Restorative Neurology and Neuroscience - Volume 34, issue 5

Authors: Fernández-del-Olmo, Miguel

Article Type: Letter

DOI: 10.3233/RNN-160648

Citation: Restorative Neurology and Neuroscience, vol. 34, no. 5, pp. 691-692, 2016

Authors: Arcolin, Ilaria | Pisano, Fabrizio | Delconte, Carmen | Godi, Marco | Schieppati, Marco | Mezzani, Alessandro | Picco, Daniele | Grasso, Margherita | Nardone, Antonio

Article Type: Letter

DOI: 10.3233/RNN-169001

Citation: Restorative Neurology and Neuroscience, vol. 34, no. 5, pp. 693-695, 2016

Authors: Maniglia, Marcello | Pavan, Andrea | Sato, Giovanni | Contemori, Giulio | Montemurro, Sonia | Battaglini, Luca | Casco, Clara

Article Type: Research Article

Abstract: Background: Macular Degeneration (MD), a visual disease that produces central vision loss, is one of the main causes of visual disability in western countries. Patients with MD are forced to use a peripheral retinal locus (PRL) as a substitute of the fovea. However, the poor sensitivity of this region renders basic everyday tasks very hard for MD patients. Objective: We investigated whether perceptual learning (PL) with lateral masking in the PRL of MD patients, improved their residual visual functions. Method: Observers were trained with two distinct contrast detection tasks: (i) a Yes/No task with no …feedback (MD: N = 3; controls: N = 3), and (ii) a temporal two-alternative forced choice task with feedback on incorrect trials (i.e., temporal-2AFC; MD: N = 4; controls: N = 3). Observers had to detect a Gabor patch (target) flanked above and below by two high contrast patches (i.e., lateral masking). Stimulus presentation was monocular with durations varying between 133 and 250 ms. Participants underwent 24– 27 training sessions in total. Results: Both PL procedures produced significant improvements in the trained task and learning transferred to visual acuity. Besides, the amount of transfer was greater for the temporal-2AFC task that induced a significant improvement of the contrast sensitivity for untrained spatial frequencies. Most importantly, follow-up tests on MD patients trained with the temporal-2AFC task showed that PL effects were retained between four and six months, suggesting long-term neural plasticity changes in the visual cortex. Conclusion: The results show for the first time that PL with a lateral masking configuration has strong, non-invasive and long lasting rehabilitative potential to improve residual vision in the PRL of patients with central vision loss. Show more

Keywords: Macular degeneration (MD), perceptual learning, neural plasticity, visual rehabilitation

DOI: 10.3233/RNN-150575

Citation: Restorative Neurology and Neuroscience, vol. 34, no. 5, pp. 697-720, 2016

Authors: Franz, Elizabeth A. | Fu, Yan | Moore, Matthew | Winter, Taylor | Mayne, Terence | Debnath, Ranjan | Stringer, Catherine

Article Type: Research Article

Abstract: Background: Mirror therapy (MT) is an increasingly employed method aimed at reducing phantom pain and other negative sensations following loss of a limb or damage to sensorimotor systems. However, the brain processes associated with the perception of limb ownership, a key correlate of MT, are unknown. Objective: To examine whether transient perceptions of limb ownership together with associated neural activity can be elucidated using a purpose-developed mirror reflection task combined with electrophysiological (EEG) measures and cutting-edge analyses. Methods: Brain activity was measured online using EEG in 20 healthy controls while they produced opening-closing movements of …one hand in control conditions or while viewing the mirror reflection of the movements. The key experimental condition required participants to make a foot pedal response whenever a change in perception of ownership (of a mirror-reflected limb) occurred (Mirror condition). Control conditions and a strict epoching regime were employed using standard subtractive logic to isolate the perception of limb ownership (which was further verified by self-reports). Results: Data from 15 participants were suitable for complete analysis; the remaining reported no experience of ownership. Significant spectral power increases were found in central-parietal regions in association with perceptions of ownership, with the most prominent effect specific to the alpha frequency band (8–13 Hz) measured at the right parietal area. Source localization analyses further identified brain networks associated with the mirror reflection condition in the alpha frequency (parietal lobe) and the beta frequency (middle temporal areas). These were distinct from localized networks associated with the foot pedal response. Conclusion: Transient perceptions of ownership can be captured experimentally, and are associated with localized sites of neural activation. This is an initial step toward eventual development of therapeutic targets for interventions including brain computer interfaces (BCIs) aimed at ameliorating the negative effects associated with impaired or missing limbs. Show more

Keywords: Neurorehabilitation, amputation, phantom limb, mirror, perception of ownership, bimanual

DOI: 10.3233/RNN-150622

Citation: Restorative Neurology and Neuroscience, vol. 34, no. 5, pp. 721-732, 2016

Authors: Jones, Paul W. | Borich, Michael R. | Vavsour, Irene | Mackay, Alex | Boyd, Lara A.

