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Functional correlates of cognitive dysfunction in multiple sclerosis: A multicenter fMRI Study.

Maria A Rocca1, Paola Valsasina, Hanneke E Hulst

  • 1Neuroimaging Research Unit, Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy; Department of Neurology, Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy.

Human Brain Mapping
|July 22, 2014
PubMed
Summary

Cognitively preserved multiple sclerosis (MS) patients show greater right dorsolateral prefrontal cortex activity during cognitive tasks. This preserved frontal lobe function correlates with better cognitive performance in MS.

Keywords:
cognitioncognitive impairmentdefault mode networkfMRIfunctional reservemultiple sclerosisprefrontal cortex

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Area of Science:

  • Neuroimaging
  • Cognitive Neuroscience
  • Neurology

Background:

  • Multiple sclerosis (MS) frequently causes cognitive dysfunction.
  • Functional magnetic resonance imaging (fMRI) can reveal brain activity patterns associated with cognitive performance.

Purpose of the Study:

  • To define the functional brain correlates of cognitive dysfunction in MS patients using fMRI.
  • To investigate differences in brain activation between cognitively impaired (CI) and cognitively preserved (CP) MS patients and healthy controls.

Main Methods:

  • A multicenter study involving 42 relapsing-remitting MS patients and 52 healthy controls.
  • fMRI scans were acquired during the N-back task at 3.0 Tesla scanners.
  • Cognitive function was assessed using standardized neuropsychological tests; CI was defined by at least two abnormal test results.

Main Results:

  • 47% of MS patients were identified as cognitively impaired.
  • CP MS patients exhibited increased right dorsolateral prefrontal cortex recruitment compared to controls and CI patients.
  • CI MS patients showed reduced fronto-parieto-temporal lobe activation and altered default mode network deactivation with increasing task difficulty.
  • Abnormal fMRI patterns correlated with cognitive performance and brain lesion volumes.

Conclusions:

  • Preserved frontal lobe fMRI activity is associated with a better cognitive profile in MS patients.
  • fMRI is a feasible tool for monitoring disease progression and treatment effects in MS.