{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,7]],"date-time":"2026-04-07T23:09:25Z","timestamp":1775603365926,"version":"3.50.1"},"reference-count":99,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2023,5,6]],"date-time":"2023-05-06T00:00:00Z","timestamp":1683331200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Sensors"],"abstract":"<jats:p>There is increasing interest in the application of neuroimaging technology in exercise neurorehabilitation research among persons with multiple sclerosis (MS). The inclusion and focus on neuroimaging outcomes in MS exercise training research is critical for establishing a biological basis for improvements in functioning and elevating exercise within the neurologist\u2019s clinical armamentarium alongside disease modifying therapies as an approach for treating the disease and its consequences. Indeed, the inclusion of selective neuroimaging approaches and sensor-based technology among physical activity, mobility, and balance outcomes in such MS research might further allow for detecting specific links between the brain and real-world behavior. This paper provided a scoping review on the application of neuroimaging in exercise training research among persons with MS based on searches conducted in PubMed, Web of Science, and Scopus. We identified 60 studies on neuroimaging-technology-based (primarily MRI, which involved a variety of sequences and approaches) correlates of functions, based on multiple sensor-based measures, which are typically targets for exercise training trials in MS. We further identified 12 randomized controlled trials of exercise training effects on neuroimaging outcomes in MS. Overall, there was a large degree of heterogeneity whereby we could not identify definitive conclusions regarding a consistent neuroimaging biomarker of MS-related dysfunction or singular sensor-based measure, or consistent neural adaptation for exercise training in MS. Nevertheless, the present review provides a first step for better linking correlational and randomized controlled trial research for the development of high-quality exercise training studies on the brain in persons with MS, and this is timely given the substantial interest in exercise as a potential disease-modifying and\/or neuroplasticity-inducing behavior in this population.<\/jats:p>","DOI":"10.3390\/s23094530","type":"journal-article","created":{"date-parts":[[2023,5,8]],"date-time":"2023-05-08T02:29:22Z","timestamp":1683512962000},"page":"4530","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Neuroimaging Technology in Exercise Neurorehabilitation Research in Persons with MS: A Scoping Review"],"prefix":"10.3390","volume":"23","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2013-7632","authenticated-orcid":false,"given":"Brian M.","family":"Sandroff","sequence":"first","affiliation":[{"name":"Center for Neuropsychology and Neuroscience Research, Kessler Foundation, 1199 Pleasant Valley Way, West Orange, NJ 07052, USA"},{"name":"Department of Physical Medicine and Rehabilitation, Rutgers New Jersey Medical School, Newark, NJ 07103, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-3786-5692","authenticated-orcid":false,"given":"Caroline M.","family":"Rafizadeh","sequence":"additional","affiliation":[{"name":"Center for Neuropsychology and Neuroscience Research, Kessler Foundation, 1199 Pleasant Valley Way, West Orange, NJ 07052, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert W.","family":"Motl","sequence":"additional","affiliation":[{"name":"Department of Kinesiology and Nutrition, University of Illinois Chicago, Chicago, IL 60607, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,5,6]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"e1029","DOI":"10.1212\/WNL.0000000000007035","article-title":"The prevalence of MS in the United States: A population-based estimate using health claims data","volume":"92","author":"Wallin","year":"2019","journal-title":"Neurology"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"247","DOI":"10.1146\/annurev.neuro.30.051606.094313","article-title":"Multiple sclerosis: An immune or neurodegenerative disorder","volume":"31","author":"Trapp","year":"2008","journal-title":"Ann. Rev. Neurosci."