MRI Shows Brain Changes in People with MS Using Wii

Magnetic resonance images have detected changes in the brains of people with multiple sclerosis (MS) who use Wii balance boards, according to a study published in the journal Radiology.

Researchers from Italy sought to determine if high-intensity, task-oriented, visual feedback training with a Nintendo Wii system could affect the brain of people with MS by changing cerebellar connections and other supratentorial associative bundles. And if this did occur, would these changes affect clinical improvement for the patients?

Twenty-seven patients with MS participated in the 24-week, randomized, two-period crossover pilot study. All patients underwent static posturography and brain diffusion tensor imaging (DTI) three times: at the start of the study, after 12 weeks and again at the study’s end. A total of 13 patients started a 12-week training program followed by a 12-week period without any intervention; 14 patients received the intervention in reverse order. An additional 15 healthy controls also underwent static posturography and a one-time DTI.

The researchers used DTI in order to observe detailed analysis of the white matter tracts.

The results showed that the patients with MS had improvements in both movement and balance. There were relevant differences in postural sway and DTI parameters between the patients with MS and the control subjects, the authors wrote. There were also significant main effects of time by group interaction for fractional anisotropy and radial diffusivity of the left and right superior cerebellar peduncles. However, the researchers also found that any changes, both clinical and with DTI, did not persist beyond 12 weeks after training. The researchers suggested that this was because certain skills related to structural changes to the brain after an injury need to be maintained through training.

“The most important finding in this study is that a task-oriented and repetitive training aimed at managing a specific symptom is highly effective and induces brain plasticity,” lead author Luca Prosperini, MD, PhD, said in a release. “More specifically, the improvements promoted by the Wii balance board can reduce the risk of accidental falls in patients with MS, thereby reducing the risk of fall-related comorbidities like trauma and fractures.”

The researchers concluded that despite the small size of the study, their results showed that training with the Wii balance board system modified the microstructure of superior cerebellar peduncles, resulting in clinical improvement.

“This finding should have an important impact on the rehabilitation process of patients, suggesting that they need ongoing exercises to maintain good performance in daily living activities,” Prosperini added.