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Updated: Jan 26, 2026

Comprehensive Autopsy Program for Individuals with Multiple Sclerosis
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Functional Connectivity Changes After Initial Treatment With Fingolimod in Multiple Sclerosis.

Nikolaos Petsas1, Laura De Giglio2,3, Vicente González-Quintanilla4

  • 1Department of Radiology, IRCCS NEUROMED, Pozzilli, Italy.

Frontiers in Neurology
|April 11, 2019
PubMed
Summary
This summary is machine-generated.

Fingolimod treatment in Multiple Sclerosis (MS) patients significantly altered resting-state functional connectivity (FC) and improved cognitive function over six months. These changes in brain networks were linked to cognitive gains, suggesting therapeutic effects on MS-related brain alterations.

Keywords:
fingolimod (FTY720)functional connectivitymotor taskmultiple scleorsis (MS)resting-state functional MRI

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Area of Science:

  • Neuroscience
  • Radiology
  • Immunology

Background:

  • Multiple Sclerosis (MS) is characterized by functional connectivity (FC) alterations, interpreted as a multisystem disconnection syndrome.
  • The underlying mechanisms of these FC changes in MS remain under investigation.
  • Fingolimod is an established anti-inflammatory and immunomodulating agent for MS treatment.

Purpose of the Study:

  • To investigate changes in resting-state functional connectivity (RSFC) after initiating fingolimod therapy in relapsing-remitting MS patients.
  • To assess both baseline and task-induced FC changes at therapy initiation and after six months.
  • To explore the relationship between FC changes and cognitive function improvements.

Main Methods:

  • 32 relapsing-remitting MS patients underwent functional and conventional MRI at 3 Tesla.
  • Assessments were conducted before fingolimod, at therapy initiation, and at 6 months.
  • Resting-state FC was measured using seed-based analysis on the left primary motor cortex, with and without a motor-practice task, accounting for test-retest effects.

Main Results:

  • A significant decrease in baseline FC was observed at 6 months post-initiation in occipito-parietal areas and the cerebellum.
  • Task-induced FC changes significantly increased at 6 months, involving sensorimotor, posterior cortical, prefrontal, and temporal areas.
  • Cognitive function, assessed by the Paced Auditory Serial Addition Task, significantly improved at 6 months, correlating with reduced baseline FC in posterior cortical areas.

Conclusions:

  • Six months of fingolimod therapy induces significant changes in both baseline and task-induced functional connectivity in MS patients.
  • Observed FC alterations are associated with cognitive improvements, suggesting a potential mechanism of therapeutic action.
  • Fingolimod therapy impacts brain network dynamics, offering insights into the neurobiological effects of immunomodulatory treatment in MS.