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"162","DOI":"10.1016\/S1474-4422(17)30470-2","article-title":"Diagnosis of multiple sclerosis: 2017 revisions of the McDonald criteria","volume":"17","author":"Thompson","year":"2018","journal-title":"Lancet Neurol."},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Bross, M., Hackett, M., and Bernitsas, E. (2020). Approved and emerging disease modifying therapies on neurodegeneration in multiple sclerosis. Int. J. Mol. Sci., 21.","DOI":"10.3390\/ijms21124312"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"2016","DOI":"10.1016\/S0140-6736(99)90035-1","article-title":"Rehabilitation still the only way to improve function in multiple sclerosis","volume":"354","author":"Kraft","year":"1999","journal-title":"Lancet"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"848","DOI":"10.1016\/S1474-4422(17)30281-8","article-title":"Exercise in patients with multiple sclerosis","volume":"16","author":"Motl","year":"2017","journal-title":"Lancet Neurol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"313","DOI":"10.1016\/S1474-4422(22)00045-X","article-title":"Exercise training in multiple sclerosis","volume":"21","author":"Sandroff","year":"2022","journal-title":"Lancet Neurol."},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Motl, R.W., and Sandroff, B.M. (Mult. Scler. J., 2021). Physical exercise in multiple sclerosis is not just a symptomatic therapy, it has a disease-modifying effect\u2014Yes, Mult. Scler. J., in press.","DOI":"10.1177\/13524585211061651"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"260","DOI":"10.1249\/JES.0000000000000262","article-title":"The neurologist as an agent of exercise rehabilitation in multiple sclerosis","volume":"49","author":"Sandroff","year":"2021","journal-title":"Exerc. Sport Sci. Rev."},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Munn, Z., Peters, M.D., Stern, C., Tufanaru, C., McArthur, A., and Aromataris, E. (2018). Systematic review or scoping review? Guidance for authors when choosing between a systematic or scoping review approach. BMC Med. Res. Methodol., 18.","DOI":"10.1186\/s12874-018-0611-x"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"748","DOI":"10.1097\/PHM.0000000000000743","article-title":"Current trends in exercise intervention research, technology, and behavioral change strategies for people with disabilities: A scoping review","volume":"96","author":"Lai","year":"2017","journal-title":"Am. J. Phys. Med. Rehabil."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"271","DOI":"10.1007\/s11065-016-9324-2","article-title":"Systematic, evidence-based review of exercise, physical activity, and physical fitness effects on cognition in persons with multiple sclerosis","volume":"26","author":"Sandroff","year":"2016","journal-title":"Neuropsychol. Rev."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"319","DOI":"10.1038\/s41582-020-0355-1","article-title":"Treatment and management of cognitive dysfunction in patients with multiple sclerosis","volume":"16","author":"DeLuca","year":"2020","journal-title":"Nat. Rev. Neurol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"2121","DOI":"10.1212\/WNL.0b013e318200d768","article-title":"The contribution of MRI in assessing cognitive impairment in multiple sclerosis","volume":"75","author":"Filippi","year":"2010","journal-title":"Neurology"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"860","DOI":"10.1016\/S1474-4422(20)30277-5","article-title":"Cognitive impairment in multiple sclerosis: Clinical management, MRI, and therapeutic avenues","volume":"19","author":"Benedict","year":"2020","journal-title":"Lancet Neurol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"847","DOI":"10.1177\/1545968318798938","article-title":"Integrative CNS plasticity with exercise in MS: The PRIMERS (PRocessing, Integration of Multisensory Exercise-Related Stimuli) conceptual framework","volume":"32","author":"Sandroff","year":"2018","journal-title":"Neurorehabil. Neural Repair"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"fcac153","DOI":"10.1093\/braincomms\/fcac153","article-title":"Improved prediction of early cognitive impairment in multiple sclerosis combining blood and imaging biomarkers","volume":"4","author":"Brummer","year":"2022","journal-title":"Brain Commun."