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Author Spotlight: Assessing Brain Activity in Robotic-Assisted Lower Limb Rehabilitation Using fNIRS
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Real-time cortical activity during virtual reality practice in people with multiple sclerosis: a pilot fNIRS study
Rotem Lavi1, Massimiliano Pau2, Sapir Dreyer-Alster1
1Department of Physical Therapy, Stanley Steyer School of Health Professions, Gray Faculty of Medical and Health Sciences, Tel-Aviv University, Tel-Aviv, Israel.
Journal of Neuroengineering and Rehabilitation
|July 4, 2025
Summary
People with multiple sclerosis (MS) show reduced brain activity during virtual reality (VR) and actual performance tasks, indicating impaired neurovascular adaptability. VR is feasible for MS rehabilitation, but more research is needed.
Area of Science:
- Neuroscience
- Rehabilitation Medicine
- Biomedical Engineering
Background:
- Multiple sclerosis (MS) is a neuroinflammatory disease impacting motor and cognitive functions.
- Virtual reality (VR) offers controlled environments for motor training and cognitive challenges, with functional near-infrared spectroscopy (fNIRS) being a tool to assess cortical activation.
- The application of fNIRS in VR-based rehabilitation for people with MS (pwMS) is underexplored.
Purpose of the Study:
- To examine cortical activation in pwMS during an upper-limb daily life activity in VR versus actual performance (AP).
- To assess the impact of a cognitive challenge (memory recall and sequencing) during motor tasks in VR and AP.
- To compare neurovascular responses between pwMS and healthy controls.
Main Methods:
- A pilot fNIRS case-control study involving 14 pwMS and 14 matched healthy controls.
- Participants performed a dishwashing task under four conditions: VR, VR with cognitive challenge (VR-cog), AP, and AP with cognitive challenge (AP-cog).
- fNIRS measured cortical activation (ΔHbO, ΔHbR, ΔHbT) in the SMA, PMC, and SAC, analyzed using general linear models and repeated-measures ANOVA.
Main Results:
- PwMS showed reduced ΔHbT in the SMA and PMC compared to controls during both VR and AP tasks, indicating diminished neurovascular activation.
- Healthy controls exhibited task-dependent modulation of neurovascular responses in SMA and PMC.
- PwMS demonstrated impaired neurovascular adaptability with no significant differences across task conditions; cognitive challenge did not differentiate groups.
Conclusions:
- PwMS exhibit reduced neurovascular responses and impaired adaptability compared to controls, regardless of VR or AP.
- Findings support VR's feasibility for motor rehabilitation in MS.
- Further research is needed on neuroplasticity, cognitive-motor integration, and lesion-related neurovascular changes in pwMS.
