The Compensatory Increased BDNF and NGF in Patients with Multiple Sclerosis Following Home-based Aerobic Training and Vitamin D Supplementation During COVID-19 Outbreak

Abstract Background: Lifestyle modifications (physical activity and diet) are among the most promising strategies in MS rehabilitation. This study aimed to investigate the effect of home-based aerobic training and vitamin D supplementation in patients with multiple sclerosis during the COVID-19 outbreak.Methods: In this randomized, single-blinded, placebo-controlled trial, 38 females with Multiple sclerosis with EDSS: 3-5 (aged 20–40 years with body mass index [BMI] of 25–30 kg/m2) were randomly assigned into four groups: aerobic training + Vitamin D supplementation (AT+Vit D; n=10); aerobic training (AT; n=9); Vitamin D supplementation (Vit D; n=9), and Control (Placebo) (n=10). The AT program consisted of 50-70% of HRMax, 25-40 min/day, three days/wk for eight weeks. Participants in the Vit D group consumed 50000 IU of Vitamin D supplement capsules per week for eight weeks. The data were analyzed through paired t-test and one-way analysis of variance, as well as Tukey's post hoc test at the signification level of P<0.05.Results: BDNF and NGF levels improved significantly from pre-test to post-test within all experimental groups. BDNF and NGF decreased significantly in AT+Vit D, AT, and Vit D compared to C. Also, the results show that the AT+Vit D had significantly lower BDNF and NGF compared to AT (P=0.023 and P=0.011) and Vit D (P=0.001 and P=0.002). Conclusion: These findings suggest that the combination of AT+Vit D improves BDNF and NGF status more effectively than AT or Vit D alone in female Multiple sclerosis patients.

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Effect of Home-Based Aerobic Training and Vitamin D Supplementation on Fatigue and Quality of Life in Patients with Multiple Sclerosis During COVID-19 Outbreak

10.21203/rs.3.rs-655827/v1 ◽

2021 ◽

Author(s):

Elahe Bahmani ◽

Rastegar Hoseini ◽

Ehsan Amiri

Keyword(s):

Quality Of Life ◽

Multiple Sclerosis ◽

Vitamin D ◽

Aerobic Training ◽

Vitamin D Supplementation ◽

Control Group ◽

Significance Level ◽

Positive Effects ◽

Home Based

Abstract Background: Multiple sclerosis (MS)is the most common neurological disease that causes disability in the nervous system which reduces the quality of life(QoL). Studies have shown positive effects of therapeutic exercise with supplementation on motor- and cognitive functionandfatigue as well as on QoLin persons with MS. The purpose of this study was to the effect of home-based aerobic training (AT) and vitamin D(Vit D) supplementation on fatigue and QoL in patients with MS during the covid-19 outbreak. Methods: We recruited 40 females (20 - 40 years) with MS(EDSS: 3-5). Then, using simple randomization, the subjects were assigned to four groups including aerobic training (AT; n=9; 50%-75%, 20-40 min/day, 3 days/wk aerobic training), vitamin D supplementation (Vit D; n=9; 50,000 IU one day/week), aerobic training plus vitamin D supplementation (AT + Vit D; n=10), and sedentary control (C; n=10 placebo). The data were analyzed using paired t-test and one-way analysis of variance and Tukey’s post hoc test with SPSS21 at a significance level of P < 0.05.Results: After eight weeks of intervention, fatigue grade markedly reduced in the AT + Vit D, AT, and Vit D groups); However, fatigue increased in the control group. QoLincreased significantly in AT+Vit D, AT, and Vit D compared to C. Also, the results show that the AT+Vit D had significantly higherQoL compared to AT and Vit D. Conclusion:These findings suggest that therapeutic AT and VitD supplementation is very effective in reducing fatigue and consequently improves the QoLin female MS patients.

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Prevalence of Vitamin D Deficiency and Its Relationship with Clinical Outcomes in Patients with Fibromyalgia: a Systematic Review of the Literature

SN Comprehensive Clinical Medicine ◽

10.1007/s42399-021-01105-w ◽

2022 ◽

Vol 4 (1) ◽

Author(s):

Omar M. E. Ali

Keyword(s):