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"678035","DOI":"10.3389\/fneur.2021.678035","article-title":"Multimodal evoked potentials as potential biomarkers of disease activity in patients with clinically isolated syndrome","volume":"12","author":"Dziadkowiak","year":"2022","journal-title":"Front. Neurol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"855","DOI":"10.1080\/14737175.2020.1796640","article-title":"Current perspectives on exercise training in the management of multiple sclerosis","volume":"20","author":"Motl","year":"2020","journal-title":"Exp. Rev. Neurother."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1238","DOI":"10.1016\/j.neuroimage.2006.10.003","article-title":"Cardiorespiratory fitness: A predictor of cortical plasticity in multiple sclerosis","volume":"34","author":"Prakash","year":"2007","journal-title":"Neuroimage"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1016\/j.brainres.2009.06.063","article-title":"Aerobic fitness is associated with gray matter volume and white matter integrity in multiple sclerosis","volume":"1341C","author":"Prakash","year":"2010","journal-title":"Brain Res."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"661","DOI":"10.1016\/j.nicl.2015.02.017","article-title":"Cardiorespiratory fitness and its association with thalamic, hippocampal, and basal ganglia volumes in multiple sclerosis","volume":"7","author":"Motl","year":"2015","journal-title":"Neuroimage Clin."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1672","DOI":"10.1007\/s00415-022-11513-0","article-title":"The insula modulates the effects of aerobic training on cardiovascular function and ambulation in multiple sclerosis","volume":"270","author":"Albergoni","year":"2023","journal-title":"J. Neurol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"401","DOI":"10.1177\/1352458520914822","article-title":"Do subcortical gray matter volumes and aerobic capacity account for cognitive-motor coupling in multiple sclerosis?","volume":"27","author":"Motl","year":"2021","journal-title":"Mult. Scler."},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Romano, F., Motl, R.W., Valsasina, P., Amato, M.P., Brichetto, G., Bruschi, N., Chataway, J., Chiaravalloti, N.D., Cutter, G., and Dalgas, U. (J. Neurol., 2023). Abnormal thalamic functional connectivity correlates with cardiorespiratory fitness and physical activity in progressive multiple sclerosis, J. Neurol., in press.","DOI":"10.1007\/s00415-023-11664-8"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"171","DOI":"10.1016\/j.brainres.2018.09.013","article-title":"The relationship between corticospinal tract integrity and lower-extremity strength is attenuated when controlling for age and sex in multiple sclerosis","volume":"1701","author":"Baird","year":"2018","journal-title":"Brain Res."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"490","DOI":"10.1016\/j.nicl.2017.02.006","article-title":"Quantitative measures of walking and strength provide insight into brain corticospinal tract pathology in multiple sclerosis","volume":"14","author":"Fritz","year":"2017","journal-title":"Neuroimage Clin."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"482536","DOI":"10.1155\/2015\/482536","article-title":"Objectively measured physical activity is associated with brain volumetric measurements in multiple sclerosis","volume":"2015","author":"Klaren","year":"2015","journal-title":"Behav. Neurol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"3723","DOI":"10.1007\/s00415-020-10085-1","article-title":"The importance of physical activity to preserve hippocampal volume in people with multiple sclerosis: A structural MRI study","volume":"267","author":"Kalron","year":"2020","journal-title":"J. Neurol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"363","DOI":"10.1177\/13524585221143726","article-title":"Association of daily physical activity with brain volumes and cervical spinal cord areas in multiple sclerosis","volume":"29","author":"Block","year":"2023","journal-title":"Mult. Scler."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"986","DOI":"10.1017\/S1355617711001093","article-title":"Physical activity associated with increased resting-state functional connectivity in multiple sclerosis","volume":"17","author":"Prakash","year":"2011","journal-title":"J. Int. Neuropsychol. Soc."