***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: ABSTRACT Fatigue is one of the most disabling symptoms of multiple sclerosis ( MS ) . While progressive resistance training ( PRT ) has been shown to reduce fatigue in persons with MS , it is not clear why these reductions occur . One hypothesis is that PRT may induce functional changes to the cau date , a region highly implicated in MS fatigue . The aim of the current study was to study the effects of PRT on overall fatigue impact and resting-state functional connectivity of the cau date in persons with MS reporting severe fatigue . Participants were semi-r and omly assigned to either a 16-week home-based PRT ( n = 5 ) or stretching control ( n = 5 ) condition . Both groups demonstrated reductions in overall fatigue impact ( main effect of time : F = .84 , d = .65 ) . Significant group × time interactions were found , with the PRT group demonstrating post-training increases in functional connectivity between the cau date and left inferior parietal ( F = 66.0 , p < .001 ) , bilateral frontal ( both p < .001 ) , and right insula ( F = 21.8 , p = .002 ) regions compared to the stretching group . Furthermore , greater post-training increases in functional connectivity between the cau date and left inferior parietal region were associated with greater decreases in cognitive fatigue ( r = −.52 ) specifically . This study provides initial evidence for the cau date as a potential neural substrate for the beneficial effects of PRT on fatigue in persons with MS Introduction Cognitive impairment is common and debilitating among persons with multiple sclerosis ( MS ) and might be managed with exercise training . However , the effects of exercise training on viscoelastic brain properties in this population are unknown . The present pilot study adopted a single-blind r and omized controlled trial ( RCT ) design and is the first to examine the effect of an aerobic exercise training intervention on learning and memory and hippocampal viscoelasticity using magnetic resonance elastography ( MRE ) in persons with MS . Methods Eight fully ambulatory females with MS were r and omly assigned into exercise training intervention or waitlist control conditions . The intervention condition involved 12 weeks of supervised , progressive treadmill walking exercise training . All participants underwent measures of learning and memory ( i.e. , California Verbal Learning Test-II ; CVLT-II ) and further underwent MRE scans for measurement of shear stiffness ( μ ) and damping ratio ( ξ ) of the hippocampus before and after the 12-week period . Results Overall , there were small-to-moderate intervention effects on CVLT-II performance ( d = 0.34 ) and large intervention effects on hippocampal μ ( d = 0.94 ) and hippocampal ξ ( d = −1.20 ) . Change in CVLT-II scores was strongly associated with change in μ ( r = 0.93 , p < 0.01 ) and ξ ( r = −.96 , p < 0.01 ) of the hippocampus . Conclusion This small pilot RCT provides exciting proof-of-concept data supporting progressive treadmill walking exercise training for potentially improving learning and memory and underlying hippocampal viscoelastic properties in persons with MS . This is important given the high prevalence and burden of MS-related memory impairment Background : The influences of exercising on cytokine response , fatigue and cardiorespiratory values are important aspects of rehabilitation in persons with multiple sclerosis ( PwMS ) .  Exercise performed within these programs is often practised in water but the effects of immersion on PwMS have not been systematic ally investigated . Objective : The objective of this study is to determine differences in cytokine and neurotrophin concentrations , fatigue and cardiorespiratory values in response to 3 week endurance training conducted on a cycle ergometer or an aquatic bike . Methods : A r and omized controlled clinical trial was conducted in 60 MS patients ( Exp and ed Disability Status Scale range 1.0–6.5 ) .  Resting serum levels of brain-derived neurotrophic factor ( BDNF ) , nerve growth factor ( NGF ) , Interleukin-6 , soluble receptor of IL-6 and tumor necrosis factor alpha , and concentrations in response to cardiopulmonary exercise test ( CPET ) , fatigue and cardiorespiratory values were determined at entry and discharge . Subjects performed daily 30 minute training at 60 % of VO2max . Results : Cytokines and neurotrophins showed no significant differences between groups over the training intervention . Within the water group BDNF resting and post-CPET concentrations ( p<0.05 ) showed a significant increase and NGF tended to increase after the training intervention . Short-term effects on BDNF ( CEPT ) tended to increase at the start and significantly thereafter ( p<0.05 ) . No changes occurred in the l and group . Other