The effect of aerobic exercise on cognitive functions in individuals with multiple sclerosis

"In this study, we aimed to determine the effect of the molecule Dalfampridine before and after exercise using specific tests employed to measure the frequently observed cognitive system involvement in individuals with multiple sclerosis (MS). Multiple sclerosis (MS) is the most common demyelinating disease of the central nervous system (CNS) in young adults. In addition to the characteristic sensory and motor dysfunction seen in MS, cognitive impairment is observed in 40-70% of patients. Cognitive impairment can manifest early in the course of MS and remains a significant factor negatively affecting the quality of life in many young patients. The common misconception is that MS only leads to physical and motor disability. However, numerous studies have shown that it can seriously affect attention, conceptual reasoning, processing efficiency, information processing speed, memory, verbal fluency, and executive functions over time. Disabled patients are less likely to employ adaptive strategies to cope with the limitations imposed by their illness and have higher rates of unemployment, absenteeism in daily tasks, and lower socioeconomic earnings. Regardless of physical disability, they require more external social support. The term exercise training describe planned, structured, and repetitive physical activity undertaken over an extended period to maintain or enhance physical fitness and functional capacity. This definition encompasses aerobic exercise training such as cycling or walking, progressive resistance exercise or weight lifting, and some non-traditional exercise training modalities examined in some MS patients. In our study, demographic characteristics such as age, gender, body weight, height, occupation, and education status, as well as living environment, were considered from patient records. The EDSS (Expanded Disability Status Scale) score of the patients was taken into account in our assessment form. Changes in patients neurocognitive functions were compared using scales. In the study, patients were examined in two equal and homogeneous groups through stratified randomization. In the stratification, the control group consisted of MS patients who did not use medication, while the study group was composed of patients receiving routine treatment (Dalfampridine). The PASAT and MSNQ cognitive tests were used before and after exercise. The exercise regimen was implemented over 8 weeks, with subjects engaging in aerobic exercise on an electronically braked bicycle ergometer three times a week. Participants were advised not to engage in any exercise on the day before or on the day of the test, and to consume only a light meal at least two hours before the test. Each exercise session was structured as follows: - 5 minutes warm-up at 30% of VO2 max - 20 minutes exercise at 70-80% of VO2 max - 5 minutes cooldown Oxygen consumption (VO2), minute ventilation (VE), and oxygen saturation (SaO2) were recorded. To assess VO2 max, an incremental exercise test was used to determine maximum aerobic capacity. After stabilization and a 3-minute warm-up at 25 W, the load was increased every 3 minutes until exhaustion. Subjects were instructed to maintain a crank speed of 50 rpm and were encouraged verbally to continue the exercise as long as possible. Oxygen consumption (VO2), minute ventilation (VE), and oxygen saturation (SaO2) were recorded. Paced Auditory Serial Addition Test (PASAT); is used to measure the rate of information processing and attention power. It is one of the four tests developed by the Multiple Sclerosis Cognitive Function Study Group to assess cognitive functions in MS, modified by Rao et al. MSNQ (Multiple Sclerosis Neuropsychological Questionnaire); is a test developed by Benedict et al. to assess various cognitive functions using various questions. Keywords: Multipl sclerosis, Cognition, Dalfampridine, PASAT, MSNQ