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Brain Sciences
Special Issues
Lifestyle and Risk Factors for Multiple Sclerosis
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Lifestyle and Risk Factors for Multiple Sclerosis

A special issue of Brain Sciences (ISSN 2076-3425). This special issue belongs to the section "Neurodegenerative Diseases".

Deadline for manuscript submissions: closed (31 December 2025) | Viewed by 7196

Special Issue Editors

Prof. Roberta Lanzillo

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Guest Editor
Department of NSRO, Federico II University, 80131 Naples, Italy
Interests: imaging; neuroscience; neurodegeneration; neurological diseases; neurology; multiple sclerosis; demyelinating diseases
Special Issues, Collections and Topics in MDPI journals
Prof. Dr. Saverio Stranges

E-Mail Website
Guest Editor
Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
Interests: sleep epidemiology; chronic disease epidemiology and prevention; ageing research; multimorbidity; global health; public health; social and environmental determinants of health
Special Issues, Collections and Topics in MDPI journals
Prof. Marinella Clerico

E-Mail Website
Guest Editor
Department of Clinical and Biological Sciences, University of Turin, Orbassano, Italy
Interests: multiple sclerosis; neuroimmunology; clinical trials; basic science; epidemiology

Special Issue Information

Dear Colleagues,

Multiple sclerosis (MS) is a chronic autoimmune disease of the central nervous system, and several risk factors have been identified to possibly increase its likelihood and lead to a worse prognosis.

This Special Issue on lifestyle and risk factors for multiple sclerosis will be a timely and impactful contribution to the field of MS research. By gathering current insights on lifestyle, genetic, and environmental risk factors for MS, this issue could deepen our understanding of the disease, inform preventive strategies, and contribute to improved patient outcomes, as well as provide a comprehensive, multidisciplinary approach, shaping future research, clinical practice, and public health policies related to MS.

Lifestyle factors are gaining importance in this field, with new insights on nutrition, pollution, and sleep quality increasingly achieving primary importance in terms of disease risk and prognosis.

Authors are invited to present cutting-edge research and review articles that addresses a wide range of topics related to developing multiple sclerosis itself or risk factors leading to a worse prognosis.

Prof. Roberta Lanzillo
Prof. Dr. Saverio Stranges
Prof. Marinella Clerico
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 250 words) can be sent to the Editorial Office for assessment.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Brain Sciences is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2200 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • multiple sclerosis
  • lifestyle
  • risk factors
  • nutrition
  • pollution
  • sleep quality
  • progression

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Published Papers (4 papers)

