Bimanu al Tandem Motor Task with Multiple Sclerosis in Functi onal Magnetic Resonance Imaging: Effect of Physi otherape utic Techniques –  a Pilot Study


Authors: K. Řasová 1,3;  P. Brandejský 2;  J. Tintěra 4;  J. Krásenský 7;  D. Zimová 6;  E. Medová 6;  A. Herbe­nová 1;  H. Kalistová 3;  R. Jech 3;  M. Řasová 3;  P. Zemanová 7;  J. Zeman 8;  I. Ibrahim 4;  P. Mar­tin­­ková 9;  D. Doležil 6;  D. Jandová 1
Authors‘ workplace: Klinika rehabilitačního lékařství 3. LF UK a FN Královské Vinohrady, Praha, 2Ústav tělovýchovného lékařství 1. LF UK a VFN v Praze, 3Ne urologická klinika 1. LF UK a VFNv Praze, 4Klinika radi odi agnostiky a intervenční radi ologi e, odd. magnetické rezon 1
Published in: Cesk Slov Neurol N 2009; 72/105(4): 350-358
Category: Original Paper

Overview

Aim:
The aim of the study was to find out whether there is a difference in the pattern of brain activation (PBA) examined by means of functional magnetic resonance (fMRI) during a motor task in patients with multiple sclerosis (MS) and healthy probands (HP); and if it is possible to influence

clinical functions and PBA by means of neurorehabilitation (NRHB) and aerobic training (AT).

Methods:
Twelve MS patients and five HP were examined twice – at the beginning and at the end of the two-month experiment. In its course, one half of the patients underwent NRHB and one half AT. We examined chosen clinical parameters and fMRI (motor task: a simple movement of each hand separately and a tandem movement of both hands).

Results:
There was an improvement in postural functions (p = 0.008) in MS patients after the NRHB. The number of changes after NRHB was significantly higher (p = 0.009) in comparison to the group which underwent AT. The fMRI examination at the beginning of the experiment shows a statistically significant difference (p = 0.01) between MS and HP in the extent of the activated area in the collateral primary motor cortex hand, which carried out the movement as the second of the pair. This difference in the extent of activation between HP and MS reduced after both therapeutic programs and it was not significant after the therapy. If we understand this activation pattern as a manifestation of normal interhemispheric cooperation, then in this sense we can think of “recovery to normal”.

Conclusion:
This pilot study signals that the by us considered PBA during the movement carried out by both hands differs in MS and HP. Further, it turned out that NRHB and AT influence the clinical manifestation of the disease as well as the pattern of brain activity. The results need further verification.

Key words:
multiple sclerosis –  rehabilitati on –  aerobic exercise –  functi onal magnetic resonance imaging –  rehabilitati on –  plasticity –  central nervo us system


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