Vitamin D ◽

Vitamin D Deficiency ◽

Patient Flow ◽

Controlled Trial ◽

Cost Effective ◽

Therapeutic Benefit ◽

Vitamin D Supplementation ◽

Effective Interventions ◽

Randomised Controlled ◽

And Control

Abstract Fibromyalgia is a debilitating chronic condition which poses a therapeutic challenge to the clinician. With a large backlog in patient flow subsequent to the COVID-19 pandemic and rising numbers of patients with post-acute sequelae of COVID-19 (PASC) presenting with fibromyalgia-like clinical features, there is an increasingly pressing need to identify broad cost-effective interventions. Low levels of vitamin D have previously been reported in patients with fibromyalgia, though any causative link has been difficult to establish. A systematic literature review on the association between vitamin D deficiency and fibromyalgia was performed examining retrospective evidence both for and against an association between vitamin D deficiency (VDD) and fibromyalgia and evaluating the therapeutic benefit from supplementation. A group of six studies were selected based on relevance, use of controls, quality of research and citations. Four primary studies assessing the prevalence of VDD in fibromyalgia patients versus controls were evaluated with a total 3,496 subjects. Three included females only and one larger study assessed males. Two (n = 313) concluded the presence of a statistically significant association, and two (n = 161) found none. Two randomised controlled trials assessing the effect of vitamin D supplementation in a total of 80 subjects found conflicting results, with pain reduction in one and none in the other. It is likely there exists an association between VDD deficiency and fibromyalgia in a large subset of patients, although establishing primary causation is difficult. There is a need for larger randomised controlled trial designs with more effective comparison with healthy subjects and control for confounding factors. Given VDD is a major problem in the general population, we recommend supplementation be recommended by healthcare professionals to fibromyalgia patients for the purpose of maintaining bone health given their potentially increased susceptibility to developing deficiency and its sequelae.

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Vitamin D supplementation in multiple sclerosis patients in 2012: hype or reality as an adjunctive therapy?

Acta Neurologica Belgica ◽

10.1007/s13760-012-0162-6 ◽

2012 ◽

Vol 112 (4) ◽

pp. 325-325

Author(s):

V. van Pesch ◽

C. J. M. Sindic

Keyword(s):

Multiple Sclerosis ◽

Vitamin D ◽

Adjunctive Therapy ◽

Vitamin D Supplementation ◽

Multiple Sclerosis Patients

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Relationship between 25-OH-D serum level and relapse rate in multiple sclerosis patients before and after vitamin D supplementation

Therapeutic Advances in Neurological Disorders ◽

10.1177/1756285612447090 ◽

2012 ◽

Vol 5 (4) ◽

pp. 187-198 ◽

Cited By ~ 44

Author(s):

Charles Pierrot-Deseilligny ◽

Sophie Rivaud-Péchoux ◽

Pierre Clerson ◽

Raphaël de Paz ◽

Jean-Claude Souberbielle

Keyword(s):

Multiple Sclerosis ◽

Vitamin D ◽

Serum Level ◽

Relapse Rate ◽

Vitamin D Supplementation ◽

Before And After ◽

Multiple Sclerosis Patients

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Assessment of 25-hydroxyvitamin D and 1,25-dihydroxyvitamin D3 concentrations in male and female multiple sclerosis patients and control volunteers

Multiple Sclerosis Journal ◽

10.1177/1352458506072666 ◽

2007 ◽

Vol 13 (5) ◽

pp. 670-672 ◽

Cited By ~ 36

Author(s):

M.S. Barnes ◽

M.P. Bonham ◽

P.J. Robson ◽

J.J. Strain ◽

A.S. Lowe-Strong ◽

...

Keyword(s):

Multiple Sclerosis ◽

Vitamin D ◽

Active Form ◽

Plasma Concentrations ◽

Secondary Analysis ◽

Vitamin D Metabolism ◽

Hydroxyvitamin D ◽

25 Hydroxyvitamin D ◽

Multiple Sclerosis Patients ◽

And Control

Populations with insufficient ultraviolet exposure and who consume diets low in vitamin D have low vitamin D status (plasma 25-hydroxyvitamin D (25(OH)D) concentrations) and a reported higher incidence of multiple sclerosis (MS). The active form of vitamin D, 1,25-dihydroxyvitamin D3 (1,25(OH)2D3), is an effective anti-inflammatory molecule. No research to date has assessed 1,25(OH)2D3 concentrations in individuals with MS. In this study, plasma concentrations of 25(OH)D, 1,25(OH)2D 3 and parathyroid hormone (PTH) were measured in 29 individuals with MS and 22 age- and sex-matched control volunteers. There were no significant differences in plasma PTH, 25(OH)D and 1,25(OH)2D3 concentrations between individuals with MS and control volunteers. Women with MS had significantly higher 25(OH)D and 1,25(OH)2D3 concentrations than men with MS (79.1 ±45.4 versus 50.2±15.3 nmol/L, P=0.019 and 103.8± 36.8 versus 70.4±28.7 pmol/L, P=0.019, respectively). There was a significant positive correlation between 25(OH)D and 1,25(OH)2D 3 concentrations in all subjects (r=0.564, P=0.000), but secondary analysis revealed that the correlation was driven by women with MS (r=0.677, P= 0.001). Significant sex differences in vitamin D metabolism were observed and were most marked in individuals with MS, suggesting that vitamin D requirements may differ between the sexes, as well as by underlying disease state. Multiple Sclerosis 2007; 13: 670-672. http://msj.sagepub.com

