Monitoring the effect of facilitation physiotherapy in multiple sclerosis - using functional magnetic resonance imaging

Abstract

The aim was to find relation between changes of the brain effective connectivity (through the analysis of fMRI data) and changes of clinical functions following facilitation physiotherapy in MS and also comparison with healthy controls.12 multiple sclerosis patients underwent facilitation physiotherapy program (one hour therapy, twice a week, two months). The clinical and fMRI examination was carried out before and after therapy.

The index for right and left hand (summarization of evaluation of tremor, diadochokinesis, spasticity, muscle strength and ataxia) was defined for evaluation of clinical function.Analyses of EC showed strong connection between SMA and both PMA (patients had in more cases stronger connection than healthy controls, significant between SMA and m1L PMA p=0.005). The EC between m1R and m1L PMA were not observed in general.

The improvement occurred in all of clinical trials (in the index for right hand p<0.001, in the index for left hand p<0.001), but any changes in the EC were not found after therapy. This study shows the way to the objectification of brain plasticity, not only anatomically, but also from a functional point of view.

It shows interesting finding for better understanding of motor control. Facilitation physiotherapy had significant effect on clinical functions that was not visible on fMRI.