Abstract
Exercise training may affect the blood levels of brain-derived neurotrophic factor (BDNF), but meta-analyses have not yet been performed comparing pre- and post-intervention BDNF concentrations in patients with multiple sclerosis (PwMS). To perform a meta-analysis to study the influence of exercise on BDNF levels and define components that modulate them across clinical trials of exercise training in adults living with multiple sclerosis (MS). Five databases (PubMed, EMBASE, Cochrane Library, PEDro database, CINAHL) were searched up to June 2021. According to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses, we included 13 articles in the meta-analysis, including 271 subjects. To investigate sources of heterogeneity, subgroup analysis, meta-regression, and sensitivity analysis were conducted. We performed the meta-analysis to compare pre- and post-exercise peripheral levels of BDNF in PwMS. Post-exercise concentrations of serum BDNF were significantly higher than pre-intervention levels (Standardized Mean Difference (SMD): 0.33, 95% CI: [0.04; 0.61], p-value = 0.02). Meta-regression indicated that the quality of the included studies based on the PEDro assessment tool might be a source of heterogeneity, while no significant effect was found for chronological age and disease severity according to the expanded disability status scale. This systematic review and meta-analysis shows that physical activity increases peripheral levels of BDNF in PwMS. More research on the effect of different modes of exercise on BDNF levels in PwMS is warranted.
Highlights
Brain-derived neurotrophic factor (BDNF) is a member of the neurotrophin family, which plays an essential role in neuroregeneration and neuroprotection [1]
Post-exercise concentrations of serum brain-derived neurotrophic factor (BDNF) were significantly higher than pre-intervention levels (Standardized Mean Difference (SMD): 0.33, 95% confidence interval (CI): [0.04; 0.61], p-value = 0.02)
Meta-regression indicated that the quality of the included studies based on the PEDro assessment tool might be a source of heterogeneity, while no significant effect was found for chronological age and disease severity according to the expanded disability status scale
Summary
Brain-derived neurotrophic factor (BDNF) is a member of the neurotrophin family, which plays an essential role in neuroregeneration and neuroprotection [1]. Besides the central nervous system, BDNF has been found in different organs, such as the brain, lungs, heart, spleen, gastrointestinal tract, and liver. When the demyelination process is actively evolving, BDNF levels tend to increase, probably as a compensatory mechanism against neuronal and glial damage [6]. Astrocytes and neurons, central nervous system (CNS) infiltrating Immune cells (e.g., T cells and phagocyte cells) can secrete BDNF in demyelinating MS lesions [6]. Exercise training may affect the blood levels of brain-derived neurotrophic factor (BDNF), but meta-analyses have not yet been performed comparing pre- and post-intervention BDNF concentrations in patients with multiple sclerosis (PwMS)
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