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Linking lesions in sensorimotor cortex to contralateral hand function in multiple sclerosis: a 7 T MRI study.

Mads A J Madsen1, Vanessa Wiggermann1, Marta F M Marques1

  • 1Danish Research Centre for Magnetic Resonance, Copenhagen University Hospital-Amager and Hvidovre, 2650 Hvidovre, Denmark.

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Summary

Cortical lesions in the primary sensorimotor hand area of multiple sclerosis patients impair hand motor and sensory function. Different lesion types differentially affect motor function and corticomotor physiology.

Keywords:
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Area of Science:

  • Neuroscience
  • Neurology
  • Radiology

Background:

  • Cortical lesions are a key feature of multiple sclerosis (MS), contributing to disability.
  • The specific impact of cortical lesions and their subtypes on domain-specific impairments remains unclear.
  • Understanding these relationships is crucial for predicting MS progression and developing targeted therapies.

Purpose of the Study:

  • To investigate the relationship between cortical lesions in the primary sensorimotor hand area and sensorimotor function of the contralateral hand in MS patients.
  • To assess how corticomotor physiology is affected by the presence and type of cortical lesions.
  • To explore the influence of other MS-related brain and spinal cord damage on sensorimotor hand function.

Main Methods:

  • Cross-sectional study involving 50 MS patients and 28 healthy controls.
  • Whole-brain 7 Tesla MRI to map cortical lesions and quantify brain/spinal cord metrics.
  • Transcranial magnetic stimulation (TMS) and somatosensory-evoked potentials (SEPs) to assess corticomotor excitability and conduction.
  • Clinical assessment of sensorimotor hand function.

Main Results:

  • Cortical lesions in the primary sensorimotor hand area were associated with worse motor and sensory hand function.
  • Lesion presence correlated with reduced motor-evoked potential amplitude and delayed corticomotor conduction.
  • Multiple factors, including white matter lesions, spinal cord atrophy, and infratentorial lesions, contributed to motor impairment.
  • Specific cortical lesion subtypes (intracortical, subpial, leucocortical) differentially impacted motor function and electrophysiological measures.

Conclusions:

  • Cortical lesions in the primary sensorimotor hand area significantly impair hand motor and sensory function in MS, independent of subcortical damage.
  • The findings highlight the differential impact of cortical lesion subtypes on specific aspects of sensorimotor function.
  • This multilevel assessment provides insights into the complex pathophysiology of sensorimotor deficits in MS.