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Review

13 pages, 861 KB  
Review
Obesity, Nutrition and the Multiple Sclerosis Risk in Adolescents
by Marta Giovengo, Margherita Rosa and Claudia Mandato
Brain Sci. 2026, 16(3), 283; https://doi.org/10.3390/brainsci16030283 - 28 Feb 2026
Viewed by 693
Abstract
Multiple Sclerosis (MS) is a chronic, autoimmune neurological disease resulting from the interplay between genetic susceptibility and environmental factors. In recent decades, the rising incidence of MS, particularly pediatric-onset forms, has paralleled the global obesity pandemic. This article explores the causal link between [...] Read more.
Multiple Sclerosis (MS) is a chronic, autoimmune neurological disease resulting from the interplay between genetic susceptibility and environmental factors. In recent decades, the rising incidence of MS, particularly pediatric-onset forms, has paralleled the global obesity pandemic. This article explores the causal link between pediatric obesity, systemic inflammation, and neuroinflammation, with a specific focus on the microbiota–gut–liver–brain axis. We analyze how nutritional habits can play a pivotal role by inducing dysbiosis, with alteration in microbiota-driven metabolites, and leaky gut related abnormalities—which may trigger blood–brain barrier (BBB) disruption and microglial activation—or by acting as a protective factor, such as through the Mediterranean Diet (MD). Furthermore, we evaluate the emerging therapeutic perspectives offered by Glucagon-Like Peptide-1 (GLP-1) agonists, which may offer dual benefits in weight management and immune modulation. Full article
(This article belongs to the Special Issue Lifestyle and Risk Factors for Multiple Sclerosis)
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10 pages, 215 KB  
Review
The Role of Lifestyle Factors in Multiple Sclerosis: An Integrative Perspective
by Roberta Lanzillo, Marinella Clerico and Saverio Stranges
Brain Sci. 2026, 16(2), 224; https://doi.org/10.3390/brainsci16020224 - 13 Feb 2026
Cited by 1 | Viewed by 1017
Abstract
Multiple sclerosis (MS) is a chronic, immune-mediated neurological disorder characterized by inflammation, demyelination, and progressive neurodegeneration. While genetic susceptibility contributes to disease risk, a growing body of evidence highlights the crucial role of modifiable lifestyle factors in influencing MS onset, disease activity, progression, [...] Read more.
Multiple sclerosis (MS) is a chronic, immune-mediated neurological disorder characterized by inflammation, demyelination, and progressive neurodegeneration. While genetic susceptibility contributes to disease risk, a growing body of evidence highlights the crucial role of modifiable lifestyle factors in influencing MS onset, disease activity, progression, and overall quality of life. In this narrative review, we explored the relevant literature from commonly used datasets (PubMed, Scopus, Google Scholar), using search terms such as “Lifestyle and Multiple Sclerosis”, “Diet and Multiple Sclerosis”, “Sleep and Multiple Sclerosis”, “Alcohol consumption and Multiple Sclerosis”, and “Physical Activity and Multiple Sclerosis”. Obesity, particularly during adolescence, has emerged as a significant risk factor for MS, acting through immunometabolic mechanisms such as chronic low-grade inflammation, insulin resistance, and dysregulated adipokine signaling. Sleep disturbances are increasingly recognized as contributors to neuroinflammation and cognitive dysfunction, potentially mediated by impaired glymphatic clearance. Smoking is consistently associated with accelerated disability progression, while alcohol consumption shows dose-dependent effects, with excessive intake negatively impacting sleep and glymphatic function. Overall, lifestyle factors converge on shared biological pathways involving immune regulation, metabolic health, vascular integrity, and glymphatic function. Integrating evidence-based lifestyle counseling with disease-modifying therapies may represent a complementary strategy to optimize long-term outcomes in people with MS, while highlighting key areas for future translational and clinical research. Full article
(This article belongs to the Special Issue Lifestyle and Risk Factors for Multiple Sclerosis)
35 pages, 1208 KB  
Review
Targeting Lifestyle in CNS Inflammatory Demyelinating Diseases: Insights from Diet and Exercise as Potential Disease Modifiers
by Eleonora Virgilio, Federico Abate Daga, Matteo Bronzini, Marta Morra, Rachele Rosso, Alessandro Maglione, Manuela Matta, Federica Masuzzo and Simona Rolla
Brain Sci. 2026, 16(1), 57; https://doi.org/10.3390/brainsci16010057 - 30 Dec 2025
Viewed by 1617
Abstract
This narrative review explores the impact of diet and physical exercise both as a risk factor of central nervous system inflammatory diseases, but more importantly as potential adjunctive disease modifiers in Multiple Sclerosis (MS), Neuromyelitis Optica Spectrum Disorders (NMOSD), and Myelin Oligodendrocyte Glycoprotein [...] Read more.
This narrative review explores the impact of diet and physical exercise both as a risk factor of central nervous system inflammatory diseases, but more importantly as potential adjunctive disease modifiers in Multiple Sclerosis (MS), Neuromyelitis Optica Spectrum Disorders (NMOSD), and Myelin Oligodendrocyte Glycoprotein (MOG) antibody-associated disease (MOGAD). The majority of evidence relies on MS preclinical and clinical studies, but preclinical studies also support the benefit of lifestyle intervention in NMOSD and MOGAD. In MS, adherence to healthy diets (particularly Mediterranean and MIND diets) could lead to a milder disease course with reduced relapse rates, while structured exercise from early disease stages promotes neuroprotection by upregulating neurotrophic factors and preserving brain volume, possibly impacting disease progression. The ketogenic diet and intermittent caloric restriction also showed promising results. Physical activity, including both aerobic training and resistance training, emerges as a potential disease-modifying strategy by promoting neuroprotection, reducing inflammation, and supporting functional and cognitive outcomes, particularly when implemented early in the disease course. A synergistic approach alongside disease-modifying treatments (DMTs) would further positively modulate core pathological processes. Evidence for NMOSD and MOGAD warrants further investigation. We highlight that integrating personalized lifestyle strategies would be beneficial from the early stages. However, future large-scale, standardized trials are required to fully confirm the neuroprotective potential of diet and exercise across the entire spectrum of CNS disorders. Full article
(This article belongs to the Special Issue Lifestyle and Risk Factors for Multiple Sclerosis)
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32 pages, 532 KB  
Review
Sex-Related Differences in Lifestyle Factors Affecting Multiple Sclerosis Susceptibility and Disease Progression
by Elena Barbuti, Claudia Piervincenzi, Serena Ruggieri and Maria Petracca
Brain Sci. 2025, 15(10), 1097; https://doi.org/10.3390/brainsci15101097 - 11 Oct 2025
Cited by 5 | Viewed by 2889
Abstract
Multiple sclerosis (MS) is a chronic autoimmune disease of the central nervous system that affects women more frequently than men. This sex gap has widened over the past century, and appears to be shaped by lifestyle factors more than biological factors. This narrative [...] Read more.
Multiple sclerosis (MS) is a chronic autoimmune disease of the central nervous system that affects women more frequently than men. This sex gap has widened over the past century, and appears to be shaped by lifestyle factors more than biological factors. This narrative review examines the evidence for sex-specific differences in lifestyle risk factors and their impact on both MS susceptibility and disease progression, with implications for diagnosis, monitoring, and treatment. Smoking, obesity, vitamin D deficiency, ultraviolet radiation exposure, and Epstein–Barr virus infection all interact with sex-related biological pathways to influence MS risk. Women appear to be more vulnerable to the pathogenic effects of smoking and obesity, both independently and in synergy with genetic risk alleles, while vitamin D and UV exposure confer stronger protective effects in females than in males. EBV infection also exhibits sex-dependent immune responses, shaped by hormonal regulation and host–virus genetic interactions. Sex-related lifestyle factors also modulate MS progression. Women experience more inflammatory activity and relapses, whereas men more often develop a progressive phenotype with greater neurodegeneration. Hormonal changes during female reproductive phases, such as pregnancy, breastfeeding, menopause, and hormone-based therapies, critically influence disease activity and progression in MS. Obesity, smoking, vitamin D status, diet, and gut microbiota further interact with sex hormones and genetic background, contributing to variable disease trajectories, also modulated by social determinants such as education level. These findings underscore the need to integrate into clinical practice the evaluation of lifestyle factors in a sex-specific way for diagnosis, monitoring, and treatment of MS. Full article
(This article belongs to the Special Issue Lifestyle and Risk Factors for Multiple Sclerosis)
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