Neuroplasticity-Based Technologies and Interventions for Restoring Motor Functions in Multiple Sclerosis

Chapter
Part of the Advances in Experimental Medicine and Biology book series (AEMB, volume 958)

Abstract

Motor impairments are very common in multiple sclerosis (MS), leading to a reduced Quality of Life and active participation. In the past decades, new insights into the functional reorganization processes that occur after a brain injury have been introduced. Specifically, the motor practice seems to be determinant to induce neuroplastic changes and motor recovery. More recently, these findings have been extended to multiple sclerosis, in particular, it has been hypothesized that disease progression, functional reorganization and disability are mutually related. For this reason, neuroplasticity-based technologies and interventions have been rapidly introduced in MS rehabilitation. Constraint-induced movement therapy (CIMT), robotics and virtual reality training are new rehabilitative interventions that deliver an intensive e task-specific practice, which are two critical factors associated with functional improvements and cortical reorganization. Another promising strategy for enhancing neuroplastic changes is non-invasive brain stimulation that can be used with a priming effect on motor training. The aims of this chapter are to review the evidence of neuroplastic changes in multiple sclerosis and to present technologies and interventions that have been tested in clinical trials.

Keywords

Constraint-induced movement therapy Multiple sclerosis Non-invasive brain stimulation Robotics Use-dependent neuroplasticity Virtual reality 

Abbreviations

BWSTT

body weight support training on a treadmill

CIMT

constraint-induced movement therapy

CNS

central nervous system

CPGs

central pattern generators

FES

functional electrical stimulation

ICT

intensive comparison therapy

MS

multiple sclerosis

NIBS

non-invasive brain stimulation

PAS

paired associative stimulation

RAGT

robot-assisted gait training

RT

robotic training

rTMS

repetitive transcranial magnetic stimulation

tDCS

transcranial direct current stimulation

UC

usual care

VR

virtual reality

Notes

Acknowledgements

The authors thank the Rehabilitation Medicine Unit of Ferrara University Hospital and all the MS patients and their families that received rehabilitation in our center.

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© Springer International Publishing Switzerland 2017

Authors and Affiliations

  1. 1.Neuroscience and Rehabilitation DepartmentFerrara University HospitalFerraraItaly

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