A RECENT meta-analysis sheds light on nonpharmacologic treatments for amyotrophic lateral sclerosis (ALS), specifically active exercise and noninvasive brain stimulation (NIBS). ALS is a debilitating neurodegenerative disease that progressively weakens muscles and impairs motor function. While pharmacologic treatments remain limited, emerging noninvasive therapies have shown potential in preserving function.
The study included 13 randomized controlled trials with 393 ALS patients, comparing active exercise to usual care and NIBS to sham treatments. The primary focus was on functional assessments and muscle strength preservation. Results indicated that active exercise, including aerobic or resistance training, significantly preserved function in 5 out of 9 studies. NIBS, however, showed less consistent benefits, with only 2 of 4 trials reporting functional improvements.
Meta-analysis results suggest moderate evidence for active exercise’s effectiveness in slowing functional decline, with a relative risk (RR) of 0.61. However, evidence for NIBS was of very low quality, showing no significant impact on function (RR = -1.41). One NIBS study noted neuroplastic changes in the brain, but further investigations are needed to better understand its neuroprotective potential.
While active exercise appears to have a beneficial effect on preserving function in ALS, NIBS requires additional research to validate its clinical utility. Both interventions need further neurophysiological studies to clarify their role in ALS treatment.
Reference: Banos M et al. Exercises and Brain Stimulation to Preserve Function in Amyotrophic Lateral Sclerosis. Neurol Clin Pract. 2025;15(1).
Anaya Malik | AMJ
