitively demanding stepping task, changes that are directly relevant to daily functioning and fall risk. These findings may help identify individuals who require additional support to engage with and fully benefit from home-based exergame programs.</div></div>","PeriodicalId":18958,"journal":{"name":"Multiple sclerosis and related disorders","volume":"107 ","pages":"Article 106948"},"PeriodicalIF":2.9,"publicationDate":"2025-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145934382","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of exercise training on some cytokine profiles in patients with multiple sclerosis: A systematic review and meta-analysis of randomized controlled trials","authors":"Keyvan Hejazi ,&nbsp;Gholam Rasul Mohammad Rahimi ,&nbsp;Martin Hofmeister","doi":"10.1016/j.msard.2025.106951","DOIUrl":"10.1016/j.msard.2025.106951","url":null,"abstract":"<div><h3>Background</h3><div>Multiple Sclerosis (MS) is a chronic, progressive autoimmune disorder of the central nervous system, where inflammation plays a pivotal role in its pathophysiology. Exercise training has been proposed as an effective non-pharmacological strategy for managing MS. However, due to inconsistent findings in previous studies, this systematic review and meta-analysis aimed to comprehensively evaluate the effects of long-term exercise interventions on the cytokine profile in patients with MS.</div></div><div><h3>Methods</h3><div>Six electronic databases (PubMed, EMBASE, SCOPUS, Web of Science, Cochrane Library, and Google Scholar) were searched up to June 27, 2025. Only randomized controlled trials (RCTs) investigating the effects of exercise training on the levels of IL-6, IL-10, IL-17, IL-4, TNF-α, and IFN-γ in adult patients with MS were included. The quality of the articles was assessed using the PEDro scale, selecting studies with a score of 5 or higher. Data were analyzed using a random-effects model, with the effect size calculated as the Standardized Mean Difference (SMD) and a 95 % confidence interval (CI).</div></div><div><h3>Results</h3><div>A total of 19 RCTs involving 569 participants (329 in the exercise group and 240 in the control group) were included in the meta-analysis. The pooled results showed that exercise training significantly reduced the levels of the pro-inflammatory cytokines TNF-α (SMD: -0.31, <em>p</em> = 0.02), IFN-γ (SMD: -0.73, <em>p</em> &lt; 0.001) and IL-17 (SMD: -0.42, <em>p</em> &lt; 0.001). However, no significant changes were observed in the levels of IL-4 (<em>p</em> = 0.82), IL-6 (<em>p</em> = 0.49), and IL-10 (<em>p</em> = 0.13).</div></div><div><h3>Conclusions</h3><div>This meta-analysis provides robust evidence that structured exercise training can selectively modulate the inflammatory profile in patients with MS, primarily reducing the key cytokines TNF-α, IFN-γ and IL-17. These findings support the role of exercise as a complementary non-pharmacological therapy for managing inflammation in MS.</div></div>","PeriodicalId":18958,"journal":{"name":"Multiple sclerosis and related disorders","volume":"107 ","pages":"Article 106951"},"PeriodicalIF":2.9,"publicationDate":"2025-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145885830","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}