Changes in Daily Activity Linked to MS Progression

New research suggests a connection between fluctuations in daily activity levels and the progression of multiple sclerosis (MS). A study published in Neurology®, the medical journal of the American Academy of Neurology, found that individuals with MS who experienced changes in their activity habits were more likely to exhibit worsening disability and brain volume loss compared to those with more stable routines.¹

Study Findings

The study, led by Kathryn C. Fitzgerald, ScD, ScM, assistant professor of neurology at Johns Hopkins University, does not establish a cause-and-effect relationship, but rather highlights an association between activity changes and MS progression. “Rapidly identifying patients at risk of disease progression is critical to reducing long-term disability, but current tests to measure MS-related disability are not designed to detect small changes. Using a relatively inexpensive and accessible device around the wrist can aid us identify early changes in the disease,” Fitzgerald stated.¹

Researchers followed 238 people with MS, averaging 55 years traditional and living with the condition for 13 years. Participants had an average disability level of 3 on the Expanded Disability Status Scale (EDSS), indicating moderate disability in one functional system or mild disability in three or four areas, but no significant walking problems.¹

Over an average of three years, participants wore wrist-worn devices 24 hours a day to track their activity levels, including periods of inactivity, light, moderate, and vigorous physical activity, and sleep-wake patterns. Disability levels were assessed every six months, and brain scans were conducted at the beginning and end of the study period.¹

The study revealed that 120 participants experienced disease progression. Those whose daytime activity levels decreased were more likely to experience progression, with a roughly 20% increased risk for those showing a decline in activity during the first half of the day.¹

Decreases in morning activity (between 8 a.m. And 10 a.m.) were also linked to brain volume loss. Specifically, each standard deviation decrease in activity was associated with a 0.18% reduction in whole brain volume, a 0.34% decrease in deep gray matter, and a 0.35% loss in thalamus volume.¹

Future Research and Implications

Researchers emphasize the need for further investigation to confirm these findings. “More research is needed to confirm these findings, but it is exciting to think that using easily accessible devices could help us predict who is at risk for worsening disease and potentially prevent these changes,” Mowry said. “Detecting small changes could also help us speed up research into new treatments.”¹

The study acknowledges certain limitations. The absence of a control group without MS makes it tricky to differentiate between activity changes related to MS progression and those associated with normal aging. The participant pool consisted of individuals who were relatively older and had more advanced disability, potentially limiting the generalizability of the findings to younger individuals with less severe MS.¹

About Multiple Sclerosis

Multiple sclerosis is a chronic, often disabling disease that affects the central nervous system. It is an autoimmune disease in which the body’s immune system attacks the myelin sheath, the protective covering of nerve fibers.² This damage disrupts communication between the brain and the rest of the body. Symptoms vary widely but can include fatigue, difficulty walking, numbness, weakness, and vision problems.² Disease-modifying therapies (DMTs) are available to help manage MS and sluggish its progression.³

Disclaimer: This article provides general information and should not be considered medical advice. Consult with a healthcare professional for personalized guidance.

References

• ¹ Fitzgerald, K. C., et al. (2026). Changes in Daily Activity Are Associated with MS Progression. Neurology®. https://www.neurology.org/doi/pdf/10.1212/wnl.0000000000005347
• ² National Multiple Sclerosis Society. (n.d.). About MS. https://www.nationalmssociety.org/What-is-MS
• ³ American Academy of Neurology. (2018). Disease-Modifying Therapies For Adults With Multiple Sclerosis. https://www.guidelinecentral.com/guideline/10723/