Article

Improvement of postural control in persons with multiple sclerosis
(PwMS) is an important target for neurorehabilitation.
Although PwMS are able to
improve postural performance with training, the neural underpinnings of these
improvements are poorly understood. OBJECTIVE:
To understand the neural
underpinnings of postural motor learning in PwMS.
METHODS: Supraspinal white
matter structural connectivity in PwMS was correlated with improvements in
postural performance (balancing on an oscillating surface over 25 trials) and
retention of improvements (24 hours later). RESULTS: Improvement in postural
performance was directly correlated to microstructural integrity of white matter
tracts, measured as radial diffusivity, in the corpus callosum, posterior
parieto-sensorimotor fibers and the brainstem in PwMS. Within the corpus
callosum, the genu and midbody (fibers connecting the prefrontal and primary
motor cortices, respectively) were most strongly correlated to improvements in
postural control. Twenty-four-hour retention was not correlated to radial diffusivity. CONCLUSION: PwMS who exhibited poorer white matter tract integrity
connecting the cortical hemispheres via the corpus callosum showed the most
difficulty learning to control balance on an unstable surface. Prediction of
improvements in postural control through training
(ie, motor learning) via
structural imaging of the brain may allow for identification of individuals who
are particularly well suited for postural rehabilitation interventions.

Langue : ANGLAIS