Neuroimaging and Rehabilitation in Multiple Sclerosis

Multiple sclerosis is a neurological disease which has a significant deleterious impact in both cognitive and motor functions. Cognitive rehabilitation studies have increased steadily over the past 20 years, showing significant improvements in cognitive functioning with treatment. However, relatively few of these studies have included neuroimaging techniques to examine the neural mechanisms of treatment effectiveness following cognitive rehabilitation. The few that have been conducted however have generally shown a positive relationship between increased brain activation and/or connectivity on MRI and treatment effectiveness. The preliminary uses of new neuroimaging techniques, such as transcranial magnetic stimulation and transcranial direct stimulation, have also been positive, but still need to be refined and studied further. New approaches such as real-time fMRI may provide additional tools, which may further help to understand the mechanisms associated with treatment effectiveness and neural plasticity. In the end, the discovery of mechanisms associated with effective cognitive rehabilitation may help guide our understanding of which treatments may be best for improving the quality of life of persons with MS.