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Effects of motor rehabilitation on mobility and brain plasticity in multiple sclerosis: a structural and functional MRI study

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Abstract

Background

Rehabilitation seems to promote brain plasticity, but objective measures of efficacy are lacking and there is a limited understanding of the mechanisms underlying functional recovery.

Objective

To study functional and structural brain changes induced by gait rehabilitation.

Methods

We enrolled MS inpatients (EDSS 4.5–6.5) undergoing a 4-week neurorehabilitation. Several clinical measures were obtained, including: 2-min walk test (2MWT), dynamic gait index (DGI), Berg balance scale (BBS). Furthermore, motor-task functional MRI (fMRI) of plantar dorsiflexion, resting state fMRI, and regional diffusion tensor imaging (DTI) metrics were obtained. All the assessments were performed at baseline (T0), after the end of the rehabilitation period (T1) and 3 months later (T2).

Results

Twenty-nine patients were enrolled at T0, 26 at T1, and 16 completed all timepoints. At T1, there was a significant improvement of 2MWT, DGI, and BBS scores, along with a reduced extent of the widespread activation related to the motor task at the fMRI and an increased functional connectivity in the precentral and post-central gyrus, bilaterally. None of these changes were maintained at T2.

Conclusions

Our findings show a short-term beneficial effect of motor rehabilitation on gait performances in MS, accompanied by brain functional reorganization in the sensory-motor network.

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Acknowledgements

This study was supported by a grant from Fondazione Italiana Sclerosi Multipla (FISM) (Grant # 2013/R/26).

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Author notes

  1. Eleonora Tavazzi and Niels Bergsland equally contributed to the study conduction and analysis.

Authors and Affiliations

  1. Scientific Institute Santa Maria Nascente, Don C. Gnocchi Foundation ONLUS, Via Capecelatro 66, 20148, Milan, Italy

    Eleonora Tavazzi, Niels Bergsland, Davide Cattaneo, Elisa Gervasoni, Maria Marcella Laganà, Ottavia Dipasquale, Cristina Grosso, Francesca Lea Saibene, Francesca Baglio & Marco Rovaris

  2. Department of Neurology, School of Medicine and Biomedical Sciences, Buffalo Neuroimaging Analysis Center, University at Buffalo, State University of New York, Buffalo, NY, USA

    Niels Bergsland

  3. Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK

    Ottavia Dipasquale

Authors
  1. Eleonora Tavazzi
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  2. Niels Bergsland
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  3. Davide Cattaneo
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  7. Cristina Grosso
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  9. Francesca Baglio
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  10. Marco Rovaris
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Corresponding author

Correspondence to Marco Rovaris.

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Ethical statement

The study has been approved by the local ethics committee and has, therefore, been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments.

Informed consent

All the subjects recruited in the study gave their written informed consent prior to their inclusion in the study.

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Tavazzi, E., Bergsland, N., Cattaneo, D. et al. Effects of motor rehabilitation on mobility and brain plasticity in multiple sclerosis: a structural and functional MRI study. J Neurol 265, 1393–1401 (2018). https://doi.org/10.1007/s00415-018-8859-y

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  • DOI: https://doi.org/10.1007/s00415-018-8859-y

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