Systematic exercise as a neuroprotective and disease-modifying intervention in multiple sclerosis and the prodromal phase of neurodegenerative disorders: Molecular mechanisms, biomarkers, imaging correlates, and clinical implications
Year: 2026
Type: article
Abstract: Multiple sclerosis and neurodegenerative disorders such as Alzheimer's disease and Parkinson's disease share overlapping mechanisms of neuroinflammation, axonal injury, and progressive neurodegeneration, yet the disease-modifying role of systematic exercise remains incompletely defined across the disease continuum. This narrative review integrates evidence from randomized trials, cohort studies, meta-analyses, and biomarker investigations examining aerobic and resistance exercise effects on neuroplasticity, neurotrophic signaling, axonal injury markers, brain imaging outcomes, immune function, mitochondrial efficiency, cognition, fatigue, mobility, and quality of life. Exercise enhanced neurotrophic signaling, promoted synaptic plasticity, reduced axonal injury markers, improved mitochondrial function, modulated immune responses, and favorably influenced brain imaging outcomes, while improving walking capacity, muscle strength, fatigue, cognition, and quality of life. Emerging evidence further supports a preventive role during early neurodegenerative stages. Biomarker-informed exercise medicine may redefine therapeutic paradigms, constituting a biologically grounded, feasible, cost-effective strategy warranting integration into disease management and further validation through adequately powered trials.
Language: English
Subfield: Clinical Neurology
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W7204198784