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The Effect of Eight Weeks of Aerobic Exercise on Balance Function and Physiological Cost Index in Multiple Sclerosis Patients

Journal of Community Health Research ◽

10.18502/jchr.v9i4.4980 ◽

2020 ◽

Author(s):

Mohammad Reza Sadeh ◽

Reza Sharifatpour

Keyword(s):

Multiple Sclerosis ◽

Aerobic Exercise ◽

Aerobic Training ◽

Dynamic Balance ◽

Balance Function ◽

Cost Index ◽

Physiological Cost ◽

Multiple Sclerosis Patients ◽

And Control ◽

Experimental Group

Introduction: Muscle weakness and balance problems are limiting factors in Multiple sclerosis patients that can be improved due to physical activity. The purpose of this study was to investigate the effect of 8 weeks of aerobic exercise on balance function and Physiological Cost Index in patients with MS in Yazd city in 1394. Methods: This quasi-experimental study was conducted in two stages: pretest and post-test. The subjects were selected by targeted and available sampling and randomly divided into training and control groups that included 30 patients (15 in the experimental group and 15 in the control group). The subjects were randomly divided into two groups of experimental and control. Subjects in the experimental group participated in an aerobic exercise program for eight weeks, three days a week, each session of 60-90 minutes with an intensity of 50-70% of maximum heart rate. For statistical analysis we used descriptive statistics such as mean, standard deviation, and the Shapiro-Wilk test used to measure the normality of the data, independent t-test and the covariance (ANCOVA). The significance level of the tests was p < 0.05 by using the SPSS-25 software. Results: ANCOVA results revealed that the selected aerobic training significantly increased both static balance (p = 0.007) and dynamic balance (p = 0.001). Moreover, aerobic training positively influenced the physiological cost index (P = 0.001. Conclusion: aerobic exercise can improve both static and dynamic balance and increase the Physiological Cost Index in M.S patients. Therefore, these exercises are recommended for patients with MS.

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Inflammatory activity and vitamin D levels in an MS population treated with rituximab

Multiple Sclerosis Journal - Experimental Translational and Clinical ◽

10.1177/2055217319826598 ◽

2019 ◽

Vol 5 (1) ◽

pp. 205521731982659 ◽

Cited By ~ 1

Author(s):

Johan Linden ◽

Gabriel Granåsen ◽

Jonatan Salzer ◽

Anders Svenningsson ◽

Peter Sundström

Keyword(s):

Multiple Sclerosis ◽

Vitamin D ◽

Magnetic Resonance ◽

Vitamin D Supplementation ◽

Inflammatory Activity ◽

T2 Lesions ◽

Vitamin D Levels ◽

25 Hydroxy Vitamin D ◽

Multiple Sclerosis Patients

Background Most multiple sclerosis patients on disease-modifying treatment at Umeå University Hospital are treated with rituximab and the prevalence of vitamin D supplementation has increased over time. Follow-up studies of these off-label treatments are needed. Objective To study inflammatory activity and adverse effects in rituximab-treated multiple sclerosis patients, and associations with 25-hydroxy-vitamin D levels. Methods Retrospectively collected data on repeated estimates of relapses, disability, side effects, magnetic resonance imaging, laboratory measures including 25-hydroxy-vitamin D levels and self-perceived health. Results In 272 multiple sclerosis patients with a mean follow-up of 43 months, we identified seven possible relapses during active rituximab treatment. On magnetic resonance imaging examination, new T2 lesions were seen in 1.3% (10 out of 792 scans), and 0.25% (two out of 785 scans) showed contrast enhancement. Adjusted 25-hydroxy-vitamin D levels in samples drawn close to all magnetic resonance images with new T2 lesions were lower compared to the remainder (62 vs. 81 nmol/l; P = 0.030). Levels of 25-hydroxy-vitamin D were associated with self-perceived health ( r = 0.18, P = 0.041, n = 130) and C-reactive protein ( r = –0.13, P = 0.042) but not with the risk of side effects. Conclusion The inflammatory activity in this rituximab-treated multiple sclerosis population that increasingly used vitamin D supplementation was extremely low. Higher 25-hydroxy-vitamin D levels were associated with beneficial outcomes.

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