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"103639","DOI":"10.1016\/j.msard.2022.103639","article-title":"Lifetime physical activity is associated with gut bacteria and brain health in people with multiple sclerosis: Focus on physical activity intensity","volume":"59","author":"Mokhtarzade","year":"2022","journal-title":"Mult. Scler. Relat. Disord."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"714","DOI":"10.1111\/jon.12869","article-title":"Physical activity may contribute to brain health in multiple sclerosis: An MR volumetric and spectroscopy study","volume":"31","author":"Negaresh","year":"2021","journal-title":"J. Neuroimaging"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"1663","DOI":"10.1212\/WNL.0000000000001939","article-title":"Lower physical activity is associated with higher disease burden in pediatric multiple sclerosis","volume":"85","author":"Grover","year":"2015","journal-title":"Neurology"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"225","DOI":"10.1016\/j.jns.2016.02.044","article-title":"Diffusion tensor imaging of the corticospinal tract and walking performance in multiple sclerosis","volume":"363","author":"Hubbard","year":"2016","journal-title":"J. Neurol. Sci."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"103702","DOI":"10.1016\/j.msard.2022.103702","article-title":"Do physical activity, cardiorespiratory fitness, and subcortical brain structures explain reduced walking performance in older adults with multiple sclerosis?","volume":"60","author":"Baird","year":"2022","journal-title":"Mult. Scler. Relat. Disord."},{"key":"ref_37","doi-asserted-by":"crossref","unstructured":"Baird, J.F., and Motl, R.W. (2021). Cognitive function and whole-brain MRI metrics are not associated with mobility in older adults with multiple sclerosis. Int. J. Environ. Res. Public Health, 18.","DOI":"10.3390\/ijerph18084232"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"286","DOI":"10.1177\/15459683221076461","article-title":"Whole-brain metabolic abnormalities are associated with mobility in older adults with multiple sclerosis","volume":"36","author":"Mueller","year":"2022","journal-title":"Neurorehabil. Neural Repair"},{"key":"ref_39","doi-asserted-by":"crossref","unstructured":"Preziosa, P., Rocca, M.A., Pagani, E., Valsasina, P., Amato, M.P., Brichetto, G., Bruschi, N., Chataway, J., Chiaravalloti, N.D., and Cutter, D. (J. Neurol., 2022). Structural and functional magnetic resonance imaging correlates of fatigue and dual-task performance in progressive multiple sclerosis, J. Neurol., in press.","DOI":"10.1007\/s00415-022-11486-0"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1016\/j.neuropsychologia.2018.05.007","article-title":"Associations of functional connectivity and walking performance in multiple sclerosis","volume":"117","author":"Bollaert","year":"2018","journal-title":"Neuropsychologia"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"1193","DOI":"10.1002\/hbm.26151","article-title":"Turning and multitask gait unmask gait disturbance in mild-to-moderate multiple sclerosis: Underlying specific cortical thinning and connecting fibers damage","volume":"44","author":"Chen","year":"2023","journal-title":"Hum. Brain Mapp."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"1773","DOI":"10.1177\/13524585221094464","article-title":"Gait stability reflects motor tracts damage at early stages of multiple sclerosis","volume":"28","author":"Strik","year":"2022","journal-title":"Mult. Scler."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"3861","DOI":"10.1007\/s00415-021-10543-4","article-title":"Cortical diffusion kurtosis imaging and thalamic volume are associated with cognitive and walking performance in relapsing-remitting multiple sclerosis","volume":"268","author":"Nygaard","year":"2021","journal-title":"J. Neurol."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"4213","DOI":"10.1007\/s00415-022-11044-8","article-title":"The association between cognition and motor performance is beyond structural damage in relapsing-remitting multiple sclerosis","volume":"269","author":"Mistri","year":"2022","journal-title":"J. Neurol."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"179","DOI":"10.1016\/j.jocn.2020.10.034","article-title":"A cross-sectional comparison of performance, neurophysiological and MRI outcomes of responders and non-responders to fampridine treatment in multiple sclerosis\u2014An explorative study","volume":"82","author":"Mamoei","year":"2020","journal-title":"J. Clin. Neurosci."