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

Original languageEnglish
JournalJournal of Neurology
Early online date7 Apr 2018
Publication statusPublished - 2018

King's Authors


Background Rehabilitation seems to promote brain plasticity, but objective measures of efcacy 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 dorsifexion, resting state fMRI, and regional difusion 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 signifcant
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 fndings show a short-term benefcial efect of motor rehabilitation on gait performances in MS, accompanied by brain functional reorganization in the sensory-motor network.

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