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Relation between functional connectivity and disability in multiple sclerosis: a non-linear model.

Silvia Tommasin1, Laura De Giglio1,2, Serena Ruggieri1

  • 1Department of Human Neuroscience, Sapienza University of Rome, Viale dell'Università, 30, 00185, Rome, Italy.

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Summary
This summary is machine-generated.

Brain functional connectivity changes reflect adaptation to multiple sclerosis (MS) damage. Decreased connectivity above Expanded Disability Status Score 3.0 signals exhaustion of compensatory mechanisms in MS patients.

Keywords:
DisabilityFunctional connectivityMultiple sclerosisPlasticityfMRI

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Area of Science:

  • Neuroscience
  • Radiology
  • Neurology

Background:

  • Multiple sclerosis (MS) involves brain damage and inflammation, leading to progressive disability.
  • Brain functional connectivity (FC) may represent adaptive mechanisms to structural damage.
  • Understanding the relationship between FC and disability is crucial for MS management.

Purpose of the Study:

  • To characterize the relationship between brain FC and disability in MS patients.
  • To identify critical thresholds of disability and FC indicating the exhaustion of adaptive mechanisms.

Main Methods:

  • Resting-state functional MRI (fMRI) was used to assess FC in 119 MS patients and 42 healthy controls.
  • Correlation analyses identified brain regions where FC related to the Expanded Disability Status Scale (EDSS).
  • Mathematical modeling explored the interplay between structural and functional measures in relation to EDSS.

Main Results:

  • Disability showed linear associations with lesion load, reduced thalamic volume, and bi-frontal FC.
  • Non-linear associations were observed between disability and cerebello-temporal/frontal FC.
  • A critical EDSS of 3.0 was identified, with 85% of patients above this score exhibiting reduced cerebello-temporal/frontal FC compared to healthy subjects.

Conclusions:

  • FC changes can be adaptive but not always clinically beneficial in MS.
  • A significant decrease in FC relative to structural measures at EDSS > 3.0 suggests the exhaustion of compensatory mechanisms.
  • These findings highlight potential critical points in MS progression where adaptive capacity is overwhelmed.