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1186\/s12984-017-0280-8","article-title":"Frontal brain activation changes due to dual-tasking under partial body wight support conditions in older adults with multiple sclerosis","volume":"14","author":"Chaparro","year":"2017","journal-title":"J. Neuroeng. Rehabil."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"277","DOI":"10.1016\/j.jns.2016.10.002","article-title":"Brain activation changes during locomotion in middle-aged to older adults with multiple sclerosis","volume":"370","author":"Hernandez","year":"2016","journal-title":"J. Neurol. Sci."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"296","DOI":"10.3389\/fnbeh.2018.00296","article-title":"The role of premotor areas in dual tasking in healthy controls and persons with multiple sclerosis: An fNIRS imaging study","volume":"12","author":"Saleh","year":"2018","journal-title":"Front. Behav. Neurosci."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"1119","DOI":"10.1016\/j.clinph.2020.01.024","article-title":"Mobility brain\/body imaging of cognitive-motor impairment in multiple sclerosis: Deriving EEG-based neuro-markers during a dual-task walking study","volume":"131","author":"Malcolm","year":"2020","journal-title":"Clin. Neurophysiol."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"1243","DOI":"10.1111\/ene.13689","article-title":"Neural correlates of gait variability in people with multiple sclerosis with fall history","volume":"25","author":"Kalron","year":"2018","journal-title":"Eur. J. Neurol."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"159","DOI":"10.1016\/j.jns.2018.11.015","article-title":"Supplementary motor area connectivity and dual-task walking variability in multiple sclerosis","volume":"396","author":"Fritz","year":"2019","journal-title":"J. Neurol. Sci."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"454","DOI":"10.1111\/ene.14119","article-title":"Is the walk ratio a window to the cerebellum in multiple sclerosis? A structural magnetic resonance imaging study","volume":"27","author":"Kalron","year":"2020","journal-title":"Eur. J. Neurol."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"945","DOI":"10.1007\/s12311-017-0871-8","article-title":"Impairments in walking ability, dexterity, and cognitive function in multiple sclerosis are associated with different regional cerebellar gray matter loss","volume":"16","author":"Grothe","year":"2017","journal-title":"Cerebellum"},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"229","DOI":"10.1016\/j.jns.2016.04.054","article-title":"Subcortical grey matter volumes predict subsequent walking function in early multiple sclerosis","volume":"366","author":"Nourbakhsh","year":"2016","journal-title":"J. Neurol. Sci."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"23","DOI":"10.2217\/nmt.15.71","article-title":"Thalamus volume and ambulation in multiple sclerosis: A cross-sectional study","volume":"6","author":"Motl","year":"2016","journal-title":"Neurodegen. Dis. Manag."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1016\/j.jns.2015.04.041","article-title":"Pallidal and caudate volumes correlate with walking function in multiple sclerosis","volume":"354","author":"Motl","year":"2015","journal-title":"J. Neurol. Sci."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"1200","DOI":"10.1093\/brain\/awp032","article-title":"Sensorimotor dysfunction in multiple sclerosis and column-specific magnetization transfer-imaging abnormalities in the spinal cord","volume":"132","author":"Zackowski","year":"2009","journal-title":"Brain"},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"1552","DOI":"10.1007\/s11682-021-00612-7","article-title":"Bridging the callosal gap in gait: Corpus callosum white matter integrity\u2019s role in lower limb coordination","volume":"16","author":"Richmond","year":"2022","journal-title":"Brain Imaging Behav."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"1592","DOI":"10.1016\/j.apmr.2021.12.010","article-title":"Cerebellar contributions to motor and cognitive control in multiple sclerosis","volume":"103","author":"Fritz","year":"2022","journal-title":"Arch. Phys. Med. Rehabil."