Related Experiment Video
Updated: May 4, 2026
Soft Pneumatic Robot Modulates Graph Theory Metrics of Brain Network for Hand Rehabilitation After Stroke
Published on: October 10, 2025
Upper limb motor rehabilitation impacts white matter microstructure in multiple sclerosis
Laura Bonzano1, Andrea Tacchino2, Giampaolo Brichetto2
1Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Genoa, Italy; Magnetic Resonance Research Centre on Nervous System Diseases, University of Genoa, Genoa, Italy.
Task-oriented rehabilitation preserved white matter integrity and bimanual coordination in multiple sclerosis patients. Passive mobilization worsened coordination and white matter microstructure, highlighting the benefits of active, voluntary movement in neurorehabilitation.
Area of Science:
- Neuroscience
- Rehabilitation Medicine
- Neuroimaging
Background:
- Multiple sclerosis (MS) frequently causes upper limb impairments, impacting daily activities.
- Optimal rehabilitation strategies for MS-related upper limb dysfunction remain debated.
- Motor training can alter white matter architecture in healthy individuals.
Purpose of the Study:
- To assess motor and white matter microstructural changes after a 2-month upper limb motor rehabilitation program in MS patients.
- To compare the effects of task-oriented exercises versus passive mobilization.
Main Methods:
- Thirty MS patients with mild-to-moderate upper limb deficits were randomized into active treatment (task-oriented exercises) or control (passive mobilization) groups.
- Motor performance was evaluated using standard tests and an engineered glove before and after the 2-month intervention.
- Diffusion tensor imaging (DTI) was used to analyze white matter integrity in key brain regions, including the corpus callosum, corticospinal tracts, and superior longitudinal fasciculi.
Main Results:
- Both groups showed similar improvements in unimanual motor performance.
- The active treatment group maintained bimanual coordination, while the control group showed significant worsening (p=0.002).
- Active rehabilitation preserved white matter integrity in the corpus callosum and corticospinal tracts, unlike the control group which showed microstructural deterioration (p<0.05).
- Both groups exhibited increased radial diffusivity in the superior longitudinal fasciculi, suggesting disease progression unrelated to the specific rehabilitation approach.
Conclusions:
- Active, task-oriented upper limb rehabilitation is crucial for preserving white matter integrity and motor coordination in MS patients.
- Rehabilitation benefits are task-dependent and selective, supporting the development of tailored therapeutic strategies.
- Voluntary movement-based rehabilitation is superior to passive mobilization for maintaining neurological function in MS.
