Motor rehabilitation impacts white matter microstructure of the corpus callosum in patients with multiple sclerosis”, Conference: 20th Annual Conference on Rehabilitation in Multiple Sclerosis (RIMS), Volume: 21. Copenhagen, Denmark

Introduction: Motor rehabilitation has the target to maintain the residual capacities of the affected individuals to the highest possible level. Consistent data on the real efficacy of the rehabilitation effects on brain structure are lacking. It has been demonstrated that corpus callosum (CC) can be damaged in PwMS also in the early stage of the disease. In this work, we investigated the relationship between upper limb motor improvements due to a rehabilitative treatment and possible changes in white matter microstructure of CC in PwMS. Methods: Thirty PwMS were included in this study and received an active (AMT group - 15 patients) or passive motor rehabilitation treatment (PMT group - 15 patients). AMT and PMT groups underwent twenty 1-hour treatment sessions, three times a week. The AMT group was treated with functional electrical stimulation, proprioceptive neuromuscular facilitation techniques and task-oriented exercises with the overall goal to improve activities of daily living including bimanual coordination. Conversely, the PMT was treated with passive mobilization of the shoulder, elbow, wrist and hand of both limbs. Upper limb motor performance was evaluated before and after the treatment using standard motor evaluation protocols and a sensor-engineered glove to quantify finger motor performance accuracy in uni- and bi-manual conditions. Further, each patient underwent an MR examination with Diffusion Tensor Imaging (15 non collinear directions; b=1000 s/mm2) before and after the rehabilitation treatment. Three Regions of Interest (ROIs) of CC (genu, body, splenium) were selected from a white matter atlas. Fractional Anisotropy (FA) maps were created for each patient, and mean FA values were calculated within these ROIs. Results: We found that, after the treatment, unimanual finger motor performance significantly improved in both groups. Conversely, bimanual coordination significantly worsened in the PMT group whilst remained stable in the AMT group. After the treatment, FA values significantly decreased in all the ROIs of the CC in the PMT group whilst they did not change in the AMT group. Conclusions: We can conclude that a better benefit seems to be induced by the active motor treatment which was found to preserve white matter integrity, normally affected by the disease course.