Parkinson’s disease (PD) is the second most common neurological disease affecting the elderly population . Pharmacological and surgical interventions usually employed for PD treatment show transient effectiveness and are associated with the insurgence of side effects. Therefore, motor rehabilitation has been proposed as a promising supplement in the treatment of PD, reducing the global burden of the disease and improving patients quality of life. The present systematic review aimed to critically analyse the literature concerning MRI markers of brain functional and structural response to motor rehabilitation in PD. Fourteen out of 1313 studies were selected according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses criteria. Despite the limited number of retrieved studies coupled with their heterogeneity prevent ultimate conclusions from being drawn, motor rehabilitation seems to have beneficial effects on PD as measured both with clinical outcomes and MRI derived indices. Interestingly, consistent results seem to indicate that motor rehabilitation acts via a dual mechanism of strengthening cortico-subcortical pathways, restoring movements automaticity, or activating compensatory networks such as the fronto-parietal one. The employment of more advanced and quantitative MRI methods is warranted to establish and validate standardized metrics capable of reliably determining the changes induced by rehabilitative intervention.

中文翻译：

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帕金森病运动康复介导的神经可塑性：对结构和功能 MRI 标志物的系统评价

帕金森病 (PD) 是影响老年人群的第二大常见神经系统疾病。通常用于 PD 治疗的药理学和手术干预显示出短暂的有效性，并且与副作用的增加有关。因此，运动康复已被提议作为治疗 PD 的有希望的补充，减轻疾病的全球负担，提高患者的生活质量。本系统评价旨在批判性地分析有关 MRI 标志物对 PD 运动康复的脑功能和结构反应的文献。根据系统评价和荟萃分析的首选报告项目标准选择了 1313 项研究中的 14 项。尽管检索到的研究数量有限，加上它们的异质性阻止了最终结论的得出，但运动康复似乎对 PD 有有益的影响，无论是通过临床结果还是 MRI 衍生指数来衡量。有趣的是，一致的结果似乎表明，运动康复通过加强皮质-皮质下通路、恢复运动自动性或激活额顶叶等代偿网络的双重机制发挥作用。有必要使用更先进和定量的 MRI 方法来建立和验证能够可靠地确定康复干预引起的变化的标准化指标。用临床结果和 MRI 衍生指标衡量，运动康复似乎对 PD 有有益的影响。有趣的是，一致的结果似乎表明，运动康复通过加强皮质-皮质下通路、恢复运动自动性或激活额顶叶等代偿网络的双重机制发挥作用。有必要使用更先进和定量的 MRI 方法来建立和验证能够可靠地确定康复干预引起的变化的标准化指标。用临床结果和 MRI 衍生指标衡量，运动康复似乎对 PD 有有益的影响。有趣的是，一致的结果似乎表明，运动康复通过加强皮质-皮质下通路、恢复运动自动性或激活额顶叶等代偿网络的双重机制发挥作用。有必要使用更先进和定量的 MRI 方法来建立和验证能够可靠地确定康复干预引起的变化的标准化指标。