An accessory on the popular video game console, Nintendo Wii, called the Balance Board System can help multiple sclerosis (MS) patients improve their balance and reduce their risk of accidental falls, according to a new study published online in the journal Radiology. The researchers used MR to evaluate changes in the brain.

The patients use the system by standing on the board, which is about the same size and shape as a bathroom scale, and following the actions on the television screen while shifting their weight accordingly. It has been reported to benefit patients with MS but there wasn't any physiological evidence to prove it before.

The researchers at Sapienza University in Rome performed an MR technique called diffusion tensor imaging (DTI) on 27 MS patients who went through a 12-week intervention that involved Wii balance board-based visual feedback training to assess changes in their brains. DTI gives an analysis of the white matter tracts that transmit nervous signals through the brain and body.
The MR scans uncovered that there were significant effects in the nerve tracts that are important in balance and movement. Additionally, the findings were comparable to findings from an assessment technique called posturography.

However, the improvements in balance did not continue after the patients stopped the training protocol. The researchers attribute that to the fact that certain skills related to structural changes to the brain after an injury need to be maintained through training.

The findings were not surprising to the researchers — it confirmed what they already expected. "Our findings are not surprising, since improved skills associated with functional and structural brain plasticity have been described even in healthy people who play video games," Dr. Luca Prosperini, lead author of the study, wrote to DOTmed News. "Moreover, we found structural changes in regions of the brain whose damage is related to balance disturbance."

Similar plasticity has been shown in individuals who play video games but the mechanisms that govern it are not known. Prosperini believes that the changes can occur within the brain at the cellular level and might be connected to myelination — the process of building the protective sheath around the nerves.

Prosperini said that the findings highlight that MS patients need ongoing exercises to maintain good performance in daily living activities but that precautions should be taken. "Patients should be encouraged to start using this system only under supervision, in order to minimize the training-related risks of knee injuries, tendinitis or lower back pain," he said.

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