Priska Zuber1,2, Charidimos Tsagkas3,2, Athina Papadopoulou3,4, Laura Gaetano5, Manuel Huerbin2, Emanuel Geiter3, Anna Altermatt2,6, Katrin Parmar3, Thierry Ettlin7, Corina Schuster-Amft7, Zorica Suica7, Hala Alrasheed8, Jens Wuerfel2,4,6, Jürg Kesselring8, Ludwig Kappos3, Till Sprenger3,9, Stefano Magon10,11. 1. Division of Cognitive Neuroscience, Faculty of Psychology, University of Basel, Basel, Switzerland. 2. Medical Image Analysis Center (MIAC AG), Basel, Switzerland. 3. Department of Neurology, University Hospital Basel, Neurologic Clinic and Policlinic, Petersgraben 4, 4031, Basel, Switzerland. 4. Neurocure Clinical Research Center, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität Zu Berlin, and Berlin Institute of Health, Berlin, Germany. 5. F. Hoffman-La Roche Ltd, Basel, Switzerland. 6. Department of Biomedical Engineering, University of Basel, Basel, Switzerland. 7. Reha Rheinfelden, Rheinfelden, Switzerland. 8. Department of Neurology and Neurorehabilitation, Clinics of Valens, Valens, Switzerland. 9. Department of Neurology, DKD Helios Klinik Wiesbaden, Wiesbaden, Germany. 10. Department of Neurology, University Hospital Basel, Neurologic Clinic and Policlinic, Petersgraben 4, 4031, Basel, Switzerland. stefano.magon@usb.ch. 11. Medical Image Analysis Center (MIAC AG), Basel, Switzerland. stefano.magon@usb.ch.
Abstract
BACKGROUND: Although multidisciplinary rehabilitation programs are commonly used in clinical practice for patients with multiple sclerosis (MS), they are currently underexamined. OBJECTIVE: This study aims to investigate the efficacy and underlying brain mechanisms of an inpatient multidisciplinary rehabilitation. METHODS: Twenty-four patients with relapse-onset MS underwent a 4-week personalized inpatient multidisciplinary rehabilitation and three assessment sessions including MRI, clinical, cognitive and motor function evaluation. Twenty-four healthy controls underwent two assessment sessions 4 weeks apart. Test performances were compared using repeated measures ANOVA, Tukey and t tests. A motor sequence learning (MSL) task was presented during fMRI and data were analysed using FSL. RESULTS: Patients had less perceived fatigue, improved walking speed and quality of life following the rehabilitation, which could be maintained at follow-up 4 weeks after rehabilitation. After rehabilitation, differences in accuracy of the MSL task between groups diminished, indicating an improved performance in patients. Improved accuracy went along with changes of brain activity in the left cerebellum and right frontal lobe post-rehabilitation, which could be maintained at follow-up. No changes between sessions were observed in controls. CONCLUSION: Multidisciplinary rehabilitation may improve highly impacting symptoms through more efficient recruitment of brain regions and therefore positively influence MS patients' quality of life.
BACKGROUND: Although multidisciplinary rehabilitation programs are commonly used in clinical practice for patients with multiple sclerosis (MS), they are currently underexamined. OBJECTIVE: This study aims to investigate the efficacy and underlying brain mechanisms of an inpatient multidisciplinary rehabilitation. METHODS: Twenty-four patients with relapse-onset MS underwent a 4-week personalized inpatient multidisciplinary rehabilitation and three assessment sessions including MRI, clinical, cognitive and motor function evaluation. Twenty-four healthy controls underwent two assessment sessions 4 weeks apart. Test performances were compared using repeated measures ANOVA, Tukey and t tests. A motor sequence learning (MSL) task was presented during fMRI and data were analysed using FSL. RESULTS:Patients had less perceived fatigue, improved walking speed and quality of life following the rehabilitation, which could be maintained at follow-up 4 weeks after rehabilitation. After rehabilitation, differences in accuracy of the MSL task between groups diminished, indicating an improved performance in patients. Improved accuracy went along with changes of brain activity in the left cerebellum and right frontal lobe post-rehabilitation, which could be maintained at follow-up. No changes between sessions were observed in controls. CONCLUSION: Multidisciplinary rehabilitation may improve highly impacting symptoms through more efficient recruitment of brain regions and therefore positively influence MSpatients' quality of life.
Entities:
Keywords:
Fatigue; Motor skills; Multidisciplinary rehabilitation; Multiple sclerosis; Quality of life; fMRI
Authors: Amy E Latimer-Cheung; Lara A Pilutti; Audrey L Hicks; Kathleen A Martin Ginis; Alyssa M Fenuta; K Ann MacKibbon; Robert W Motl Journal: Arch Phys Med Rehabil Date: 2013-05-10 Impact factor: 3.966
Authors: K Rasova; J Krasensky; E Havrdova; J Obenberger; Z Seidel; O Dolezal; P Rexova; M Zalisova Journal: Clin Rehabil Date: 2005-03 Impact factor: 3.477
Authors: Katrin Morgen; Nadja Kadom; Lumy Sawaki; Alessandro Tessitore; Joan Ohayon; Henry McFarland; Joseph Frank; Roland Martin; Leonardo G Cohen Journal: Brain Date: 2004-09-29 Impact factor: 13.501