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Region Hovedstaden - en del af Københavns Universitetshospital

Investigating the potential disease-modifying and neuroprotective efficacy of exercise therapy early in the disease course of multiple sclerosis: The Early Multiple Sclerosis Exercise Study (EMSES)

Publikation: Bidrag til tidsskriftTidsskriftartikelpeer review


  • Morten Riemenschneider
  • Lars G Hvid
  • Steffen Ringgaard
  • Mikkel Karl Emil Nygaard
  • Simon Fristed Eskildsen
  • Tobias Gaemelke
  • Melinda Magyari
  • Henrik Boye Jensen
  • Helle Hvilsted Nielsen
  • Matthias Kant
  • Masoud Falah
  • Thor Petersen
  • Egon Stenager
  • Ulrik Dalgas
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BACKGROUND: Potential supplemental disease-modifying and neuroprotective treatment strategies are warranted in multiple sclerosis (MS). Exercise is a promising non-pharmacological approach, and an uninvestigated 'window of opportunity' exists early in the disease course.

OBJECTIVE: To investigate the effect of early exercise on relapse rate, global brain atrophy and secondary magnetic resonance imaging (MRI) outcomes.

METHODS: This randomized controlled trial (n = 84, disease duration <2 years) included 48 weeks of supervised aerobic exercise or control condition. Population-based control data (Danish MS Registry) was included (n = 850, disease duration <2 years). Relapse rates were obtained from medical records, and patients underwent structural and diffusion-kurtosis MRI at baseline, 24 and 48 weeks.

RESULTS: No between-group differences were observed for primary outcomes, relapse rate (incidence-rate-ratio exercise relative to control: (0.49 (0.15; 1.66), p = 0.25) and global brain atrophy rate (-0.04 (-0.48; 0.40)%, p = 0.87), or secondary measures of lesion load. Aerobic fitness increased in favour of the exercise group. Microstructural integrity was higher in four of eight a priori defined motor-related tracts and nuclei in the exercise group compared with the control (thalamus, corticospinal tract, globus pallidus, cingulate gyrus) at 48 weeks.

CONCLUSION: Early supervised aerobic exercise did not reduce relapse rate or global brain atrophy, but does positively affect the microstructural integrity of important motor-related tracts and nuclei.

TidsskriftMultiple Sclerosis Journal
Udgave nummer10
Sider (fra-til)1620-1629
Antal sider10
StatusUdgivet - sep. 2022

ID: 79732457