Effects of rhythmic-cued gait training on gait-like task related brain activation in people with multiple sclerosis
Open accessAbstract
BACKGROUND: Walking impairment is one of the most debilitating symptoms of multiple sclerosis (MS). A better understanding of brain mechanisms underlying successful gait training could help to improve development of targeted therapy. We therefore investigated changes in brain activation associated with improvements in walking function after rhythmic-cued gait training. METHODS: Thirty-one people with MS (pwMS; median EDSS = 2.5, range:2.0-5.0) and 17 age- and sex-matched healthy controls (HC) completed behavioural and MRI assessments at baseline and post-intervention (four weeks after baseline). All included pwMS received a four-week actual and/or imagined gait training with rhythmic-auditory cueing, while HC received no intervention. All participants performed a bipedal ankle plantar- and dorsiflexion and a corresponding motor-imagery task during fMRI. PwMS displaying a > 5 % walking distance increase in the 2-Minute Walk Test (2MWT) from baseline to post-intervention were defined as responders. RESULTS: Responders did not differ from non-responders in terms of demographics, clinical variables, and walking function at baseline. Responders, non-responders, and HC showed similar movement-related brain activation at baseline. At post-intervention, responders showed decreased brain activation within the premotor cortex, precuneus, and middle frontal gyrus during the movement task. Stronger decreases within these areas were associated with higher walking function improvements in all pwMS after controlling for potential confounders. No association was observed between walking function and motor imagery-related brain activation changes. CONCLUSION: Improved walking function after rhythmic-cued gait training was associated with reduced brain activation in motor planning and attention areas. This suggests a more efficient recruitment of areas subserving motor function after successful training.
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Enhanced FC between the precentral gyrus and MFG is an important indicator of cerebral functional adaptation.
“Furthermore, studies involving interventions on limb motor function through brain–computer interfaces or motor training have identified enhanced FC between these regions as an important indicator of cerebral functional adaptation.[38,39]”
From Brain Rewires to Stabilize Walking During Visual Impairment · cites this paper as [39]
The Results (§3.3) report changes in task-related activation in the MFG and premotor cortex, and the Discussion (§4) interprets activation decreases as possible adaptive changes. A search for functional connectivity between the precentral gyrus and MFG found no passage identifying enhanced connectivity between them as an indicator of adaptation. Activation in separate regions does not establish connectivity between them. (LLM, conf=0.76)
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Research works printed but not linked: 1
- M.H. Thaut, Rhythm, Music, and the Brain, Routledge, New York, 2007, https:// doi.org/10.4324/9780203958827. Epub ahead of print 2007. · DOI
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(n.d.) · Chinese Medical Journal / Neuroscience News · doi:10.1097/cm9.0000000000004040
“[38,39] In the current study, insufficient optical flow likely required the brain to recruit greater motor planning and attentional resources.”
- Authors
- Helmlinger, B., Seebacher, B., Ropele, S., Hechenberger, S., Heschl, B., Reishofer, G., Jordan, S., Tinauer, C., Wurth, S., Valsasina, P., Rocca, M. A., Filippi, M., Ehling, R., Reindl, M., Khalil, M., Deisenhammer, F., Brenneis, C., Enzinger, C., & Pinter, D.
- Affiliations
- Medical University of Graz (AT)
- Innsbruck Medical University (AT)
- IRCCS Ospedale San Raffaele (IT)
- Vita-Salute San Raffaele University (IT)
- Corresponding author
- Pinter, Daniela
- ORCID
- Helmlinger, Birgit
- Seebacher, Barbara
- Ropele, Stefan
- Hechenberger, Stefanie
- Heschl, Bettina
- Reishofer, Gernot
- Tinauer, Christian
- Wurth, Sebastian
- Valsasina, Paola
- Rocca, Maria Assunta
- Filippi, Massimo
- Ehling, Rainer
- Reindl, Markus
- Khalil, Michael
- Deisenhammer, Florian
- Brenneis, Christian
- Enzinger, Christian
- Pinter, Daniela
- Venue
- Journal of the Neurological Sciences
- Publisher
- Elsevier BV
- Published
- 2025-04
- Volume
- 471
- Pages
- 123426
- ISSN
- 0022-510X (ISSN-L)
- OpenAlex
- W4407397854
- Cited by
- 4
- References
- 58
- Citations by year
- 2026: 3 · 2025: 1
- FWCI
- 2.64
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Journal of the Neurological Sciences (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Archivio Istituzionale della Ricerca - Università Vita-Salute San Raffaele (submittedVersion, cc-by)
- Funders
- Bristol-Myers Squibb Company (NA-CL-MS-PI-13909)
- Austrian Academy of Sciences
- Topics
- Health Sciences › Medicine › Pathology and Forensic Medicine › Multiple Sclerosis Research Studies
- Health Sciences › Medicine › Rehabilitation › Stroke Rehabilitation and Recovery
- Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Balance, Gait, and Falls Prevention
- Keywords
- multiple sclerosis, gait training, rhythmic auditory cueing, motor imagery, brain activation, gait disturbance, premotor cortex, precuneus, middle frontal gyrus, motor planning, attention, treatment response, ankle dorsiflexion, plantar flexion
- MeSH terms
- Adult, Brain, Cues, Exercise Therapy, Female, Gait, Humans, Magnetic Resonance Imaging, Male, Middle Aged, Multiple Sclerosis, Walking, Treatment Outcome, Gait Disorders, Neurologic
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