Fractional anisotropy and mean diffusivity in the corpus callosum of patients with multiple sclerosis: the effect of physiotherapy

Ibrahim, Ibrahim; Tintěra, Jaroslav; Škoch, Antonín; Jírů, Filip; Hluštı́k, Petr; Martinková, Patrícia; Zvára, Karel; Řasová, Kamila

doi:10.1007/s00234-011-0879-6

Cited by 52 publications

(64 citation statements)

References 53 publications

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“…Indeed, increment of structural connectivity has been suggested in MS (Li et al, 2013) and related with WM lesion load (He et al, 2009). It can be present at early stages of disease (Fleischer et al, 2016), during recovery from relapses (Théaudin et al, 2012) and after a rehabilitation program (Ibrahim et al, 2011) evidencing dynamic variations of WM. Changes in the number of axons, axon diameter, the packing density of fibers, axon branching, axon trajectories, myelination, glial cell increase in number and size could underlie increased FA (Zatorre et al, 2012).…”

Section: Discussionmentioning

confidence: 99%

Structural networks involved in attention and executive functions in multiple sclerosis

Llufriú

Martínez‐Heras

Solana

et al. 2017

NeuroImage: Clinical

100

107

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Attention and executive deficits are disabling symptoms in multiple sclerosis (MS) that have been related to disconnection mechanisms. We aimed to investigate changes in structural connectivity in MS and their association with attention and executive performance applying an improved framework that combines high order probabilistic tractography and anatomical exclusion criteria postprocessing. We compared graph theory metrics of structural networks and fractional anisotropy (FA) of white matter (WM) connections or edges between 72 MS subjects and 38 healthy volunteers (HV) and assessed their correlation with cognition. Patients displayed decreased network transitivity, global efficiency and increased path length compared with HV (p < 0.05, corrected). Also, nodal strength was decreased in 26 of 84 gray matter regions. The distribution of nodes with stronger connections or hubs of the network was similar among groups except for the right pallidum and left insula, which became hubs in patients. MS subjects presented reduced edge FA widespread in the network, while FA was increased in 24 connections (p < 0.05, corrected). Decreased integrity of frontoparietal networks, deep gray nuclei and insula correlated with worse attention and executive performance (r between 0.38 and 0.55, p < 0.05, corrected). Contrarily, higher strength in the right transverse temporal cortex and increased FA of several connections (mainly from cingulate, frontal and occipital cortices) were associated with worse functioning (r between − 0.40 and − 0.47, p < 0.05 corrected). In conclusion, structural brain connectivity is disturbed in MS due to widespread impairment of WM connections and gray matter structures. The increased edge connectivity suggests the presence of reorganization mechanisms at the structural level. Importantly, attention and executive performance relates to frontoparietal networks, deep gray nuclei and insula. These results support the relevance of network integrity to maintain optimal cognitive skills.

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Section: Discussionmentioning

confidence: 99%

Structural networks involved in attention and executive functions in multiple sclerosis

Llufriú

Martínez‐Heras

Solana

et al. 2017

NeuroImage: Clinical

100

107

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“…Some studies have identified structural changes on diffusion tensor imaging as a result of rehabilitation in the context of physiotherapy [42, 43]. Our study attempted to explore the role of myelin in rehabilitation and repair.…”

Section: Discussionmentioning

confidence: 99%

A Randomised Controlled Trial of Efficacy of Cognitive Rehabilitation in Multiple Sclerosis: A Cognitive, Behavioural, and MRI Study

et al. 2016

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Aim. To explore the efficacy of home-based, computerised, cognitive rehabilitation in patients with multiple sclerosis using neuropsychological assessment and advanced structural and functional magnetic resonance imaging (fMRI). Methods. 38 patients with MS and cognitive impairment on the Brief International Cognitive Assessment for MS (BICAMS) were enrolled. Patients were randomised to undergo 45 minutes of computerised cognitive rehabilitation using RehaCom software (n = 19) three times weekly for six weeks or to a control condition (n = 19). Neuropsychological and MRI data were obtained at baseline (time 1), following the 6-week intervention (time 2), and after a further twelve weeks (time 3). Cortical activations were explored using fMRI and microstructural changes were explored using quantitative magnetisation transfer (QMT) imaging. Results. The treatment group showed a greater improvement in SDMT gain scores between baseline and time 2 compared to the control group (p = 0.005). The treatment group exhibited increased activation in the bilateral prefrontal cortex and right temporoparietal regions relative to control group at time 3 (p < 0.05FWE corrected). No significant changes were observed on QMT. Conclusion. This study supports the hypothesis that home-based, computerised, cognitive rehabilitation may be effective in improving cognitive performance in patients with MS. Clinical trials registration is ISRCTN54901925.