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"529","DOI":"10.3389\/fneur.2020.00529","article-title":"A comprehensive approach to disentangle the effect of cerebellar damage on physical disability in multiple sclerosis","volume":"11","author":"Ruggieri","year":"2020","journal-title":"Front. Neurol."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"1681","DOI":"10.1177\/1352458514568826","article-title":"Functional connectivity changes and their relationship with clinical disability and white matter integrity in patients with relapsing-remitting multiple sclerosis","volume":"21","author":"Sbardella","year":"2015","journal-title":"Mult. Scler."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"114","DOI":"10.1016\/j.gaitpost.2020.10.015","article-title":"Advanced characterization of static postural control dysfunction in persons with multiple sclerosis and associated neural mechanisms","volume":"83","author":"Richmond","year":"2021","journal-title":"Gait Posture"},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"92","DOI":"10.1007\/s12311-020-01190-y","article-title":"White matter microstructure of the cerebellar peduncles is associated with balance performance during sensory re-weighting in people with multiple sclerosis","volume":"20","author":"Odom","year":"2021","journal-title":"Cerebellum"},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"258","DOI":"10.1016\/j.apmr.2019.07.011","article-title":"Cerebellar white matter damage is associated with postural sway deficits in people with multiple sclerosis","volume":"101","author":"Gera","year":"2020","journal-title":"Arch. Phys. Med. Rehabil."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"105451","DOI":"10.1016\/j.clineuro.2019.105451","article-title":"Spinal cord dysfunction contributes to balance impairment in multiple sclerosis patients","volume":"184","author":"Capone","year":"2019","journal-title":"Clin. Neurol. Neurosurg."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"267","DOI":"10.1148\/radiol.2017170311","article-title":"Role of cerebellar dentate functional connectivity in balance deficits in patients with multiple sclerosis","volume":"287","author":"Tona","year":"2018","journal-title":"Radiology"},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"343","DOI":"10.1177\/1545968316680487","article-title":"Corpus callosum structural integrity is associated with postural control improvement in persons with MS who have minimal disability","volume":"31","author":"Peterson","year":"2017","journal-title":"Neurorehabil. Neural Repair"},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1177\/1352458513490546","article-title":"Balance deficit with opened or closed eyes reveals involvement of different structures of the central nervous system in multiple sclerosis","volume":"20","author":"Prosperini","year":"2014","journal-title":"Mult. Scler."},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"181","DOI":"10.1148\/radiol.13121695","article-title":"Multiple sclerosis: White and gray matter damage associated with balance deficit detected at static posturography","volume":"268","author":"Prosperini","year":"2013","journal-title":"Radiology"},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"281","DOI":"10.1016\/j.nicl.2015.04.023","article-title":"Functional connectivity underlying postural motor adaptation in people with multiple sclerosis","volume":"8","author":"Fling","year":"2015","journal-title":"Neuroimage Clin."},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1016\/j.jns.2011.02.014","article-title":"The relationship between infratentorial lesions, balance deficit and accidental falls in multiple sclerosis","volume":"304","author":"Prosperini","year":"2011","journal-title":"J. Neurol. Sci."},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"103108","DOI":"10.1016\/j.nicl.2022.103108","article-title":"The network collapse in multiple sclerosis: An overview of novel concepts to address disease dynamics","volume":"35","author":"Schoonheim","year":"2022","journal-title":"Neuroimage Clin."