Article Type: Research Article

Abstract: Background: Hemiparesis is one of the most prevalent chronic disabilities after stroke. Biochemical and structural magnetic resonance imaging approaches may be employed to study the neural substrates underpinning upper-extremity (UE) recovery after chronic stroke. Objective: The purposes of this study were to 1) quantify anatomical and metabolic differences in the precentral gyrus, and 2) test the relationships between anatomical and metabolic differences, and hemiparetic arm function in individuals in the chronic stage of stroke recovery. Our hypotheses were: 1) the Stroke group would exhibit reduced precentral gyrus cortical thickness and lower concentrations of total N-acetylaspartate (tNAA) and …glutamate+glutamine (Glx) in the ipsilesional motor cortex; and 2) that each of these measures would be associated with UE motor function after stroke. Methods: Seventeen individuals with chronic (>6 months) subcortical ischemic stroke and eleven neurologically healthy controls were recruited. Single voxel proton magnetic resonance spectroscopy (H1 MRS) was performed to measure metabolite concentrations of tNAA and Glx in the precentral gyrus in both ipsilesional and contralesional hemispheres. Surface-based cortical morphometry was used to quantify precentral gyral thickness. Upper-extremity motor function was assessed using the Wolf Motor Function Test (WMFT). Results: Results demonstrated significantly lower ipsilesional tNAA and Glx concentrations and precentral gyrus thickness in the Stroke group. Ipsilesional tNAA and Glx concentration and precentral gyrus thickness was significantly lower in the ipsilesional hemisphere in the Stroke group. Parametric correlation analyses revealed a significant positive relationship between precentral gyrus thickness and tNAA concentration bilaterally. Multivariate regression analyses revealed that ipsilesional concentrations of tNAA and Glx predicted the largest amount of variance in WMFT scores. Cortical thickness measures alone did not predict a significant amount of variance in WMFT scores. Conclusion: While stroke impairs both structure and biochemistry in the ipsilesional hemisphere our data suggest that tNAA has the strongest relationship with motor function. Show more

Keywords: Stroke, human, metabolite, motor function, cortical thickness

DOI: 10.3233/RNN-150623

Citation: Restorative Neurology and Neuroscience, vol. 34, no. 5, pp. 733-746, 2016

Authors: Chang, Won Hyuk | Uhm, Kyeong Eun | Shin, Yong-Il | Pascual-Leone, Alvaro | Kim, Yun-Hee

Article Type: Research Article

Abstract: Background and Purpose: High-frequency repetitive transcranial magnetic stimulation (rTMS) aids motor recovery in patients with subacute stroke. However, the response to high-frequency rTMS is highly variable between patients. The aim of this study was to identify the factors associated with improved motor function in response to high-frequency rTMS in subacute stroke patients with moderate to severe upper extremity motor involvement. Methods: Sixty-two patients with subacute stroke were enrolled. rTMS was applied over the primary motor cortex of the affected hemisphere at 10 Hz with 1,000 pulses/day for 10 days. Upper limb motor function was scored with the upper …limb of Fugl-Meyer Assessment (FMA-UL) score before intervention and immediately after intervention. All FMA-UL changes greater than or equal to 5 points were considered clinically significant. Potential influencing factors considered included patient characteristics, motor function, corticospinal tract (CST) integrity assessments, and genetics. Multivariate logistic regression analysis was used to identify the significance of each of these factors. Results: We found that the two factors with the greatest impact on the improvement in FMA-UL score were: 1) the functional integrity of the CST, and 2) the brain-derived neurotrophic factor (BDNF) genotype (p  < 0.05). Age tended to influence clinically significant changes in the FMA-UL score, although this effect was not significant. Conclusion: Our findings suggest that high-frequency rTMS interventions aimed at improving upper extremity motor function in patients with subacute stroke with moderate to severe motor involvement should be individually tailored according to functional CST status and BDNF genotype. Show more

