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Functional and structural plasticity following action observation training in multiple sclerosis.

Maria A Rocca1, Alessandro Meani2, Silvia Fumagalli2

  • 1Neuroimaging Research Unit, Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy/Department of Neurology, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy.

Multiple Sclerosis (Houndmills, Basingstoke, England)
|August 8, 2018
PubMed
Summary

Action observation training (AOT) improved hand motor function in multiple sclerosis (MS) patients. This 10-day intervention led to significant clinical and neuroimaging changes, highlighting AOT

Keywords:
Multiple sclerosisaction observationhand motor impairmentplasticitytraining

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Area of Science:

  • Neuroscience
  • Rehabilitation Medicine
  • Clinical Neurology

Background:

  • Multiple sclerosis (MS) frequently causes hand motor deficits, impacting daily living and contributing to overall disability.
  • Action observation training (AOT) presents a promising non-invasive strategy for enhancing upper limb function in individuals with neurological impairments.

Purpose of the Study:

  • To investigate the effects of AOT on dominant-hand motor performance in MS patients with existing upper limb motor impairment.
  • To conduct an exploratory analysis of the neuroanatomical and functional magnetic resonance imaging (MRI) substrates underlying AOT-induced changes in MS.

Main Methods:

  • A randomized controlled trial involving 41 MS patients and 46 healthy controls (HC).
  • Participants were assigned to either AOT (watching daily-life action videos) or a control-training group (watching landscape videos) for 10 days.
  • Behavioral, structural MRI, and functional MRI (resting-state and during object manipulation) were performed pre- and post-intervention.

Main Results:

  • MS patients in the AOT group showed significant improvements in right upper limb function (p < 0.0001).
  • AOT induced regional gray matter volume increases in fronto-temporal areas in MS patients (p < 0.001), without affecting white matter integrity.
  • Functional MRI revealed altered activation within the action observation matching system and its connections in the MS-AOT group (p < 0.001).
  • Motor improvements correlated significantly with volumetric and functional MRI changes (r from -0.78 to 0.77, p < 0.001).

Conclusions:

  • A 10-day AOT intervention promotes significant clinical improvements in MS patients.
  • These improvements are associated with structural and functional neuroplasticity within the action observation matching system.