Abstract
Aim: To evaluate neuroplastic changes during a neurorehabilitation protocol mediated by a serious video game in virtual reality using a multimodal assessment.
Methods: Case study with 18 serious video game sessions. The following were recorded: (i) clinical evolution using the Fugl"“Meyer Assessment, (ii) in-game performance, (iii) task functional magnetic resonance imaging with motor paradigms (unilateral and bilateral), and (iv) resting state functional magnetic resonance imaging.
Results: The total Fugl"“Meyer Assessment increased from 52 (T0) to 61 points (T2), with greater gains in "˜upper limb"™ and "˜coordination/speed."™ Performance in the serious video game showed progression in line with clinically planned levels. In task functional magnetic resonance imaging, a significant difference was observed in the bilateral paradigm (Wilcoxon, p=0.0016), consistent with functional reorganisation. In resting state functional magnetic resonance imaging, there was evidence of increased interhemispheric connectivity between Precentral Gyrus, Postcentral Gyrus and Supplementary Motor Cortex and a more organised pattern of the somatomotor network compared to T0; connectivity approximated the normotypical reference pattern.
Conclusion: serious video game -mediated intervention is associated with clinical improvements and markers of neuroplasticity measured by functional magnetic resonance imaging; the proposed multimodal strategy is viable for quantifying functional reorganisation during rehabilitation and warrants further study in larger cohorts.