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The Multiple Sclerosis Performance Test MSPT: An iPad-Based Disability Assessment Tool
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Preserved network functional connectivity underlies cognitive reserve in multiple sclerosis.

Tom A Fuchs1,2, Ralph H B Benedict1, Alexander Bartnik1,2

  • 1Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York (SUNY), Buffalo, New York.

Human Brain Mapping
|August 25, 2019
PubMed
Summary

Preserved functional connectivity explains cognitive reserve in people with multiple sclerosis (PwMS). This neural mechanism helps maintain cognitive function despite brain damage, highlighting the importance of brain network resilience.

Keywords:
MRIcognitioncognitive reservedisconnectiondiseasefunctional connectivitygray mattermultiple sclerosisnetwork analysisstructural connectivitywhite matter

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Area of Science:

  • Neuroscience
  • Neurology
  • Cognitive Science

Background:

  • Cognitive reserve, or mental resilience to brain damage, is recognized in conditions like multiple sclerosis (MS) and Alzheimer's disease.
  • The underlying neural mechanisms of cognitive reserve remain incompletely understood.
  • Investigating the role of functional connectivity in cognitive reserve is crucial for understanding brain resilience.

Purpose of the Study:

  • To determine if preserved functional connectivity underlies cognitive reserve in people with multiple sclerosis (PwMS).
  • To explore the relationship between structural brain damage, functional connectivity, and cognitive performance in PwMS.

Main Methods:

  • Seventy-four PwMS and 29 healthy controls (HCs) underwent neuropsychological assessments and 3 Tesla MRI scans.
  • Structural damage was quantified using gray matter (GM) atrophy and white matter (WM) tract disruption.
  • Resting-state functional connectivity was assessed within relevant brain networks.

Main Results:

  • PwMS showed significant impairments in cognitive processing speed and visual/spatial memory compared to HCs.
  • PwMS exhibited greater functional connectivity variance within relevant networks than HCs.
  • Higher premorbid verbal intelligence predicted preserved functional connectivity, even with GM atrophy.
  • Preserved functional connectivity mitigated the negative impact of WM tract disruption on cognitive processing speed and visual/spatial memory.

Conclusions:

  • Preserved functional connectivity is a key neural mechanism explaining cognitive reserve in PwMS.
  • This resilience in brain network function helps maintain cognitive capacity despite accumulating structural brain damage.
  • Findings underscore the importance of neural network integrity for cognitive resilience in neurological conditions.