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Comprehensive Autopsy Program for Individuals with Multiple Sclerosis
Published on: July 19, 2019
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Staging of cortical and deep grey matter functional connectivity changes in multiple sclerosis
Kim A Meijer1, Anand J C Eijlers1, Jeroen J G Geurts1
1Department of Anatomy and Neurosciences, VUmc MS Center Amsterdam, Amsterdam Neuroscience, VU University Medical Center, Amsterdam, The Netherlands.
Journal of Neurology, Neurosurgery, and Psychiatry
|October 8, 2017
Summary
Functional connectivity changes in multiple sclerosis (MS) begin in deep grey matter and progress to cortical changes. These alterations correlate with disease stage, disability, and cognitive function in MS patients.
Area of Science:
- Neuroscience
- Neurology
- Medical Imaging
Background:
- Multiple sclerosis (MS) is characterized by complex changes in brain functional connectivity.
- These changes may vary with disease stage and progression, potentially following patterns of atrophy from deep grey matter to the cortex.
- Understanding the temporal and spatial development of these connectivity alterations is crucial for comprehending MS progression.
Purpose of the Study:
- To investigate the onset and location of functional connectivity changes across different stages of multiple sclerosis (MS).
- To explore the clinical and cognitive relevance of these connectivity alterations in early relapsing-remitting MS (RRMS), late RRMS, and secondary progressive MS (SPMS).
Main Methods:
- A cohort of 121 early RRMS, 122 late RRMS, 53 SPMS patients, and 96 healthy controls underwent MRI and neuropsychological testing.
- Functional connectivity was analyzed within deep grey matter, between deep grey matter and cortex, and within the cortex.
- A post hoc regional analysis identified specific regions driving connectivity changes.
Main Results:
- Increased deep grey matter connectivity (putamen, pallidum) was observed in late RRMS and SPMS patients, connecting to other deep grey matter structures and the cortex.
- Within-cortex connectivity decreased in SPMS patients, particularly in temporal, occipital, and frontal regions, compared to early RRMS.
- Deep grey matter connectivity alterations correlated with cognition and disability, while within-cortex connectivity changes were linked only to disability.
Conclusions:
- Increased deep grey matter connectivity emerges in late RRMS and intensifies in SPMS.
- The combination of progressive deep grey matter changes and cortical network degeneration in SPMS may account for the characteristic rapid clinical decline in this disease phase.
