Neuroplasticity and brain reorganization associated with positive outcomes of multidisciplinary rehabilitation in progressive multiple sclerosis: A fMRI study

Mult Scler Relat Disord. 2020 Jul:42:102127. doi: 10.1016/j.msard.2020.102127. Epub 2020 May 6.

Abstract

Background: Multiple sclerosis (MS) is characterized by a range of symptoms, including motor, sensorimotor and cognitive impairments, that limit the quality of life. A multidisciplinary rehabilitation approach in people affected by multiple sclerosis was recently reported to improve the functional abilities of MS patients in daily activities. The purpose of the study was to assess the effect of multidisciplinary rehabilitation on the whole brain of MS patients by means of functional magnetic resonance imaging (fMRI).

Methods: Thirty individuals affected by MS (49.9 ± 12.1 years; disease duration: 16.0 ± 8.5 years) with a medium-high severity of disease were enrolled. The fMRI examination assessed a range of action-related tasks involving passive movement, mental simulation of action and miming of action triggered by external stimuli, such as object photography. The three tasks were performed using each arm separately. The fMRI acquisitions were performed at T1 (inclusion in the study), T2 (3 months later, at the start of rehabilitation) and T3 (after 3 months of multidisciplinary rehabilitation).

Results: The fMRI results revealed a significant reduction in the activity of brain areas related to task-specific networks as well as the activation of cerebral regions not usually involved in task-specific related network, such as the medial prefrontal area.

Conclusions: The effectiveness of multidisciplinary rehabilitation on activity and participation has been established in previous studies. Our study sheds new light on the effect of such treatment on brain reorganization.

Keywords: Brain; Functional MRI; Multiple sclerosis; Neurorehabilitation; Rehabilitation.

MeSH terms

  • Adult
  • Brain / diagnostic imaging
  • Brain / physiopathology*
  • Brain Mapping*
  • Female
  • Humans
  • Magnetic Resonance Imaging
  • Middle Aged
  • Motor Activity / physiology*
  • Multiple Sclerosis, Chronic Progressive / diagnostic imaging
  • Multiple Sclerosis, Chronic Progressive / physiopathology*
  • Multiple Sclerosis, Chronic Progressive / rehabilitation*
  • Nerve Net / diagnostic imaging
  • Nerve Net / physiopathology*
  • Neurological Rehabilitation* / methods
  • Neuronal Plasticity / physiology*
  • Prefrontal Cortex / diagnostic imaging
  • Prefrontal Cortex / physiopathology
  • Sensorimotor Cortex / diagnostic imaging
  • Sensorimotor Cortex / physiopathology
  • Treatment Outcome