title: Fractional anisotropy and mean diffusivity in the corpus callosum of patients with multiple sclerosis: the effect of physiotherapy.
abstract: BACKGROUND
  Modulation of neurodegeneration by physical activity is an active topic in contemporary research. The purpose of this study was to investigate changes in the brain's microstructure in multiple sclerosis (MS) after facilitation physiotherapy.
  
  
  METHODS
  Eleven patients with MS were examined using motor and neuropsychological testing and multimodal MRI at the beginning of the study, with second baseline measurement after 1 month without any therapy, and after a 2-month period of facilitation physiotherapy. Eleven healthy controls were examined at the beginning of the study and after 1 month. Fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (λ (ax)), and radial diffusivity (λ (rad)) were calculated for the whole corpus callosum (CC) in the midsagittal slice of T1W 3D MPRAGE spatially normalized images. Data were analyzed using linear mixed-effect models, paired, and two-sample tests.
  
  
  RESULTS
  At the baseline, patients with MS showed significantly lower values in FA (p < 0.001), and significantly higher values in MD (p < 0.001), λ (ax) (p = 0.003), and λ (rad) (p < 0.001) compared to control subjects. The FA, MD, λ (ax), and λ (rad) did not change between the first and second baseline examinations in either group. Differences 2 months after initiating facilitation physiotherapy were in FA, MD, and in λ (rad) significantly higher than differences in healthy controls (p < 0.001 for FA, p = 0.02 for MD, and p = 0.002 for λ (rad)). In MS patients, FA in the CC significantly increased (p < 0.001), MD and λ (rad) significantly decreased (p = 0.014 and p = 0.002), and thus approached the values in healthy controls.
  
  
  CONCLUSIONS
  The results of the study show that facilitation physiotherapy influences brain microstructure measured by DTI.
authors.affiliation: MR Unit, Department of Diagnostic and Interventional Radiology, Institute for Clinical and Experimental Medicine, Videnska 1958/9 Prague, Czech Republic. ibib@medicon.cz
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Ibrahim
authors.forename: Jaroslav
authors.initials: J
authors.lastname: Tintera
authors.forename: Antonin
authors.initials: A
authors.lastname: Skoch
authors.forename: Filip
authors.initials: F
authors.lastname: Jirů
authors.forename: Petr
authors.initials: P
authors.lastname: Hlustik
authors.forename: Patricia
authors.initials: P
authors.lastname: Martinkova
authors.forename: Karel
authors.initials: K
authors.lastname: Zvara
authors.forename: Kamila
authors.initials: K
authors.lastname: Rasova
mesh_terms: D000328:Adult; D016880:Anisotropy; D016022:Case-Control Studies; D003337:Corpus Callosum / Q000473:pathology*; D056324:Diffusion Tensor Imaging / Q000379:methods*; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008297:Male; D008875:Middle Aged; D008959:Models, Neurological; D009103:Multiple Sclerosis / Q000473:pathology* / Q000628:therapy*; D009483:Neuropsychological Tests; D026741:Physical Therapy Modalities; D016896:Treatment Outcome