Keywords: Transcranial magnetic stimulation, rTMS, motor recovery, BDNF, cortical excitability, stroke

DOI: 10.3233/RNN-150634

Citation: Restorative Neurology and Neuroscience, vol. 34, no. 5, pp. 747-755, 2016

Authors: Jafari, Zahra | Malayeri, Saeed

Article Type: Research Article

Abstract: Background: Congenital visual deprivation underlies neural plasticity in different brain areas, and provides an outstanding opportunity to study the neuroplastic capabilities of the brain. Objectives: The present study aimed to investigate the effect of congenital blindness on subcortical auditory processing using electrophysiological and behavioral assessments in children. Methods: A total of 47 children aged 8–12 years, including 22 congenitally blind (CB) children and 25 normal-sighted (NS) control, were studied. All children were tested using an auditory brainstem response (ABR) test with both click and speech stimuli. Speech recognition and musical abilities were tested using standard …tools. Results: Significant differences were observed between the two groups in speech ABR wave latencies A, F and O (p ≤0.043), wave amplitude F (p  = 0.039), V–A slope (p  = 0.026), and three spectral magnitudes F0, F1 and HF (p ≤0.002). CB children showed a superior performance compared to NS peers in all the subtests and the total score of musical abilities (p ≤0.003). Moreover, they had significantly higher scores during the nonsense syllable test in noise than the NS children (p  = 0.034). Significant negative correlations were found only in CB children between the total music score and both wave A (p  = 0.039) and wave F (p  = 0.029) latencies, as well as nonsense-syllable test in noise and the wave A latency (p  = 0.041). Conclusion: Our results suggest that neuroplasticity resulting from congenital blindness can be measured subcortically and has a heightened effect on temporal, musical and speech processing abilities. The findings have been discussed based on models of plasticity and the influence of corticofugal modulation in synthesizing complex auditory stimuli. Show more

Keywords: Congenitally-blind, auditory brainstem response, speech, corticofugal modulation

DOI: 10.3233/RNN-160639

Citation: Restorative Neurology and Neuroscience, vol. 34, no. 5, pp. 757-768, 2016

Authors: Kristjánsson, Árni | Moldoveanu, Alin | Jóhannesson, Ómar I. | Balan, Oana | Spagnol, Simone | Valgeirsdóttir, Vigdís Vala | Unnthorsson, Rúnar

Article Type: Research Article

Abstract: An exciting possibility for compensating for loss of sensory function is to augment deficient senses by conveying missing information through an intact sense. Here we present an overview of techniques that have been developed for sensory substitution (SS) for the blind, through both touch and audition, with special emphasis on the importance of training for the use of such devices, while highlighting potential pitfalls in their design. One example of a pitfall is how conveying extra information about the environment risks sensory overload. Related to this, the limits of attentional capacity make it important to focus on key information and …avoid redundancies. Also, differences in processing characteristics and bandwidth between sensory systems severely constrain the information that can be conveyed. Furthermore, perception is a continuous process and does not involve a snapshot of the environment. Design of sensory substitution devices therefore requires assessment of the nature of spatiotemporal continuity for the different senses. Basic psychophysical and neuroscientific research into representations of the environment and the most effective ways of conveying information should lead to better design of sensory substitution systems. Sensory substitution devices should emphasize usability, and should not interfere with other inter- or intramodal perceptual function. Devices should be task-focused since in many cases it may be impractical to convey too many aspects of the environment. Evidence for multisensory integration in the representation of the environment suggests that researchers should not limit themselves to a single modality in their design. Finally, we recommend active training on devices, especially since it allows for externalization, where proximal sensory stimulation is attributed to a distinct exterior object. Show more

Keywords: Sensory substitution, neural plasticity, multisensory perception

DOI: 10.3233/RNN-160647

Citation: Restorative Neurology and Neuroscience, vol. 34, no. 5, pp. 769-787, 2016

Authors: Kawakami, Michiyuki | Fujiwara, Toshiyuki | Ushiba, Junichi | Nishimoto, Atsuko | Abe, Kaoru | Honaga, Kaoru | Nishimura, Atsuko | Mizuno, Katsuhiro | Kodama, Mitsuhiko | Masakado, Yoshihisa | Liu, Meigen

