are highly relevant for biological network behaviour and can be traced longitudinally to depict brain reorganization processes in brain diseases 7,8. Early EC studies in MS patients demonstrated higher EC levels during Paced Auditory Serial Addition Test (PASAT) performance in the working memory network 9 , during a sensorimotor and information processing speed task within frontal networks 10,11 as well as during Stroop task performance in the sensorimotor cortex 10each in a cross-sectional approach. These differences in EC measures between MS patients and healthy controls (HC) were primarily interpreted as an adaptive response to maintain cognitive and/or sensorimotor function for review see 12. Recently, altered connectivity patterns were found during high cognitive control demands in the executive control network among different MS phenotypes 13 , in particular a loss of top-down connections was seen in patients with progressive MS 14. These task-related EC changes point towards dynamic connectivity patterns that change during the course of the disease. But in contrast to task-dependent approaches, the dynamics of EC in the absence of behavioural measures are largely unknown and existing research still lacks the understanding of how directed connectivity changes over time in MS patients. Hence, longitudinal investigations of brain reorganization in MS patients are necessary to provide maps of brain plasticity processes over time, very likely relevant for disability progression. In our study, we performed two parallel EC analyses based on recently established methods, neither of which require any a priori information on the existence of a connection between two regions as is necessary for dynamic causal modelling 10,15 or structural equation modelling (SEM) 9,16. Specifically, we analysed EC based on Causal Bayesian Networks (CBN) proposed by Smith et al. 17 and, since EC can also be simultaneously estimated in two domains (namely frequency and time), we additionally assessed EC based on the so-called Time-resolved Partial Directed Coherence (TPDC) method 18-23 developed in the context of electrophysiological measurements of frequency-filtered blood oxygen-level dependent (BOLD) fMRI time courses. Ultimately, we aimed to provide a longitudinal outline of EC changes derived from resting-state fMRI with these two methodological approaches. Therefore, relapsing-remitting (RR)MS patients were followed-up over five successive time points at twelve-week intervals. In addition, we validated these findings by comparing our results with longitudinal EC data from HC over the same period of time. Finally, we investigated the link between the strength of EC and clinical disability, patient fatigue and disease duration.