cytokines and fatigue scores remained unchanged over the training period . Cardiorespiratory values improved significantly over time within both groups . Conclusion : This study indicates that aquatic training activates BDNF regulation and can be an effective training method during rehabilitation in PwMS Multiple sclerosis leads to prominent hippocampal atrophy , which is linked to memory deficits . Indeed , 50 % of multiple sclerosis patients suffer memory impairment , with negative consequences for quality of life . There are currently no effective memory treatments for multiple sclerosis either pharmacological or behavioral . Aerobic exercise improves memory and promotes hippocampal neurogenesis in nonhuman animals . Here , we investigate the benefits of aerobic exercise in memory-impaired multiple sclerosis patients . Pilot data were collected from two ambulatory , memory-impaired multiple sclerosis participants r and omized to non-aerobic ( stretching ) and aerobic ( stationary cycling ) conditions . The following baseline/follow-up measurements were taken : high-resolution MRI ( neuroanatomical volumes ) , fMRI ( functional connectivity ) , and memory assessment . Intervention was 30-minute sessions 3 times per week for 3 months . Aerobic exercise result ed in 16.5 % increase in hippocampal volume and 53.7 % increase in memory , as well as increased hippocampal resting-state functional connectivity . Improvements were specific , with no comparable changes in overall cerebral gray matter ( + 2.4 % ) , non-hippocampal deep gray matter structures ( thalamus , cau date : −4.0 % ) , or in non-memory cognitive functioning ( executive functions , processing speed , working memory : changes ranged from −11 % to + 4 % ) . Non-aerobic exercise result ed in relatively no change in hippocampal volume ( 2.8 % ) or memory ( 0.0 % ) , and no changes in hippocampal functional connectivity  . This is the first evidence for aerobic exercise to increase hippocampal volume and connectivity and improve memory in multiple sclerosis . Aerobic exercise represents a cost-effective , widely available , natural , and self-administered treatment with no adverse side effects that may be the first effective memory treatment for multiple sclerosis patients In recent years it has become clear that multiple sclerosis ( MS ) patients benefit from physical exercise as performed in aerobic training but little is known about the effect on functional domains and physiological factors mediating these effects . We studied immunological , endocrine and neurotrophic factors as well as coordinative function and quality of life during an 8-week aerobic bicycle training in a waitlist control design . In the immune-endocrine study ( 1 ) 28 patients were included , the coordinative extension study ( 2 ) included 39 patients .  Training was performed at 60 % VO(2)max after determining individual exertion levels through step-by-step ergometry .  Metabolic ( lactate ) , endocrine ( cortisol , adrendocortico-releasing hormone , epinephrine , norepinephrine ) , immune ( IL-6 , soluble IL-6 receptor ) , and neurotrophic ( brain-derived neurotrophic factor ( BDNF ) , nerve growth factor ( NGF ) ) parameters were compared from a pre study and a post study endurance test at 60 % VO(2)max for 30 min . In study ( 1 ) , lowered lactate levels despite higher workload levels indicated a training effect . Disease-specific quality of life ( as measured by the Hamburg Quality of Life Question naire for Multiple Sclerosis , HAQUAMS ) significantly increased in the training group . No significant training effects were seen for endocrine and immune parameters or neurotrophins . In study ( 2 ) , two out of three coordinative parameters of the lower extremities were significantly improved . In summary , low-level aerobic training in MS improves not only quality of life but also coordinative function and physical fitness Background : Multiple sclerosis ( MS ) is characterised by accelerated brain atrophy , which relates to disease progression . Previous research shows that progressive resistance training ( PRT ) can counteract brain atrophy in other population s. Objective : To evaluate the effects of PRT by magnetic resonance imaging ( MRI ) and clinical measures of disease progression in people with MS . Methods : This study was a 24-week r and omised controlled cross-over trial , including a Training ( n = 18 , 24 weeks of PRT followed by self-guided physical activity ) and Waitlist group ( n = 17 , 24 weeks of habitual lifestyle followed by PRT ) . Assessment s included disability measures and MRI ( lesion load , global brain volume , percentage brain volume change ( PBVC ) and cortical thickness ) . Results : While the MS Functional Composite score improved , Exp and ed Disability Status Scale , lesion load and global brain