Is it possible to actively and purposely make use of plasticity and adaptability in the neurorehabilitation treatment of multiple sclerosis patients? A pilot project.
OBJECTIVE
To investigate whether neurorehabilitation is able to influence clinical parameters and brain function measured radiologically.


METHODS
A group of healthy probands was compared with two groups of multiple sclerosis (MS) patients, one of which received rehabilitative therapy.


METHODS
Outpatient in a university hospital.


METHODS
Twenty-eight patients with multiple sclerosis (MS), 17 of whom received rehabilitative therapy, and 13 healthy controls.


METHODS
Two months of rehabilitative eclectic therapy based on principles of sensorimotor learning and adaptation.


METHODS
Multiple Sclerosis Functional Composite, Modified Fatigue Impact Scale, Beck Depression Inventory Score, Barthel Index, Environment Status Scale and Multiple Sclerosis Quality of Life--54, and functional magnetic resonance imaging (fMRI).


RESULTS
Patients who underwent neurorehabilitation showed a greater drop in fatigue, depression, impairment, disability and handicap and more improvement in quality of life than those who did not receive therapy. Correlation of brain activity between the right and the left hemisphere is greater in healthy individuals than in MS patients. Neurorehabilitation resulted in a trend for increased correlation between the left and the right hemisphere in patients (approaching the standard). In comparison with control groups, signal amplitudes in anatomical areas did not show any significant changes.


CONCLUSIONS
Clinical changes seen with neurorehabilitation were not associated with any detectable changes in fMRI observations.
Rasova
K
K
Department of Neurology, 1st Medical Faculty, Charles University, Katerinska 30, Prague 2, 121 28, Czech Republic. kamila.rasova@centrum.cz
Krasensky
J
J
Havrdova
E
E
Obenberger
J
J
Seidel
Z
Z
Dolezal
O
O
Rexova
P
P
Zalisova
M
M
D016022:Case-Control Studies; D006801:Humans; D008279:Magnetic Resonance Imaging; D009103:Multiple Sclerosis / Q000534:rehabilitation*; D009473:Neuronal Plasticity / Q000502:physiology*; D026741:Physical Therapy Modalities; D010865:Pilot Projects; D011788:Quality of Life; D016896:Treatment Outcome