Supplemental Digital Content is Available in the Text. Background and Purpose: Even a single bout of aerobic exercise (AE) enhances corticospinal excitability (CSE), a biomarker of neuroplasticity. Because neurodegeneration limits capacity for neuroplasticity, it is not clear whether AE would induce CSE changes in people with progressive multiple sclerosis (MS). Methods: People with progressive MS (n = 10) requiring ambulatory assistive devices completed a graded maximal exercise test. Dual-energy x-ray absorptiometry was used to quantify body fat and lean mass. Before and following one 40-minute AE session using body weight–supported (<10% support) treadmill at moderate intensity, CSE was measured using transcranial magnetic stimulation. Variables included resting and active motor thresholds, motor evoked potential (MEP) amplitudes, recruitment curves, and length of the cortical silent period (CSP). Results: Aerobic exercise reduced inhibition (shorter CSP) and increased excitation (increased MEP amplitude) only in the hemisphere corresponding to the stronger hand. Controlling for age, higher fitness and lower body fat significantly predicted exercise-induced reduction in resting motor threshold (ΔR2 = +0.458, P = 0.046) and CSP (ΔR2 = +0.568, P = 0.030), respectively. Discussion and Conclusions: Despite high levels of disability, capacity for exercise-induced neuroplasticity was retained among people with progressive MS. The hemisphere contralateral to the weaker hand was resistant to exercise-induced CSE changes, suggesting less neuroplastic potential. Lower fitness and higher body fat were associated with diminished exercise-induced CSE benefits, suggesting that therapists should consider interventions aimed at improving fitness and combating sedentarism to ultimately enhance the benefits of exercise on the brain. Video Abstract available for more insights from the authors (see the Video, Supplemental Digital Content 1, available at: http://links.lww.com/JNPT/A302).

中文翻译：

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进行性多发性硬化症中运动引起的大脑兴奋性变化

补充数字内容在文本中可用。背景和目的：即使是单次有氧运动 (AE) 也会增强皮质脊髓兴奋性 (CSE)，这是一种神经可塑性的生物标志物。由于神经变性限制了神经可塑性，目前尚不清楚 AE 是否会导致进行性多发性硬化 (MS) 患者的 CSE 变化。方法：需要移动辅助设备的进展性 MS 患者 (n = 10) 完成了分级最大运动测试。双能 X 射线吸收测定法用于量化体脂肪和瘦体重。在使用中等强度的体重支撑（<10% 支撑）跑步机进行一次 40 分钟的 AE 会话之前和之后，使用经颅磁刺激测量 CSE。变量包括静息和活动运动阈值、运动诱发电位 (MEP) 幅度、募集曲线和皮质静默期 (CSP) 的长度。结果：有氧运动仅在与强壮手相对应的半球中减少抑制（更短的 CSP）和增加兴奋（增加 MEP 幅度）。控制年龄、较高的健康度和较低的体脂分别显着预测运动引起的静息运动阈值 (ΔR2 = +0.458, P = 0.046) 和 CSP (ΔR2 = +0.568, P = 0.030) 的降低。讨论和结论：尽管残疾程度很高，但进行性多发性硬化症患者仍保留了运动诱发的神经可塑性能力。较弱手的对侧半球对运动引起的 CSE 变化有抵抗力，表明神经可塑性潜力较小。较低的体能和较高的体脂与运动引起的 CSE 益处减少有关，建议治疗师应考虑旨在改善健康和对抗久坐症的干预措施，以最终增强锻炼对大脑的益处。视频摘要可提供作者的更多见解（参见视频，补充数字内容 1，可在：http://links.lww.com/JNPT/A302 获得）。