While people with multiple sclerosis (PwMS) historically were advised to avoid physical activity to reduce symptoms such as fatigue, they are now encouraged to remain active and to enlist in programs of exercise. However, despite an extensive current literature that exercise not only increases physical well-being but also their cognition and mental health, many PwMS are not meeting recommended levels of exercise. Here, we emphasize the impact and mechanisms of exercise on functional and structural changes to the brain, including improved connectome, neuroprotection, neurogenesis, oligodendrogenesis, and remyelination. We review evidence from animal models of multiple sclerosis (MS) that exercise protects and repairs the brain, and provide supportive data from clinical studies of PwMS. We introduce the concept of MedXercise, where exercise provides a brain milieu particularly conducive for a brain regenerative medication to act upon. The emphasis on exercise improving brain functions and repair should incentivize PwMS to remain physically active.

中文翻译：

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多发性硬化症中的运动和大脑

虽然过去曾建议患有多发性硬化症 (PwMS) 的人避免身体活动以减轻疲劳等症状，但现在鼓励他们保持活跃并参加锻炼计划。然而，尽管目前有大量文献表明锻炼不仅可以提高身体健康，还可以提高他们的认知和心理健康，但许多 PwMS 并未达到推荐的锻炼水平。在这里，我们强调运动对大脑功能和结构变化的影响和机制，包括改善连接组、神经保护、神经发生、少突胶质细胞生成和髓鞘再生。我们回顾了运动保护和修复大脑的多发性硬化症 (MS) 动物模型的证据，并提供了来自 PwMS 临床研究的支持性数据。我们引入 MedXercise 的概念，运动提供了一个特别有利于大脑再生药物发挥作用的大脑环境。强调锻炼改善大脑功能和修复应该激励 PwMS 保持身体活跃。