Brain changes associated with postural training in patients with cerebellar degeneration: a voxel-based morphometry...

Area of Science:

• Neuroscience
• Neurorehabilitation

Background:

• Physiotherapy enhances motor performance in cerebellar degeneration.
• The cerebellum's role in motor learning is established, but its involvement in training-induced improvements in patients is unclear.
• It is unknown if motor improvements are mediated by the cerebellum or other cerebral areas.

Purpose of the Study:

• To investigate whether sensorimotor training-induced gray matter changes in cerebellar degeneration patients occur in the cerebellum or other brain regions.
• To assess the impact of sensorimotor training on balance performance and brain structure in patients with cerebellar degeneration.

Main Methods:

• Nineteen patients with cerebellar degeneration and matched controls underwent 2 weeks of balance training.
• Voxel-based morphometry was used to assess changes in gray matter volume via structural MRI.
• Postural and clinical assessments were conducted pre- and post-training.

Main Results:

• Balance performance significantly improved in patients following training.
• Patients showed a greater increase in gray matter volume in the dorsal premotor cortex compared to controls.
• A trend for increased cerebellar gray matter volume was observed, more pronounced in controls, requiring further confirmation.

Conclusions:

• Sensorimotor training in cerebellar degeneration patients leads to gray matter changes predominantly in neocortical regions within the cerebellar-cortical loop.
• These findings suggest that training may leverage residual cerebellar function or intact plasticity in remaining healthy tissue.
• Motor improvements may be mediated by non-affected cerebral areas rather than solely the degenerated cerebellum.