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“…Administration of risperidone and ziprasidone to individuals with schizophrenia led to increased cerebral gray matter volume after 28 days of treatment [239] and administration of citalopram to depressed patients increased hippocampal gray matter within 8 weeks [240]. Changes have also been observed in white matter microstructure by DWI; patients with multiple sclerosis showed increases in fractional anisotropy within 2 months of facilitation of physiotherapy [241], depressed patients showed increase in fractional anisotropy with 4 weeks of psychotherapy [242], and patients with obsessive-compulsive disorder showed a reversal of abnormal white matter microstructure after a 12-week course of antidepressant (SSRI) treatment [243]. …”

Section: Biomarkers and Medical Measuresmentioning

confidence: 99%

Updated report on tools to measure outcomes of clinical trials in fragile X syndrome

Budimirović

Berry‐Kravis

Erickson

et al. 2017

J Neurodevelop Disord

131

158

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ObjectiveFragile X syndrome (FXS) has been the neurodevelopmental disorder with the most active translation of preclinical breakthroughs into clinical trials. This process has led to a critical assessment of outcome measures, which resulted in a comprehensive review published in 2013. Nevertheless, the disappointing outcome of several recent phase III drug trials in FXS, and parallel efforts at evaluating behavioral endpoints for trials in autism spectrum disorder (ASD), has emphasized the need for re-assessing outcome measures and revising recommendations for FXS.MethodsAfter performing an extensive database search (PubMed, Food and Drug Administration (FDA)/National Institutes of Health (NIH)’s www.ClinicalTrials.gov, etc.) to determine progress since 2013, members of the Working Groups who published the 2013 Report evaluated the available outcome measures for FXS and related neurodevelopmental disorders using the COSMIN grading system of levels of evidence. The latter has also been applied to a British survey of endpoints for ASD. In addition, we also generated an informal classification of outcome measures for use in FXS intervention studies as instruments appropriate to detect shorter- or longer-term changes.ResultsTo date, a total of 22 double-blind controlled clinical trials in FXS have been identified through www.ClinicalTrials.gov and an extensive literature search. The vast majority of these FDA/NIH-registered clinical trials has been completed between 2008 and 2015 and has targeted the core excitatory/inhibitory imbalance present in FXS and other neurodevelopmental disorders. Limited data exist on reliability and validity for most tools used to measure cognitive, behavioral, and other problems in FXS in these trials and other studies. Overall, evidence for most tools supports a moderate tool quality grading. Data on sensitivity to treatment, currently under evaluation, could improve ratings for some cognitive and behavioral tools. Some progress has also been made at identifying promising biomarkers, mainly on blood-based and neurophysiological measures.ConclusionDespite the tangible progress in implementing clinical trials in FXS, the increasing data on measurement properties of endpoints, and the ongoing process of new tool development, the vast majority of outcome measures are at the moderate quality level with limited information on reliability, validity, and sensitivity to treatment. This situation is not unique to FXS, since reviews of endpoints for ASD have arrived at similar conclusions. These findings, in conjunction with the predominance of parent-based measures particularly in the behavioral domain, indicate that endpoint development in FXS needs to continue with an emphasis on more objective measures (observational, direct testing, biomarkers) that reflect meaningful improvements in quality of life. A major continuous challenge is the development of measurement tools concurrently with testing drug safety and efficacy in clinical trials.

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Fractional anisotropy and mean diffusivity in the corpus callosum of patients with multiple sclerosis: the effect of physiotherapy

Abstract: The results of the study show that facilitation physiotherapy influences brain microstructure measured by DTI.

Cited by 52 publications

References 53 publications

Structural networks involved in attention and executive functions in multiple sclerosis

Structural networks involved in attention and executive functions in multiple sclerosis

A Randomised Controlled Trial of Efficacy of Cognitive Rehabilitation in Multiple Sclerosis: A Cognitive, Behavioural, and MRI Study

Updated report on tools to measure outcomes of clinical trials in fragile X syndrome

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