Contributions
Abstract: 204
Type: Oral
Abstract Category: RIMS - Neurobiology & Rehabilitation
Background: Action Observation Therapy (AOT) facilitates motor system function, possibly through a modulation of mirror neuron system (MNS) recruitment.
Aims. We applied functional MRI to assess whether AOT modifies brain activations in healthy controls (HC) and MS patients with right (R) upper limb motor deficits.
Methods: In this blind, randomized, controlled trial, 86 R-handed subjects (46 HC; 40 MS), were randomized into 4 groups: 2 experimental groups (AOT-HC n=23; AOT-MS n=20) and 2 control groups (C-HC n=23; C-MS n=20). The training consisted of 10 sessions of 45 minutes in 2 weeks. AOT-groups watched 3 videos (5 minutes each) of daily-life actions alternated by their execution with the R hand; C-groups performed the same tasks, but watched landscapes videos. At baseline and after 2 weeks (w2) fMRI during object manipulation with the R hand was obtained.
Results: At t0, compared to HC, MS patients had a decreased activation of the superior parietal gyrus and superior frontal gyrus (SFG) and an increased activation of the angular gyrus and precuneus. At w2, C-HC had a decreased activation of the parahippocampal gyrus, whereas AOT-HC had a decreased activation of visual, temporal and frontal lobe areas, including the superior frontal gyrus (SFG). At w2, C-MS experienced a decreased activation in some areas of the visual network (the middle occipital gyrus and inferior occipital gyrus), the superior temporal gyrus, angular gyrus, superior parietal gyrus and inferior frontal gyrus (IFG), whereas AOT-MS showed a decreased activation of areas related to learning (the hippocampus and parahippocampal gyrus), the fusiform gyrus, middle temporal gyrus, angular gyrus and rolandic operculum. The analysis of AOT effect in MS patients showed a significant effect at the level of visual areas, MNS regions (including the IFG and middle temporal gyrus) and the cerebellum.
Conclusions: Two weeks of motor training in MS patients modulate recruitment of areas that are part of the motor network and MNS. These findings might contribute to improve the understanding of the functional substrates underling motor deficits recovery in patients with MS and to develop individualized treatment strategies.
Disclosure: Partially supported by grants from FISM (FISM2012R15) and Italian Ministry of Health (RF-2011-02350374).
M.A. Rocca received speakers honoraria from Biogen Idec, Novartis and ExceMed and receives research support from the Italian Ministry of Health and Fondazione Italiana Sclerosi Multipla.
S. Fumagalli has nothing to disclose.
A. M. Dirito has nothing to disclose.
A. Ravetto has nothing to disclose.
P. Preziosa has nothing to disclose.
R. Gatti has nothing to disclose.
F. Martinelli-Boneschi received honoraria for consulting, research grant and travel expenses from TEVA neuroscience, Biogen IDEC, Merck Serono.
M. Comola has nothing to disclose.
G. Comi has received consulting fees for participating on advisory boards from Novartis, Teva Pharmaceutical Ind. Ltd, Sanofi, Genzyme, Merck Serono, Bayer, Actelion and honorarium for speaking activities for Novartis, Teva Pharmaceutical Ind. Ltd, Sanofi, Genzyme, Merck Serono, Bayer, Biogen, Excemed.
M. Filippi is Editor-in-Chief of the Journal of Neurology; serves on scientific advisory boards for Teva Pharmaceutical Industries; has received compensation for consulting services and/or speaking activities from Biogen Idec, Excemed, Novartis, and Teva Pharmaceutical Industries; and receives research support from Biogen Idec, Teva Pharmaceutical Industries, Novartis, Italian Ministry of Health, Fondazione Italiana Sclerosi Multipla, Cure PSP, Alzheimer´s Drug Discovery Foundation (ADDF), the Jacques and Gloria Gossweiler Foundation (Switzerland), and ARiSLA (Fondazione Italiana di Ricerca per la SLA).
