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Resting-state functional connectivity increase after upper-limb task-oriented motor rehabilitation in progressive MS
Author(s): ,
G. Boffa
Affiliations:
University of Genova, IRCCS AOU San Martino-IST
,
A. Tacchino
Affiliations:
Italian Multiple Sclerosis Foundation, Scientific Research Area, Genova, Italy
,
E. Sbragia
Affiliations:
University of Genova, IRCCS AOU San Martino-IST
,
S. Schiavi
Affiliations:
University of Genova, IRCCS AOU San Martino-IST
,
A. Droby
Affiliations:
Department of Neurology and Neuroscience, Icahn School of Medicine at Mount Sinai, New York City, NY, United States
,
N. Piaggio
Affiliations:
University of Genova, IRCCS AOU San Martino-IST
,
G. Bommarito
Affiliations:
University of Genova, IRCCS AOU San Martino-IST
,
G. Mancardi
Affiliations:
University of Genova, IRCCS AOU San Martino-IST
,
G. Brichetto
Affiliations:
Italian Multiple Sclerosis Foundation, Scientific Research Area, Genova, Italy
M. Inglese
Affiliations:
University of Genova, IRCCS AOU San Martino-IST; Department of Neurology and Neuroscience, Icahn School of Medicine at Mount Sinai, New York City, NY, United States
ECTRIMS Online Library. Boffa G.
Oct 12, 2018; 229109
Giacomo Boffa
Giacomo Boffa
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Abstract: P1269

Type: Poster Sessions

Abstract Category: Therapy - Symptomatic treatment

Background: Upper limb motor dysfunction is common in MS, interfering with daily activities and worsening quality of life. It was previously demonstrated1 that task-oriented motor rehabilitation treatment has an impact both on motor performance and on MRI-derived metrics of white matter integrity in relapsing remitting MS. However, there is no evidence about the efficacy of this treatment in progressive (P) MS, where brain plasticity capacities may be limited.
Objective: To identify structural and functional MRI correlates of clinical and behavioral changes following task-oriented motor rehabilitation in PMS.
Methods: 34 PMS patients (mean age=53; median EDSS=5; 11 primary PMS) were recruited for the study and randomized into 3 groups: active treatment group (ATG; n=12), passive treatment group (PTG; n=13) and control group (CG; n=9). ATG received 36 rehabilitation sessions based on task-oriented exercises, while the PTG underwent 36 sessions of passive mobilization of the upper limbs. Clinical and behavioral data of upper limb motor performance were recorded at baseline and post-treatment. All subjects underwent brain MRI including 3DT1 and T2-weighted sequences, resting state (rs)-fMRI and DTI. DTI-derived metrics were measured in the corpus callosum (CC), corticospinal tracts (CST) and cerebellar peduncles (CP). Seed-based correlation analyses were performed to detect functional connectivity (FC) changes over time in the sensorimotor and cerebellar resting-state networks.
Results: No significant changes were detected in the DTI-derived metrics from the CC, CST and CP. Based on rs-fMRI, ATG patients showed increased FC in the left cerebellum (FWE-corrected; p=0,001), while no significant changes were observed in the CG and in the PTG. Compared to the CG, ATG showed an increase in FC over time in the left frontopolar cortex, superior frontal gyrus and bilateral paracingulate gyrus (FWE-corrected; p=0,003).
Conclusion: Task-oriented motor rehabilitation enhances functional connectivity in several brain areas involved in high-order motor planning and execution. PMS patients seem to maintain functional (but not structural) plasticity abilities and they could therefore benefit from tailored active rehabilitative interventions.
1Bonzano et al. “Upper limb motor rehabilitation impacts white matter microstructure in multiple sclerosis.” Neuroimage, 2013
Disclosure: G.Boffa, A.Tacchino, E.Sbragia, S.Schiavi, A.Droby, N.Piaggio, G.Bommarito, and G. Brichetto have nothing to disclose. GL. Mancardi received travel funding and/or speaker honoraria from Bayer Schering, Biogen, Merck Serono, Novartis, Sanofi-Aventis, Teva; is an associate editor for Neurological Sciences; and received research support from Italian Multiple Sclerosis Society. M. Inglese has received research grants from Novartis and Teva Neuroscience.

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