Article Type: Research Article

Abstract: Background: Hybrid assistive neuromuscular dynamic stimulation (HANDS) therapy improved paretic upper extremity motor function in patients with severe to moderate hemiparesis. We hypothesized that brain machine interface (BMI) training would be able to increase paretic finger muscle activity enough to apply HANDS therapy in patients with severe hemiparesis, whose finger extensor was absent. Objective : The aim of this study was to assess the efficacy of BMI training followed by HANDS therapy in patients with severe hemiparesis. Methods : Twenty-nine patients with chronic stroke who could not extend their paretic fingers were participated this study. We applied …BMI training for 10 days at 40 min per day. The BMI detected the patients’ motor imagery of paretic finger extension with event-related desynchronization (ERD) over the affected primary sensorimotor cortex, recorded with electroencephalography. Patients wore a motor-driven orthosis, which extended their paretic fingers and was triggered with ERD. When muscle activity in their paretic fingers was detected with surface electrodes after 10 days of BMI training, we applied HANDS therapy for the following 3 weeks. In HANDS therapy, participants received closed-loop, electromyogram-controlled, neuromuscular electrical stimulation (NMES) combined with a wrist-hand splint for 3 weeks at 8 hours a day. Before BMI training, after BMI training, after HANDS therapy and 3month after HANDS therapy, we assessed Fugl-Meyer Assessment upper extremity motor score (FMA) and the Motor Activity Log14-Amount of Use (MAL-AOU) score. Results : After 10 days of BMI training, finger extensor activity had appeared in 21 patients. Eighteen of 21 patients then participated in 3 weeks of HANDS therapy. We found a statistically significant improvement in the FMA and the MAL-AOU scores after the BMI training, and further improvement was seen after the HANDS therapy. Conclusion : Combining BMI training with HANDS therapy could be an effective therapeutic strategy for severe UE paralysis after stroke. Show more

Keywords: Brain-machine interface, rehabilitation, upper extremity, stroke

DOI: 10.3233/RNN-160652

Citation: Restorative Neurology and Neuroscience, vol. 34, no. 5, pp. 789-797, 2016

Authors: Schambra, Heidi M. | Martinez-Hernandez, Isis E. | Slane, Kevin J. | Boehme, Amelia K. | Marshall, Randolph S. | Lazar, Ronald M.

Article Type: Research Article

Abstract: Background: Reducing inhibitory neurotransmission with pharmacological agents is a potential approach for augmenting plasticity after stroke. Previous work in healthy subjects showed diminished intracortical inhibition after administration of theophylline. Objective: We assessed the effect of single-dose theophylline on intracortical and interhemispheric inhibition in patients with chronic stroke, in a double-blind, placebo-controlled, cross-over study. Methods: Eighteen subjects were randomly administered 300 mg of extended-release theophylline or placebo. Immediately and 5 hours following administration, transcranial magnetic stimulation was used to assess bihemispheric resting motor threshold, short-interval intracortical inhibition, long-interval intracortical inhibition, and interhemispheric inhibition. Adverse effects on cardiovascular, …neurological, and motor performance outcomes were also surveilled. Change between morning and afternoon sessions were compared across conditions. One week later, patients underwent the same assessments after crossing over to the opposite experimental condition. Subjects and investigators were blinded to the experimental condition during data acquisition and analysis. Results: For both hemispheres, changes in intracortical or interhemispheric neurophysiology were comparable under theophylline and placebo conditions. Theophylline induced no adverse neurological, cardiovascular, or motor performance effects. For both conditions and hemipsheres, the baseline level of inhibition inversely correlated with its change between sessions: less baseline inhibition (i.e. disinhibition) was associated with a strengthening in inhibition over the day, and vice versa. Conclusion: A single dose of theophylline is well-tolerated by patients with chronic stroke, but does not alter cortical excitability. The inverse relationship between baseline inhibition and its change suggests the existence of a homeostatic process. The lack of effect on cortical inhibition may be related to an insufficiently long exposure to theophylline, or to differential responsiveness of disinhibited neural circuitry in patients with stroke. Show more

Keywords: Recovery of function, transcranial magnetic stimulation, cerebral infarction, motor cortex, homeostasis

DOI: 10.3233/RNN-160657

Citation: Restorative Neurology and Neuroscience, vol. 34, no. 5, pp. 799-813, 2016

Authors: Fusco, Gabriele | Tidoni, Emmanuele | Barone, Nicola | Pilati, Claudio | Aglioti, Salvatore Maria

