Abstract Details

Title Contribution of Structural and Functional MRI in Predicting Response to Motor Training in People With Multiple Sclerosis

Topic Multiple Sclerosis

Presentation(s) P9 - Poster Session 9 (5:00 PM-6:00 PM)

Poster/Presentation
Number 19-008

Objective To assess whether baseline demographic, clinical, and MRI features in multiple sclerosis (MS) patients predict response to aerobic or non-aerobic training.

Background Aerobic training has emerged as a promising rehabilitation strategy for MS, offering the dual benefits of improved cardiorespiratory fitness and promotion of neuroplasticity. However, a certain heterogeneity in individual response to aerobic training and to general physical exercise may be observed.

Design/Methods Eighty-eight MS patients were randomized into aerobic (n=43) or non-aerobic (n=45) training programs, consisting of 24 training sessions (30–40 minutes/session) over 2-3 months. Patients were classified as "responders" based on a ≥21.6 meters improvement in the 6-Minute Walking Test. Baseline assessments included Expanded Disability Status Scale, Modified Fatigue Impact Scale, Timed 25-Foot Walk Test and peak oxygen consumption. Structural and functional MRI scans were also performed at baseline to evaluate various measures of lesional volume, brain volumetrics, cortical thickness, white matter (WM) microstructural integrity, and resting-state functional connectivity. Seventy healthy controls were analyzed to compare baseline measurements and determine pathological values. Baseline demographic, clinical, and MRI predictors of response to training were identified using random forest.

Results Post-intervention, 34 MS patients (aerobic group=20, non-aerobic group=14) were classified as responders. Independent predictors of treatment response were corticospinal tract (CST) fractional anisotropy (FA) and middle cerebellar peduncle (MCP) FA in the aerobic group (out-of-bag area under the curve [OOB-AUC]=0.682), superior cerebellar peduncle (SCP) mean diffusivity (MD) in the non-aerobic group (OOB-AUC=0.713), and SCP MD, MCP MD, CST MD, CST FA, and MCP FA in the whole MS cohort (OOB-AUC=0.734).

Conclusions Response to motor training in MS patients is predicted by microstructural integrity of key WM tracts essential for motor functions, independently from the training strategy employed. These findings underscore the potential of neuroimaging in identifying MS patients most likely to benefit from rehabilitation.

Authors/Disclosures
Tetsu Morozumi, PT (Ospedale San Raffaele S.r.l.) PRESENTER	Mr. Morozumi has nothing to disclose.
Paolo Preziosa (Ospedale San Raffaele)	Mr. Preziosa has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Bristol Myers Squibb . Mr. Preziosa has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Sanofi Genzyme. Mr. Preziosa has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Novartis. Mr. Preziosa has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Roche. Mr. Preziosa has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Merck.
Alessandro Meani	Alessandro Meani has nothing to disclose.
Elisabetta Pagani	Elisabetta Pagani has nothing to disclose.
Paola Valsasina	Paola Valsasina has nothing to disclose.
Chiara Arezzo, PT	Miss Arezzo has nothing to disclose.
Francesco Romano (San Raffaele Hospital)	Francesco Romano has nothing to disclose.
Matteo Albergoni, PT (Ospedale San Raffaele SRL (VAT: IT 07636600962))	Dr. Albergoni has nothing to disclose.
Massimo Filippi, MD, FAAN (Ospedale San Raffaele, Neuroimaging Research Unit)	Dr. Filippi has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Alexion, Almirall, Biogen, Merck, Novartis, Roche, Sanofi. Dr. Filippi has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Alexion, Biogen, Bristol-Myers Squibb, Merck, Novartis, Roche, Sanofi, Sanofi-Aventis, Sanofi-Genzyme, Takeda. Dr. Filippi has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Bayer, Biogen, Celgene, Chiesi Italia SpA, Eli Lilly, Genzyme, Janssen, Merck-Serono, Neopharmed Gentili, Novartis, Novo Nordisk, Roche, Sanofi, Takeda, and TEVA. Dr. Filippi has received personal compensation in the range of $10,000-$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Springer Nature. The institution of Dr. Filippi has received research support from Biogen Idec, Merck-Serono, Novartis, Roche, the Italian Ministry of Health, the Italian Ministry of University and Research, and Fondazione Italiana Sclerosi Multipla.
Maria A. Rocca (Neuroimaging Research Unit)	Maria Assunta Rocca has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Biogen, Bristol Myers Squibb, Eli Lilly, Janssen, Roche. Maria Assunta Rocca has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for AstraZaneca, Biogen, Bristol Myers Squibb, Bromatech, Celgene, Genzyme, Horizon Therapeutics Italy, Merck Serono SpA, Novartis, Roche, Sanofi and Teva. The institution of Maria Assunta Rocca has received research support from MS Society of Canada, the Italian Ministry of Health, the Italian Ministry of University and Research, and Fondazione Italiana Sclerosi Multipla.

��ɫ��

��ɫ��