Relating functional changes during hand movement to clinical parameters in patients with multiple sclerosis in a multi‐centre fMRI study

Abstract

We performed a prospective multi-centre study using functional magnetic resonance imaging (fMRI) to better characterize the relationships between clinical expression and brain function in patients with multiple sclerosis (MS) at eight European sites (56 MS patients and 60 age-matched, healthy controls). Patients showed greater task-related activation bilaterally in brain regions including the pre- and post-central, inferior and superior frontal, cingulate and superior temporal gyri and insula (P < 0.05, all statistics corrected for multiple comparisons). Both patients and healthy controls showed greater brain activation with increasing age in the ipsilateral pre-central and inferior frontal gyri (P < 0.05). Patients, but not controls, showed greater brain activation in the anterior cingulate gyrus and the bilateral ventral striatum (P < 0.05) with less hand dexterity. An interaction between functional activation changes in MS and age was found. This large fMRI study over a broadly selected MS patient population confirms that movement for patients demands significantly greater cognitive 'resource allocation' and suggests age-related differences in brain responses to the disease. These observations add to evidence that brain functional responses (including potentially adaptive brain plasticity) contribute to modulation of clinical expression of MS pathology and demonstrate the feasibility of a multi-site functional MRI study of MS.

Cognitively preserved MS patients demonstrate functional differences in processing neutral and emotional faces

“…This observation fits into the concept of functional reorganization with the progression of MS (Rocca et al 2009;Sumowski et al 2009;Sweet et al 2006;Wegner et al 2008).…”

Grey matter pathology in clinically early multiple sclerosis: Evidence from magnetic resonance imaging

“…Work by Audoin et al [47] demonstrates that it occurs even in the earliest clinical stages of MS, while recent work by Wegner et al [48] highlights its complexities, reminding us that not only can MS associated tissue damage affect functional activation of the cortex, so can normal ageing, and that the two may interact. It remains unclear what the relative contributions of ageing, disease duration, MS subtype, and different elements of GM and WM pathology have on the ability of the central nervous system to functionally reorganise, and to what extent such functional reorganisation does or does not have a beneficial impact on clinical outcomes.…”

Physiopathology of symptoms and signs in multiple sclerosis

“…In MS patients, functional brain reorganization mainly consists of an increase in the extent of activation of the brain areas used by healthy subjects, as well as the recruitment of additional brain areas 48 . Neural plasticity is a recent and promising research field in MS, addressed in the literature with studies showing adaptive compensation for motor 49,50 , visual 51 , memory and other cognitive tasks [52][53][54] , even in the resting state 55 and in benign forms 56,57 . Table 2.…”