Abstract: 204
Type: Oral
Abstract Category: RIMS - Neurobiology & Rehabilitation
Background: Action Observation Therapy (AOT) facilitates motor system function, possibly through a modulation of mirror neuron system (MNS) recruitment.
Aims. We applied functional MRI to assess whether AOT modifies brain activations in healthy controls (HC) and MS patients with right (R) upper limb motor deficits.
Methods: In this blind, randomized, controlled trial, 86 R-handed subjects (46 HC; 40 MS), were randomized into 4 groups: 2 experimental groups (AOT-HC n=23; AOT-MS n=20) and 2 control groups (C-HC n=23; C-MS n=20). The training consisted of 10 sessions of 45 minutes in 2 weeks. AOT-groups watched 3 videos (5 minutes each) of daily-life actions alternated by their execution with the R hand; C-groups performed the same tasks, but watched landscapes videos. At baseline and after 2 weeks (w2) fMRI during object manipulation with the R hand was obtained.
Results: At t0, compared to HC, MS patients had a decreased activation of the superior parietal gyrus and superior frontal gyrus (SFG) and an increased activation of the angular gyrus and precuneus. At w2, C-HC had a decreased activation of the parahippocampal gyrus, whereas AOT-HC had a decreased activation of visual, temporal and frontal lobe areas, including the superior frontal gyrus (SFG). At w2, C-MS experienced a decreased activation in some areas of the visual network (the middle occipital gyrus and inferior occipital gyrus), the superior temporal gyrus, angular gyrus, superior parietal gyrus and inferior frontal gyrus (IFG), whereas AOT-MS showed a decreased activation of areas related to learning (the hippocampus and parahippocampal gyrus), the fusiform gyrus, middle temporal gyrus, angular gyrus and rolandic operculum. The analysis of AOT effect in MS patients showed a significant effect at the level of visual areas, MNS regions (including the IFG and middle temporal gyrus) and the cerebellum.
Conclusions: Two weeks of motor training in MS patients modulate recruitment of areas that are part of the motor network and MNS. These findings might contribute to improve the understanding of the functional substrates underling motor deficits recovery in patients with MS and to develop individualized treatment strategies.
Disclosure: Partially supported by grants from FISM (FISM2012R15) and Italian Ministry of Health (RF-2011-02350374).
M.A. Rocca received speakers honoraria from Biogen Idec, Novartis and ExceMed and receives research support from the Italian Ministry of Health and Fondazione Italiana Sclerosi Multipla.
S. Fumagalli has nothing to disclose.
A. M. Dirito has nothing to disclose.
A. Ravetto has nothing to disclose.
P. Preziosa has nothing to disclose.
R. Gatti has nothing to disclose.
F. Martinelli-Boneschi received honoraria for consulting, research grant and travel expenses from TEVA neuroscience, Biogen IDEC, Merck Serono.
M. Comola has nothing to disclose.
G. Comi has received consulting fees for participating on advisory boards from Novartis, Teva Pharmaceutical Ind. Ltd, Sanofi, Genzyme, Merck Serono, Bayer, Actelion and honorarium for speaking activities for Novartis, Teva Pharmaceutical Ind. Ltd, Sanofi, Genzyme, Merck Serono, Bayer, Biogen, Excemed.
M. Filippi is Editor-in-Chief of the Journal of Neurology; serves on scientific advisory boards for Teva Pharmaceutical Industries; has received compensation for consulting services and/or speaking activities from Biogen Idec, Excemed, Novartis, and Teva Pharmaceutical Industries; and receives research support from Biogen Idec, Teva Pharmaceutical Industries, Novartis, Italian Ministry of Health, Fondazione Italiana Sclerosi Multipla, Cure PSP, Alzheimer´s Drug Discovery Foundation (ADDF), the Jacques and Gloria Gossweiler Foundation (Switzerland), and ARiSLA (Fondazione Italiana di Ricerca per la SLA).