volumes did not differ between groups . PBVC tended to differ between groups and higher absolute cortical thickness values were observed in 19 of 74 investigated cortical regions after PRT . Observed changes were confirmed and reproduced when comparing relative cortical thickness changes between groups for four areas : anterior cingulate gyrus , temporal pole , orbital sulcus and inferior temporal sulcus . Conclusion : PRT seem to induce an increase in cortical thickness , indicating that PRT have a neuroprotective or even neuroregenerative effect in relapsing-remitting MS BACKGROUND Clinical studies have suggested beneficial effects of exercise on cognitive function in ageing adults and neurodegenerative diseases such as dementia . Recent work indicates the same for progressive multiple sclerosis ( MS ) , an inflammatory and degenerative disease of the central nervous system ( CNS ) . The biological pathways associated with these effects are however not well understood . OBJECTIVE In this r and omized controlled study , we explored serum levels of the myokine Irisin , the neurotrophin brain-derived neurotrophic factor ( BDNF ) and Interleukin-6 ( IL-6 ) during acute endurance exercise and over the course of a 9-weeks endurance exercise training period in n=42 patients with progressive MS . RESULTS We detected a significant increase of BDNF levels in progressive MS patients after 30min of bicycling ( p<0.001 ) . However , there were no significant changes for baseline levels after 22 sessions of training . No significant effects of acute or prolonged exercise could be found for Irisin or Interleukin-6 . CONCLUSION Our results indicate that BDNF is strongly induced during acute exercise even in patients with progressive MS and advanced physical disability . Long-term effects of exercise programs on biological parameters ( Irisin , BDNF , IL-6 ) were much less pronounced . Given the hypothesis-driven selection of a limited set of biological markers in this pilot study , future studies should use unbiased approaches in larger sample s to obtain a comprehensive picture of the networks involved in exercise effects on neurological diseases BACKGROUND Suppressors of cytokine signaling ( SOCS ) and brain-derived neurotrophic factor ( BDNF ) are important immunologic , and neurotrophic factors for MS pathogenesis . The impact of exercise on these factors is yet to be fully eluci date d in patients with MS . OBJECTIVE The primary aim of this study is to investigate the effect of 8-week combined exercise training on serum concentrations of SOCS1 , SOCS3 , and BDNF . The secondary aim is to determine the effects of combined exercise training on balance , functional exercise capacity , and fatigue in patients with MS . METHODS Serum SOCS1 , SOCS3 , and BDNF levels were assessed in 36 MS patients and 18 healthy individuals . In addition , balance , functional exercise capacity , and fatigue were assessed in the patients with MS . The patients were r and omly divided into the combined exercise group ( MS-EX , n:18 ) and the control group ( MS-C , n:18 ) . MS-EX received an 8-week combined exercise training . RESULTS The serum SOCS1 , SOCS3 , and BDNF levels were similar in the MS patients and healthy control ( HC ) . In MS-EX , the serum BDNF level , balance , functional exercise capacity , and fatigue improved after 8weeks ( p<0.05 ) , but the serum SOCS1 , and SOCS3 levels did not change significantly ( p>0.05 ) . In MS-C , the serum SOCS1 level , and fatigue increased significantly after 8weeks ( p<0.05 ) , but serum SOCS3 , BDNF , balance and functional exercise capacity did not change ( p>0.05 ) . CONCLUSIONS In summary , the combined exercise training  improved BDNF , and physical performance in patients with MS . But , future studies are needed to clarify the role of SOCS proteins in MS pathogenesis and the effect of exercise on SOCS Blood-brain barrier ( BBB ) and neurotrophic factors seemingly have an important role in multiple sclerosis pathology . Physical activity may influence blood-brain barrier function and levels of neurotrophic factors , and such effects might be moderated by body weight status . This study investigated the effect of exercise training on markers of blood-brain barrier permeability and neurotrophic factors as a function of weight status in multiple 
    Output:
    
The existing evidence from MRI studies confirmed that exercise training can improve CNS integrity and function .
There is evidence of a positive effect of exercise training on modulation of BBB permeability markers and brain-derived neurotrophic factor .
CONCLUSIONS Exercise  successfully improves MRI outcomes and peripheral biomarkers ( i.e. brain-derived neurotrophic factor ) in people with MS .
This suggests that exercise can be recommended as an adjuvant therapy for MS treatment .