Wii balance board use temporarily improves balance of MS patients by changing brain

Use of a video game’s balance board at home improved the balance of patients with multiple sclerosis (MS) by temporarily altering their brains, according to a study published online in Radiology.

Luca Prosperini, MD, PhD, from Sapienza University in Rome, and colleagues wrote that MS patients who used the balance board underwent temporary beneficial changes in brain connections related to balance. However, their improvement of balance did not last, and its neuro-biologic basis is unknown, they said.

In a press release, Prosperini said the brain changes were a manifestation of neural plasticity, or the ability of the brain to adapt and form new connections.

“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,” he said.

“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.”

Similar brain plasticity has been described in those who play video games, but the exact mechanisms behind the phenomenon are still unknown. Prosperini hypothesized that changes can occur at the cellular level.

Prosperini and colleagues commented that the study showed “training-induced behavioral changes in standing balance may be accompanied by transient structural white matter plasticity … specifically involving the superior cerebellar peduncles.“

However, the improvement is temporary and “training-induced changes in clinical and diffusion- tensor imaging parameters are not sustained after discontinuation of training,“ they wrote.

During the 12-week study, 27 MS patients used the Nintendo Wii Balance Board System at home. The board is a battery-powered device, similar in shape and size to a bathroom scale, which allows users to stand on it and shift their balance as they follow action on a television screen.

Balance impairment is one of the most pervasive and disabling symptoms of MS. Physical rehabilitation is often used to improve balance, and Prosperini and colleagues said the study shows that “home-based training (using the Wii Balance Board) is an effective option to improve balance of patients with multiple sclerosis.”

However, the improvement is temporary and not sustained after discontinuation of training, they noted.

Researchers used an MRI technique called diffusion tensor imaging (DTI) to examine the MS patients’ brain changes in nerve tracts related to balance and movement.  The changes seen on the MRI scans were measured by an assessment technique called posturography.

The researchers wrote that the “observed improvement in fractional anisotropy observed after balance training … was mainly due to a reduction in radial diffusivity, suggesting the occurrence of activity-dependent modulation of myelin in partially damaged pathways.”