{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,22]],"date-time":"2026-08-22T11:25:34Z","timestamp":1787397934105,"version":"build-2736575974"},"reference-count":41,"publisher":"SAGE Publications","issue":"8","license":[{"start":{"date-parts":[[2026,6,9]],"date-time":"2026-06-09T00:00:00Z","timestamp":1780963200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,6,9]],"date-time":"2026-06-09T00:00:00Z","timestamp":1780963200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"Ministero della Salute, Ricerca Finalizzata 2019","award":["RF 2019 12370447"],"award-info":[{"award-number":["RF 2019 12370447"]}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Mult Scler"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Motor rehabilitation effectiveness in progressive multiple sclerosis (PMS) remains uncertain. We assessed whether task-oriented (TO) rehabilitation, with or without non-immersive virtual reality, improves upper limb function in PMS and evaluated magnetic resonance imaging (MRI) changes related to motor performance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Eighty-one progressive multiple sclerosis patients on B-cell depleting therapy were randomized to task-oriented rehabilitation with virtual reality (TO-VR), TO rehabilitation, or passive mobilization (CG) for 8\u2009weeks. Upper extremity performance was measured with the Nine-Hole Peg Test (9-HPT), Action Research Arm Test (ARAT), AbilHand Test (ABILHAND), and Manual Ability Measure-36 (MAM-36). Upper limb function, neurological status, and MRI were evaluated at baseline, after rehabilitation, and at 3\u2009months.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Seventy-nine patients completed the study. No difference was observed in 9-HPT, but in the whole sample, ABILHAND improved post-treatment (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u20090.001), and ARAT improved on the left side (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.014, false discovery rate adjusted\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.084). Additional gains appeared in several neurological tests. Brain volumes, morphometry, and diffusion indices were unchanged, while functional MRI showed increased connectivity post-treatment in TO-VR and TO groups, but not in CG. Connectivity changes were correlated, in particular, with clinical amelioration (ABILHAND) in both TO-VR (\n                      <jats:italic toggle=\"yes\">r<\/jats:italic>\n                      \u2009=\u20090.54,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.013) and TO groups (\n                      <jats:italic toggle=\"yes\">r<\/jats:italic>\n                      \u2009=\u20090.50,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.035).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>In PMS treated with high-efficacy therapy, TO rehabilitation, particularly when combined with VR, can improve motor function, inducing functional gains and plasticity in cerebral networks.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/13524585261450820","type":"journal-article","created":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T05:54:12Z","timestamp":1781070852000},"page":"864-877","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Task-oriented virtual reality and brain functional plasticity in progressive multiple sclerosis: A randomized controlled trial on upper limb rehabilitation"],"prefix":"10.1177","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9371-4832","authenticated-orcid":false,"given":"Mehrnaz","family":"Hamedani","sequence":"first","affiliation":[{"name":"Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, Genova, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giada","family":"Lombardi","sequence":"additional","affiliation":[{"name":"Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, Genova, Italy; Institute of Psychiatry, Psychology &amp; Neuroscience (IoPPN), King\u2019s College London, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2220-9422","authenticated-orcid":false,"given":"Giacomo","family":"Boffa","sequence":"additional","affiliation":[{"name":"Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, Genova, Italy; Neurologic Clinic, IRCCS Azienda Ospedaliera Metropolitana, Genova, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caterina","family":"Pistarini","sequence":"additional","affiliation":[{"name":"Department of Neurorehabilitation, Istituti Clinici Scientifici Maugeri IRCCS, Pavia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Federico Maria","family":"Cossa","sequence":"additional","affiliation":[{"name":"Department of Neurologic Rehabilitation, Istituti Clinici Scientifici Maugeri IRCCS Veruno, Veruno, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisabetta","family":"Capello","sequence":"additional","affiliation":[{"name":"Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, Genova, Italy; Neurologic Clinic, IRCCS Azienda Ospedaliera Metropolitana, Genova, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3624-5715","authenticated-orcid":false,"given":"Simona","family":"Malucchi","sequence":"additional","affiliation":[{"name":"Department of Neurology and CRESM, San Luigi Gonzaga University Hospital, Orbassano (Torino), Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arianna","family":"Anselmino","sequence":"additional","affiliation":[{"name":"Department of Neurologic Rehabilitation, Istituti Clinici Scientifici Maugeri IRCCS Veruno, Veruno, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena Maria","family":"Fiabane","sequence":"additional","affiliation":[{"name":"Psychology Unit, Istituti Clinici Scientifici Maugeri IRCCS , Pavia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5575-7567","authenticated-orcid":false,"given":"Alessia","family":"Di Sapio","sequence":"additional","affiliation":[{"name":"Department of Neurology and CRESM, San Luigi Gonzaga University Hospital, Orbassano (Torino), Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ilaria","family":"Poir\u00e8","sequence":"additional","affiliation":[{"name":"Neurologic Clinic, IRCCS Azienda Ospedaliera Metropolitana, Genova, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chiara","family":"Sciolla","sequence":"additional","affiliation":[{"name":"Department of Neurology and CRESM, San Luigi Gonzaga University Hospital, Orbassano (Torino), Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cinzia","family":"Calautti","sequence":"additional","affiliation":[{"name":"Physical and Rehabilitation Medicine, Istituti Clinici Scientifici Maugeri Genova Nervi, Genova, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabio","family":"Incollu","sequence":"additional","affiliation":[{"name":"Physical and Rehabilitation Medicine, Istituti Clinici Scientifici Maugeri Genova Nervi, Genova, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesca","family":"Spada","sequence":"additional","affiliation":[{"name":"Physical and Rehabilitation Medicine, Istituti Clinici Scientifici Maugeri Genova Nervi, Genova, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7052-1907","authenticated-orcid":false,"given":"Antonio","family":"Bertolotto","sequence":"additional","affiliation":[{"name":"Neurology, Koelliker Hospital, Torino, Italy; 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