},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"529","DOI":"10.1148\/radiol.14140168","article-title":"Multiple sclerosis: Changes in microarchitecture of white matter tracts after training with a video game balance board","volume":"273","author":"Prosperini","year":"2014","journal-title":"Radiology"},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1007\/s00234-016-1767-x","article-title":"Exercise training effects on memory and hippocampal viscoelasticity in multiple sclerosis: A novel application of magnetic resonance elastography","volume":"59","author":"Sandroff","year":"2017","journal-title":"Neuroradiology"},{"key":"ref_75","first-page":"2055217318760641","article-title":"Treadmill walking exercise training and brain function in multiple sclerosis: Preliminary evidence setting the stage for a network-based approach to rehabilitation","volume":"4","author":"Sandroff","year":"2018","journal-title":"Mult. Scler. J. Exp. Transl. Clin."},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"1356","DOI":"10.1177\/1352458517722645","article-title":"Can resistance training impact MRI outcomes in relapsing-remitting multiple sclerosis?","volume":"24","author":"Siemonsen","year":"2018","journal-title":"Mult. Scler."},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"1393","DOI":"10.1007\/s00415-018-8859-y","article-title":"Effects of motor rehabilitation on mobility and brain plasticity in multiple sclerosis: A structural and functional MRI study","volume":"265","author":"Tavazzi","year":"2018","journal-title":"J. Neurol."},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"92","DOI":"10.1177\/1352458517740211","article-title":"Effects of an individual 12-week community-located \u201cstart-to-run\u201d program on physical capacity, walking, fatigue, cognitive function, brain volumes, and structures in persons with multiple sclerosis","volume":"25","author":"Feys","year":"2019","journal-title":"Mult. Scler."},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"1594","DOI":"10.1177\/1352458519863644","article-title":"A pilot study of the effects of running training on visuospatial memory in MS: A stronger functional embedding of the hippocampus in the default-mode network?","volume":"26","author":"Huiskamp","year":"2019","journal-title":"Mult. Scler."},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"255","DOI":"10.3389\/fnhum.2020.00255","article-title":"Aerobic exercise induces functional and structural reorganization of CNS networks in multiple sclerosis: A randomized controlled trial","volume":"14","author":"Stellmann","year":"2020","journal-title":"Front. Hum. Neurosci."},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"2772","DOI":"10.2340\/16501977-2814","article-title":"Impact of aerobic exercise on clinical and magnetic resonance imaging biomarkers in persons with multiple sclerosis: An exploratory randomized controlled trial","volume":"53","author":"Savsek","year":"2021","journal-title":"J. Rehabil. Med."},{"key":"ref_82","doi-asserted-by":"crossref","first-page":"e203","DOI":"10.1212\/WNL.0000000000011241","article-title":"Efficacy of high-intensity aerobic exercise on brain MRI measures in multiple sclerosis","volume":"96","author":"Hvid","year":"2021","journal-title":"Neurology"},{"key":"ref_83","doi-asserted-by":"crossref","first-page":"102936","DOI":"10.1016\/j.msard.2021.102936","article-title":"A pilot randomized controlled trial of robotic exoskeleton-assisted exercise rehabilitation in multiple sclerosis","volume":"51","author":"Androwis","year":"2021","journal-title":"Mult. Scler. Relat. Disord."},{"key":"ref_84","doi-asserted-by":"crossref","first-page":"106563","DOI":"10.1016\/j.cct.2021.106563","article-title":"Effects of walking exercise training on learning and memory and hippocampal neuroimaging outcomes in MS: A targeted, pilot randomized controlled trial","volume":"110","author":"Sandroff","year":"2021","journal-title":"Contemp. Clin. Trials"},{"key":"ref_85","doi-asserted-by":"crossref","unstructured":"Riemenschneider, M., Hvid, L.G., Ringgaard, S., Nygaard, M.K.E., Eskildsen, S.F., Gaemelke, T., Magyari, M., Jensen, H.B., Nielsen, H.H., and Kant, M. (Mult. Scler., 2022). 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), Mult. Scler., in press.","DOI":"10.1177\/13524585221079200"},{"key":"ref_86","doi-asserted-by":"crossref","first-page":"695","DOI":"10.1080\/13554794.2013.841951","article-title":"Aerobic exercise increases hippocampal volume and improves memory in multiple sclerosis: Preliminary findings","volume":"20","author":"Leavitt","year":"2014","journal-title":"Neurocase"},{"key":"ref_87","doi-asserted-by":"crossref","first-page":"1380","DOI":"10.1249\/MSS.0000000000001914","article-title":"Effect of high-intensity exercise on multiple sclerosis function and phosphorus magnetic resonance spectroscopy outcomes","volume":"51","author":"Orban","year":"2019","journal-title":"Med. Sci. Sports Exerc."