Abstract Details

Title Preserved Brain Functional Plasticity After Upper Limb Task-Oriented Rehabilitation in Progressive Multiple Sclerosis

Topic Neuro-rehabilitation

Presentation(s) S33 - Neuro-rehabilitation: Brain and Neuromuscular Recovery (1:11 PM-1:22 PM)

Poster/Presentation
Number 002

Background Despite clinical relevance of UL dysfunction, limited research has been dedicated to UL rehabilitation in PMS, leading to lack of evidence-based guidelines. It’s therefore still unknown whether more disabled patients with advanced PMS could still benefit from motor rehabilitation.

Objective To investigate the effect of task-oriented upper limb (UL) rehabilitation in progressive multiple sclerosis (PMS) and to assess the MRI correlates of changes in motor performance.

Design/Methods Thirty-five PMS patients were prospectively enrolled and randomized into 3 groups: active treatment group (ATG, n=13), passive treatment group (PTG, n=13) and control group (CG, n=9). At baseline and after training, patients underwent MRI scans and were evaluated with the action research arm test (ARAT), nine hole peg test (9-HPT), ABILHAND scale, modified fatigue impact scale (MFIS). Measures of motor finger performance were also obtained by engineered glove measuring.

Results After rehabilitation, ATG improved in several UL motor tasks (0.02≤p≤0.03) and showed increased ABILHAND scores compared to PTG (p<0.01). ATG showed increased functional connectivity of the sensorimotor and thalamic resting state networks compared to CG and PTG (p<0.05 cluster-wise-FDR-corrected). Correlations were found between motor improvement and thalamic, sensorimotor and basal ganglia networks (0.70≤r≤0.79, 0.008≤p≤0.04). No structural MRI changes were detected as measured by DTI.

Conclusions PMS patients could benefit from task-oriented UL rehabilitation, which seems to be
more efficient than passive mobilization. Despite extensive brain damage, functional neuroplasticity
seems to be preserved in PMS, thus providing a rationale for the use of rehabilitative treatments in late PMS.

Authors/Disclosures
Giacomo Boffa (Department of Neuroscience, University of Genova) PRESENTER	Mr. Boffa has nothing to disclose.
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Giampaolo Brichetto, MD, PhD (Italian MS Society)	Giampaolo Brichetto, MD, PhD has received personal compensation for serving as an employee of Italian MS Society.
Matilde Inglese, MD, PhD (University of Genoa)	Dr. Inglese has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for SANOFI GENZYME. Dr. Inglese has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for BIOGEN. Dr. Inglese has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for NOVARTIS. Dr. Inglese has received personal compensation in the range of $0-$499 for serving on a Scientific Advisory or Data Safety Monitoring board for MERCK-SERONO. Dr. Inglese has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for ROCHE. Dr. Inglese has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for MS Journal.

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