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Published on: June 26, 2013
Functional brain reorganization in multiple sclerosis: evidence from fMRI studies
Patrizia Pantano1, Caterina Mainero, Francesca Caramia
1Department of Neurological Sciences, University La Sapienza, Viale dell'Università 30, 00185 Rome, Italy. patrizia.pantano@uniroma1.it
Abstract:
In patients with multiple sclerosis (MS), the severity of clinical signs is not closely related to indices of structural brain damage provided by conventional magnetic resonance MR. Accordingly, patients with MS may show symptom recovery while progressively accumulating tissue damage. Changes in functional organization of the cerebral cortex have been reported in functional magnetic resonance (fMRI) studies that have compared the activation patterns during motor, visual, and cognitive tasks of patients with MS with those of healthy controls. fMRI studies on MS have provided the results that are difficult to compare and may be discrepant because of differences in the criteria used for patient selection, the activation paradigm, the experimental design, and the MR acquisition parameters. Nevertheless, they do provide a new, interesting tool that sheds light on how the brain changes its functional organization in response to MS. In patients with MS, 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. These findings have been interpreted as adaptive or compensatory mechanisms that allow normal performance despite neural damage or loss. However, brain functional activity may also change in response to clinical disability, though the precise role of brain functional changes in MS has yet to fully understand. Longitudinal studies designed to explore the effects of both rehabilitation and pharmacological agents on brain plasticity might shed light on this issue.
Insights
Multiple sclerosis (MS) patients may recover symptoms despite ongoing brain damage. Functional MRI reveals brain reorganization, with increased activation and recruitment of new areas, suggesting compensatory mechanisms in MS.
Area of Science:
- Neuroscience
- Neurology
- Medical Imaging
Background:
- Clinical signs in multiple sclerosis (MS) do not correlate well with structural brain damage shown by MRI.
- Patients with MS may experience symptom recovery while their brain tissue continues to deteriorate.
- Functional MRI (fMRI) studies have observed altered brain activation patterns in MS patients compared to healthy individuals during various tasks.
Purpose of the Study:
- To investigate changes in the functional organization of the cerebral cortex in patients with multiple sclerosis (MS).
- To understand how the brain reorganizes its functional networks in response to MS.
- To explore the adaptive or compensatory mechanisms underlying functional brain changes in MS.
Main Methods:
- Utilized functional magnetic resonance imaging (fMRI) to compare brain activation patterns.
- Compared task-based activation in MS patients versus healthy controls.
- Analyzed motor, visual, and cognitive task performance and associated brain activity.
Main Results:
- fMRI studies on MS have yielded discrepant results due to variations in methodology.
- Functional brain reorganization in MS primarily involves expanded activation in typical brain areas and recruitment of additional areas.
- These changes are interpreted as adaptive or compensatory mechanisms enabling normal performance despite neural damage.
Conclusions:
- Functional brain reorganization, including increased activation extent and recruitment of new areas, is a key response to MS.
- These functional changes may represent compensatory mechanisms allowing for sustained performance.
- Further longitudinal studies are needed to clarify the role of brain plasticity and the impact of interventions like rehabilitation and pharmacological agents in MS.
