Functional and structural plasticity following action observation training in multiple sclerosis. (October 2019)

• Record Type: Journal Article
• Authors: Rocca, Maria A; Meani, Alessandro; Fumagalli, Silvia; Pagani, Elisabetta; Gatti, Roberto; Martinelli-Boneschi, Filippo; Esposito, Federica; Preziosa, Paolo; Cordani, Claudio; Comi, Giancarlo; Filippi, Massimo
• Is Part Of: Multiple sclerosis. Volume 25:Number 11(2019)
• Page Start: 1472
• Page End: 1487
• Publication Date: 2019-10
• Subjects: Multiple sclerosis -- training -- hand motor impairment -- action observation -- plasticity; Central nervous system -- Diseases -- Periodicals; Myelin sheath -- Diseases -- Periodicals; Inflammation -- Periodicals; Multiple sclerosis -- Periodicals; Central Nervous System Diseases -- Periodicals; Demyelinating Diseases -- Periodicals; Inflammation -- Periodicals; Multiple Sclerosis -- Periodicals; Système nerveux central -- Maladies -- Périodiques; Gaine de myéline -- Maladies -- Périodiques; Inflammation (Pathologie) -- Périodiques; Sclérose en plaques -- Périodiques; Electronic journals; 616.834005
• DOI: 10.1177/1352458518792771
• Languages: English
• ISSNs: 1352-4585

Abstract

Background: Hand motor deficits contribute to multiple sclerosis (MS)-related disability. Action observation training (AOT) is promising to improve upper limb function in neurologic patients. Objectives: In this preliminary study, we investigated AOT effects on dominant-hand motor performance in MS patients with upper limb motor impairment and performed an explorative analysis of their anatomical and functional magnetic resonance imaging (MRI) substrates. Methods: In total, 46 healthy controls (HC) and 41 MS patients with dominant-hand motor impairment were randomized to AOT (HC-AOT = 23; MS-AOT = 20; watching daily-life action videos and execution) or control-training (HC-Control = 23; MS-Control = 21; watching landscapes videos and execution). Behavioral, structural, and functional (at rest and during object manipulation) MRI scans were acquired before and after a 2-week training. Results: After training, MS groups improved in right upper limb functions, mainly in AOT group ( p from 0.02 to 0.0001). All groups showed regional increased and decreased gray matter volume, with specific AOT effects in fronto-temporal areas in MS-AOT ( p < 0.001), without white matter (WM) integrity modifications. Increased and reduced recruitments of the action observation matching system and its connections in MS-AOT were found ( p < 0.001). Motor improvements were correlated with volumetric and functional MRI modifications ( r from −0.78 to 0.77, p < 0.001). Conclusion: The 10-day AOT promotes clinical improvements in MS patients through structural and functional modifications of the action observation matching system.