Noninvasive tongue stimulation combined with intensive cognitive and physical rehabilitation induces neuroplastic changes in patients with multiple sclerosis: A multimodal neuroimaging study. Issue 1 (February 2017)

• Record Type: Journal Article
• Authors: Leonard, Gabriel; Lapierre, Yves; Chen, Jen-Kai; Wardini, Rima; Crane, Joelle; Ptito, Alain
• Is Part Of: Multiple sclerosis journal, experimental, translational and clinical. Volume 3:Issue 1(2017)
• Publication Date: 2017-02
• Subjects: Cognition -- functional MRI -- multiple sclerosis -- rehabilitation; Multiple sclerosis -- Periodicals; 616.834
• DOI: 10.1177/2055217317690561
• Languages: English
• ISSNs: 2055-2173

Abstract

Background: Multiple sclerosis (MS) patients have central nervous system (CNS) lesions that may impede cognitive and sensorimotor function. Few rehabilitative therapies are available. Objectives: The objective of this paper is to study effects of noninvasive tongue stimulation using the Portable Neuromodulation Stimulator (PoNS™) combined with intensive cognitive and physical rehabilitation on working memory, gait, balance and concomitant changes in the brain. Methods: Fourteen MS patients, seven each in an active and a sham stimulation group, participated. Participants received intensive physical therapy and working memory training for 14 weeks. Functional magnetic resonance imaging (fMRI) using motor imagery and working-memory tasks were completed prior to and following therapy, as were sensory organization tests (SOT), motor performance measures, and neuropsychological assessment. Results: On the SOT, the active group showed significant improvement from baseline. fMRI revealed significant blood oxygen level-dependent signal changes in the left primary motor cortex for the Active Group, while the sham group had increased activity in bilateral premotor cortices. All individuals improved on working-memory tasks, but only the active group showed increased dorsolateral prefrontal cortex activity. Conclusions: In this cohort of MS patients, the results suggest that PoNS stimulation can enhance motor performance and working memory while also driving neuroplasticity. Further studies are warranted to explore these findings.