},{"key":"ref_88","doi-asserted-by":"crossref","first-page":"54","DOI":"10.1080\/09602011.2018.1449758","article-title":"Progressive resistance exercise training and changes in resting-state functional connectivity of the caudate in persons with multiple sclerosis and severe fatigue: A proof-of-concept study","volume":"30","author":"Akbar","year":"2018","journal-title":"Neuropsychol. Rehabil."},{"key":"ref_89","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1186\/s40814-021-00806-2","article-title":"A pilot study of the impact of an exercise intervention on brain structure, cognition, and psychosocial symptoms in individuals with relapsing-remitting multiple sclerosis","volume":"7","author":"Mayo","year":"2021","journal-title":"Pilot Feasibility Stud."},{"key":"ref_90","doi-asserted-by":"crossref","first-page":"575","DOI":"10.1177\/1545968320921836","article-title":"Systematic review on exercise training as a neuroplasticity-inducing behavior in multiple sclerosis","volume":"34","author":"Sandroff","year":"2020","journal-title":"Neurorehabil. Neural Repair"},{"key":"ref_91","unstructured":"American College of Sports Medicine (2013). ACSM\u2019s Resource Manual for Guidelines for Exercise Testing and Prescription, Lippincott Williams & Wilkins. [7th ed.]."},{"key":"ref_92","doi-asserted-by":"crossref","unstructured":"Bouchard, C., and Shephard, R.J. (1994). Physical Activity, Fitness, and Health: International Proceedings and Consensus Statement, Human Kinetics.","DOI":"10.1249\/00005768-199401000-00024"},{"key":"ref_93","doi-asserted-by":"crossref","first-page":"626","DOI":"10.3389\/fnhum.2016.00626","article-title":"Mediators of physical activity on neurocognitive function: A review at multiple levels of analysis","volume":"10","author":"Stillman","year":"2016","journal-title":"Front. Hum. Neurosci."},{"key":"ref_94","doi-asserted-by":"crossref","unstructured":"Hejazi, S., Karwowski, W., Farahani, F.V., Marek, T., and Hancock, P.A. (2023). Graph-based analysis of brain connectivity in multiple sclerosis using functional MRI: A systematic review. Brain Sci., 13.","DOI":"10.3390\/brainsci13020246"},{"key":"ref_95","doi-asserted-by":"crossref","first-page":"3316","DOI":"10.1073\/pnas.0400266101","article-title":"Cardiovascular fitness, cortical plasticity, and aging","volume":"101","author":"Colcombe","year":"2004","journal-title":"Proc. Natl. Acad. Sci. USA"},{"key":"ref_96","unstructured":"Pesce, C. (2009). Exercise and Cognitive Function, John Wiley & Sons."},{"key":"ref_97","doi-asserted-by":"crossref","first-page":"513","DOI":"10.1097\/PHM.0000000000001955","article-title":"Cervical spinal lesion, completeness of injury, stress, and depression reduce the efficiency of mental imagery in people with spinal cord","volume":"101","author":"Kaur","year":"2022","journal-title":"Am. J. Phys. Med. Rehabil."},{"key":"ref_98","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1007\/s11065-014-9252-y","article-title":"Strengthening connections: Functional connectivity and brain plasticity","volume":"24","author":"Kelly","year":"2014","journal-title":"Neuropsychol. Rev."},{"key":"ref_99","doi-asserted-by":"crossref","first-page":"835","DOI":"10.1080\/14737175.2019.1555038","article-title":"Application of advanced MRI techniques to monitor pharmacologic and rehabilitative treatment in multiple sclerosis: Current status and future perspectives","volume":"19","author":"Rocca","year":"2019","journal-title":"Exp. Rev. Neurother."}],"container-title":["Sensors"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1424-8220\/23\/9\/4530\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T19:30:27Z","timestamp":1760124627000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1424-8220\/23\/9\/4530"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,5,6]]},"references-count":99,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2023,5]]}},"alternative-id":["s23094530"],"URL":"https:\/\/doi.org\/10.3390\/s23094530","relation":{},"ISSN":["1424-8220"],"issn-type":[{"value":"1424-8220","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,5,6]]}}}