Contributions
Abstract: 203
Type: Oral
Motor and cognitive impairments are common and disabling symptoms affecting people with multiple sclerosis (MS). Rehabilitation of these dysfunctions remains still an important way to improve quality of life and promote independence, regardless of the increasing availability of pharmacological intervention to treat MS.
Neural plasticity (i.e. the intrinsic property of the central nervous system to structurally and functionally adapt itself in response to external stimuli, environmental changes, or injuries) represents the substrate by which the damaged brain re-learns lost behaviours in response to rehabilitation. The anatomical basis of plasticity in human brain relies on highly-connected neural networks providing internal and external redundancy even in case of brain damage.
Seminal studies based on the most advanced magnetic resonance imaging (MRI) techniques have demonstrated that rapid-onset plasticity and functionally relevant chronic reorganization processes are preserved in people with MS, supporting that adaptive plasticity is enhanced by rehabilitation. There is indeed MRI-based evidence that functional and/or structural brain changes can be detected following motor or cognitive rehabilitation in people with MS.
Studies on motor rehabilitation showed that high-intensity, repetitive and target-selected training is suitable for enhancing brain plasticity, supporting the notion that training-induced plasticity is specifically linked to the trained function, such as balance, upper limbs dexterity, visual-motor coordination.
Studies on cognitive rehabilitation pointed out the role of some specific brain regions such as the cingulated cortex, precuneus, and cerebellum as main targets for intervention strategies consisting of computer-assisted training of attention, short-term memory, and executive functions.
However, the current knowledge about rehabilitation-induced brain plasticity in MS is still fragmented and incomplete. Efforts for future research should be focused on establishing: (i) optimal style, intensity, duration and timing for effective rehabilitation; (ii) standardised, valid, and reliable endpoints to assess the efficacy of rehabilitation; (iii) MRI metrics able to accurately detect the occurrence of beneficial brain plasticity after specific training; (iv) retention of rehabilitation-induced clinical and MRI improvement.
Disclosure: LP received research grants from the Italian MS Society (AISM) and Genzyme.
LP received also consulting fees from Biogen and Novartis; travel grants and speaking honoraria from Biogen, Genzyme, Novartis and Teva.
Abstract: 203
Type: Oral
Motor and cognitive impairments are common and disabling symptoms affecting people with multiple sclerosis (MS). Rehabilitation of these dysfunctions remains still an important way to improve quality of life and promote independence, regardless of the increasing availability of pharmacological intervention to treat MS.
Neural plasticity (i.e. the intrinsic property of the central nervous system to structurally and functionally adapt itself in response to external stimuli, environmental changes, or injuries) represents the substrate by which the damaged brain re-learns lost behaviours in response to rehabilitation. The anatomical basis of plasticity in human brain relies on highly-connected neural networks providing internal and external redundancy even in case of brain damage.
Seminal studies based on the most advanced magnetic resonance imaging (MRI) techniques have demonstrated that rapid-onset plasticity and functionally relevant chronic reorganization processes are preserved in people with MS, supporting that adaptive plasticity is enhanced by rehabilitation. There is indeed MRI-based evidence that functional and/or structural brain changes can be detected following motor or cognitive rehabilitation in people with MS.
Studies on motor rehabilitation showed that high-intensity, repetitive and target-selected training is suitable for enhancing brain plasticity, supporting the notion that training-induced plasticity is specifically linked to the trained function, such as balance, upper limbs dexterity, visual-motor coordination.
Studies on cognitive rehabilitation pointed out the role of some specific brain regions such as the cingulated cortex, precuneus, and cerebellum as main targets for intervention strategies consisting of computer-assisted training of attention, short-term memory, and executive functions.
However, the current knowledge about rehabilitation-induced brain plasticity in MS is still fragmented and incomplete. Efforts for future research should be focused on establishing: (i) optimal style, intensity, duration and timing for effective rehabilitation; (ii) standardised, valid, and reliable endpoints to assess the efficacy of rehabilitation; (iii) MRI metrics able to accurately detect the occurrence of beneficial brain plasticity after specific training; (iv) retention of rehabilitation-induced clinical and MRI improvement.
Disclosure: LP received research grants from the Italian MS Society (AISM) and Genzyme.
LP received also consulting fees from Biogen and Novartis; travel grants and speaking honoraria from Biogen, Genzyme, Novartis and Teva.