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Nineteen percent of multiple sclerosis (MS) patients worsened cognitively over five years. This cognitive decline is linked to initial ventral attention network (VAN) dysfunction, progressing to default-mode network (DMN) impairment.

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Area of Science:

  • Neuroscience
  • Neurology
  • Medical Imaging

Background:

  • Multiple sclerosis (MS) is a chronic neurological disease affecting the central nervous system.
  • Cognitive impairment is a common and significant symptom in MS patients, impacting quality of life.
  • Understanding the neural network changes associated with cognitive decline in MS is crucial for developing targeted interventions.

Purpose of the Study:

  • To investigate longitudinal changes in functional brain networks in patients with MS.
  • To characterize the relationship between network alterations and the conversion to cognitive impairment over a 5-year period.
  • To identify specific resting-state networks involved in cognitive decline progression in MS.

Main Methods:

  • A cohort of 227 MS patients and 59 healthy controls underwent repeated neuropsychological testing and resting-state functional magnetic resonance imaging (fMRI) over approximately 5 years.
  • Patients were categorized into cognitively preserved (CP), mildly impaired (MCI), or impaired (CI) groups at baseline and follow-up.
  • Functional network importance was quantified using eigenvector centrality for individual resting-state networks.

Main Results:

  • Over 5 years, 18.9% of MS patients showed a decline in cognitive status.
  • At baseline, individuals with cognitive impairment (CI) exhibited higher default-mode network (DMN) centrality compared to controls.
  • Longitudinally, the ventral attention network (VAN) showed increased importance in cognitively preserved patients, including those who converted to MCI.

Conclusions:

  • Cognitive worsening in MS is associated with a progression from initial ventral attention network (VAN) dysfunction to subsequent default-mode network (DMN) impairment.
  • The findings suggest a disruption of normal network processes that maintain stability in MS.
  • These network changes may reflect the progressive disruption of crucial processes underlying clinical progression in MS.