title: Functional and Structural Brain Plasticity Enhanced by Motor and Cognitive Rehabilitation in Multiple Sclerosis.
abstract: Rehabilitation is recognized to be important in ameliorating motor and cognitive functions, reducing disease burden, and improving quality of life in patients with multiple sclerosis (MS). In this systematic review, we summarize the existing evidences that motor and cognitive rehabilitation may enhance functional and structural brain plasticity in patients with MS, as assessed by means of the most advanced neuroimaging techniques, including diffusion tensor imaging and task-related and resting-state functional magnetic resonance imaging (MRI). In most cases, the rehabilitation program was based on computer-assisted/video game exercises performed in either an outpatient or home setting. Despite their heterogeneity, all the included studies describe changes in white matter microarchitecture, in task-related activation, and/or in functional connectivity following both task-oriented and selective training. When explored, relevant correlation between improved function and MRI-detected brain changes was often found, supporting the hypothesis that training-induced brain plasticity is specifically linked to the trained domain. Small sample sizes, lack of randomization and/or an active control group, as well as missed relationship between MRI-detected changes and clinical performance, are the major drawbacks of the selected studies. Knowledge gaps in this field of research are also discussed to provide a framework for future investigations.
authors.affiliation: Department of Neurology and Psychiatry, Sapienza University, Viale dell'Università 30, 00185 Rome, Italy.
authors.forename: Luca
authors.initials: L
authors.lastname: Prosperini
authors.affiliation: Department of Neurology and Psychiatry, Sapienza University, Viale dell'Università 30, 00185 Rome, Italy.
authors.forename: Maria Cristina
authors.initials: MC
authors.lastname: Piattella
authors.affiliation: Department of Radiological Sciences, Oncology and Pathology, Sapienza University, Rome, Italy.
authors.forename: Costanza
authors.identifier: 0000-0002-4018-169X
authors.initials: C
authors.lastname: Giannì
authors.affiliation: Department of Neurology and Psychiatry, Sapienza University, Viale dell'Università 30, 00185 Rome, Italy ; IRCCS Neuromed, Pozzilli, Italy.
authors.forename: Patrizia
authors.identifier: 0000-0001-9659-8294
authors.initials: P
authors.lastname: Pantano
mesh_terms: D001921:Brain / Q000473:pathology* / Q000503:physiopathology*; D001931:Brain Mapping; D003071:Cognition; D056324:Diffusion Tensor Imaging; D006801:Humans; D008279:Magnetic Resonance Imaging; D009103:Multiple Sclerosis / Q000473:pathology / Q000503:physiopathology / Q000523:psychology / Q000534:rehabilitation*; D009473:Neuronal Plasticity; D011597:Psychomotor Performance; D016032:Randomized Controlled Trials as Topic; D020127:Recovery of Function; D018910:Video Games; D066127:White Matter / Q000473:pathology / Q000503:physiopathology