Article Type: Research Article

Abstract: Background: Studies in healthy people show that stimulation of muscle spindles through frequency-specific tendon vibration (TV) induces the illusory perception of movement. Following spinal cord injury (SCI), motor and sensory connections between the brain and parts of the body below-the-lesion level are partially or totally impaired. Objective: The present investigation is a descriptive study aimed to investigate whether people living with SCI may experience movement illusions comparable to a control group. Methods: Healthy and people with SCI were asked to report on three illusion-related features (Vividness, Duration, Illusory Extension) after receiving 70 Hz TV on the …biceps brachii tendon of both arms. Two different forces of stimulation were applied: 2.4 N and 4.2 N. Results: Both patients and controls were susceptible to the kinesthetic illusion. However patients presented lower sensitivity to TV than healthy subjects. Participants rated stronger illusions of movement after 4.2 N than 2.4 N stimulation in all the three illusion-related features. Further, patients reported atypical illusory experiences of movement (e.g. as if the arm wanted to extend, or a sensation of pushing against something) that may reflect different reorganization processes following spinal cord injury. Conclusion: The study provides a preliminary evidence of the possible use of the proprioceptive stimulation in the upper limbs of people living with SCI. Results are discussed in the light of recent advancements of brain-computer applications based on motor imagery for the control of neuroprosthetic and robotic devices in patients with severe sensorimotor deficits. Show more

Keywords: Spinal cord injury, tendon vibration, illusion of movement, spinal cord rehabilitation, proprioception

DOI: 10.3233/RNN-160660

Citation: Restorative Neurology and Neuroscience, vol. 34, no. 5, pp. 815-826, 2016

Authors: Moore, Tara L. | Pessina, Monica A. | Finklestein, Seth P. | Killiany, Ronald J. | Bowley, Bethany | Benowitz, Larry | Rosene, Douglas L.

Article Type: Research Article

Abstract: Background: Inosine, a naturally occurring purine nucleoside, has been shown to stimulate axonal growth in cell culture and promote corticospinal tract axons to sprout collateral branches after stroke, spinal cord injury and TBI in rodent models. Objective: To explore the effects of inosine on the recovery of motor function following cortical injury in the rhesus monkey. Methods: After being trained on a test of fine motor function of the hand, monkeys received a lesion limited to the area of the hand representation in primary motor cortex. Beginning 24 hours after this injury and continuing daily …thereafter, monkeys received orally administered inosine (500 mg) or placebo. Retesting of motor function began on the 14th day after injury and continued for 12 weeks. Results: During the first 14 days after surgery, there was evidence of significant recovery within the inosine-treated group on measures of fine motor function of the hand, measures of hand strength and digit flexion. While there was no effect of treatment on the time to retrieve a reward, the treated monkeys returned to asymptotic levels of grasp performance significantly faster than the untreated monkeys. Additionally, the treated monkeys evidenced a greater degree of recovery in terms of maturity of grasp pattern. Conclusion: These findings demonstrate that inosine can enhance recovery of function following cortical injury in monkeys. Show more

Keywords: Inosine, cortical injury, rhesus monkey, recovery, motor function

DOI: 10.3233/RNN-160661

Citation: Restorative Neurology and Neuroscience, vol. 34, no. 5, pp. 827-848, 2016

Authors: Yau, Suk-Yu | Li, Ang | Tong, Jian-Bin | Bostrom, Crystal | Christie, Brian R. | Lee, Tatia M.C. | So, Kwok-Fai

Article Type: Research Article

Abstract: Background: Our previous work has shown that exposure to the stress hormone corticosterone (40 mg/kg CORT) for two weeks induces dendritic atrophy of pyramidal neurons in the hippocampal CA3 region and behavioral deficits. However, it is unclear whether this treatment also affects the dentate gyrus (DG), a subregion of the hippocampus comprising a heterogeneous population of young and mature neurons. Objective: We examined the effect of CORT treatment on the dendritic complexity of mature and young granule cells in the DG. Methods: We utilized a Golgi staining method to investigate the dendritic morphology and spine density …of young neurons in the inner granular cell layer (GCL) and mature neurons in the outer GCL in response to CORT application. The expressions of glucocorticoid receptors during neuronal maturation were examined using Western blot analysis in a primary hippocampal neuronal culture. Results: Sholl analysis revealed that CORT treatment decreased the number of intersections and shortened the dendritic length in mature, but not young, granule cells. However, the spine density of mature and young neurons was not affected. Western blot analysis showed a progressive increase in the protein levels of glucocorticoid receptors (GRs) in the cultured primary hippocampal neurons during neuronal maturation. Conclusion: These data suggest that mature neurons are likely more vulnerable to chronic exposure to CORT; this may be due to their higher expression of GRs when compared to younger DG neurons. Show more

