背景:发现多发性硬化症(pwMS)患者的运动可以改善症状管理并恢复功能。运动是否降低神经丝轻链(NfL),神经轴索损伤生物标志物,在MS中仍然未知,发现相互矛盾。在这项研究中,我们旨在评估pwMS中运动和NfL水平之间的相互作用。
方法:系统搜索Medline,中部,Embase,和WebofScience进行到2024年3月,以确定相关报告。我们纳入了调查培训计划前后NfL水平平均变化的研究,并将其与不同的运动计划或无运动活动对照组进行了比较。使用随机效应模型应用具有95%置信区间的标准化平均差(SMD)。
结果:在222篇文章中,7项研究符合纳入标准。接受结构化运动计划的患者在训练后血液NfL水平显着降低(SMD-0.55;95%CI-1.00,-0.09)。具体来说,户外普拉提和家庭训练与血液NfL降低显著相关(SMD-2.08;95%CI-2.99,-1.17)和(SMD-1.46;95%CI-2.28,-0.64),分别。对照组的患者在基线和研究结束时的血液NfL水平没有显着差异(SMD0.04;95%CI-0.17,0.24)。基于持续时间的亚组分析显示,8周的运动可显著降低血液NfL水平(SMD-0.73;95%CI-1.35,-0.11)。
结论:我们的研究为训练在降低pwMS中血液NfL水平方面的潜在作用提供了初步证据。然而,更严格,我们需要精心设计的研究来证实这些发现.
BACKGROUND: Exercise in patients with multiple sclerosis (pwMS) found to improve symptom management and regain function. Whether exercise lowers neurofilament light chain (NfL), neuroaxonal injury biomarker, in MS remains unknown with conflicting findings. In this study, we aimed to assess the interaction between exercise and NfL levels in pwMS.
METHODS: Systematic search of Medline, CENTRAL, Embase, and Web of Science was conducted until March 2024 to identify relevant reports. We included studies that investigated the mean change in NfL levels pre- and post-training programs and compared them to different exercise programs or no exercise activity control groups. A standardized mean difference (SMD) with a 95 % confidence interval were applied using a random-effects model.
RESULTS: Of 222 articles, 7 studies met the inclusion criteria. Patients who underwent structured exercise programs had a significant decrease in blood NfL levels post-training (SMD -0.55; 95 % CI -1.00, -0.09). Specifically, outdoor Pilates and home-based trainings were significantly associated with blood NfL reduction (SMD -2.08; 95 % CI -2.99, -1.17) and (SMD -1.46; 95 % CI -2.28, -0.64), respectively. Patients in the control group did not show significant differences in blood NfL levels between the baseline and at the end of the study (SMD 0.04; 95 % CI -0.17, 0.24). Subgroup analysis based on duration revealed that 8 weeks of exercise significantly reduced blood NfL levels (SMD -0.73; 95 % CI -1.35, -0.11).
CONCLUSIONS: Our study provides preliminary evidence for the potential role of training in reducing blood NfL levels in pwMS. However, more rigorous, and well-designed studies are warranted to confirm these findings.