Keywords: Corticosterone, glucocorticoid receptors, dendritic complexity, dentate gyrus, Golgi staining

DOI: 10.3233/RNN-160662

Citation: Restorative Neurology and Neuroscience, vol. 34, no. 5, pp. 849-857, 2016

Authors: Koo, Ho | Kim, Min Sun | Han, Sang Who | Paulus, Walter | Nitche, Michael A. | Kim, Yun-Hee | Kim, Hyoung-Ihl | Ko, Sung-Hwa | Shin, Yong-Il

Article Type: Research Article

Abstract: Purpose: Transcranial direct current stimulation (tDCS) is increasingly seen as a useful tool for noninvasive cortical neuromodulation. A number of studies in humans have shown that when tDCS is applied to the motor cortex it can modulate cortical excitability. It is especially interesting to note that when applied with sufficient duration and intensity, tDCS can enable long-lasting neuroplastic effects. However, the mechanism by which tDCS exerts its effects on the cortex is not fully understood. We investigated the effects of anodal tDCS under urethane anesthesia on field potentials in in vivo rats. Methods: These were measured …on the skull over the right motor cortex of rats immediately after stimulating the left corpus callosum. Results: Evoked field potentials in the motor cortex were gradually increased for more than one hour after anodal tDCS. To induce these long-lasting effects, a sufficient duration of stimulation (20 minutes or more) was found to may be required rather than high stimulation intensity. Conclusion: We propose that anodal tDCS with a sufficient duration of stimulation may modulate transcallosal plasticity. Show more

Keywords: Transcranial direct stimulation, cerebral cortex, cortical excitability, neurophysiology, rat

DOI: 10.3233/RNN-160664

Citation: Restorative Neurology and Neuroscience, vol. 34, no. 5, pp. 859-868, 2016

Authors: Spina, Emanuele | Carotenuto, Antonio | Aceto, Maria Gabriella | Cerillo, Ilaria | Silvestre, Francesco | Arace, Francesco | Paone, Paolo | Orefice, Giuseppe | Iodice, Rosa

Article Type: Research Article

Abstract: Background: Multiple Sclerosis is a heterogeneous disorders involving in early stage gait and balance. Together with immunomodulating therapies, rehabilitation had a crucial role in improving motor tasks and quality of life. Between the emerging techniques, Focal Vibrations (FV) could play a role, but they have been used in MS only to reduce muscle tone and fatigue alone or together with botulinum toxin. Objective: To assess whether FV is effective on walking impairment in a cohort of MS patients. Methods: We performed a single-centre randomized, double-blind, sham-controlled study to investigate efficacy of FV vs sham vibration …in 20 RR MS patients. Ten patients received treatment with the active device and ten patients sham treatment. Demographical, clinical and gait instrumental data analysis have been collected for each patient at baseline (T0), after treatment (T1) and after three weeks of wash out (T2). Results: Both groups were clinically and demographically comparable. Treated patients showed significant improvements during the first right step (FRS) (p  = 0.007), average stride lenght (ASL) (p  = 0.012), double support right (DSRT) (p  = 0.016) and left (DSLT) (p  = 0.003) time. Non-treated patients didn’t show any significance for any dynamic variables. Moreover, on posturographic measurements we registered only a trend towards significance in swing area with eyes open (SAEO) (p  = 0.087). We also found in treated group significant improvements in FRT (p  = 0.018); BBS (p  = 0.037) and FSS scales (p  = 0.038) between T1 and T0. Lastly, we found a significant inverse correlation in the treated group between disease duration and percentage of improvement for DSLT (r = – 0.775; p  = 0.014) in T1 vs T0 and percentage of improvement of FSS, with an inverse correlation with both disease duration (r = – 0.775; p  = 0.014) and AGE (r = – 0.733, p  = 0.025) in T1 vs T0 Conclusion: Our results suggest a beneficial effect of FV on walking impairment in MS patients suffering from spasticity and/or postural instability, which partially lasted until follow up. Show more

Keywords: Multiple sclerosis, neurorehabilitation, focal vibrations, gait analysis

DOI: 10.3233/RNN-160665

Citation: Restorative Neurology and Neuroscience, vol. 34, no. 5, pp. 869-876, 2016