Functional MRI and cognition in multiple sclerosis-Where are we now?

Area of Science:

• Neuroscience
• Radiology
• Cognitive Science

Background:

• Multiple sclerosis-related cognitive impairment (MSrCI) is prevalent in multiple sclerosis (MS) patients, causing significant disability.
• Current conventional MRI lacks reliable metrics for diagnosing MSrCI.
• Understanding neuroplasticity is crucial for explaining cognitive changes in MS.

Purpose of the Study:

• To review the application of resting-state fMRI (rs-fMRI) and task-based fMRI (tb-fMRI) in understanding neuroplasticity in MS.
• To explore the relationship between fMRI findings and cognitive changes in people with MS (pwMS).
• To assess fMRI's potential as a diagnostic tool and biomarker for MSrCI.

Main Methods:

• Systematic literature search of PubMed/Medline, Embase, Scopus, and Web of Science for recent fMRI cognitive studies in pwMS.
• Analysis of findings from rs-fMRI studies focusing on brain connectivity and network efficiency.
• Analysis of findings from tb-fMRI studies examining brain activation patterns and their correlation with disease progression and cognitive status.

Main Results:

• rs-fMRI studies indicate disrupted brain connectivity and reduced network efficiency, contributing to cognitive impairment in MS.
• tb-fMRI studies show initial increased brain activation as a compensatory mechanism, followed by decreased activation with disease progression and cognitive decline.
• These patterns suggest a progressive exhaustion of the brain's compensatory capacity over time.

Conclusions:

• fMRI provides valuable insights into neuroplasticity and compensatory mechanisms in MS-related cognitive impairment.
• fMRI may serve as a diagnostic tool for MSrCI.
• fMRI has potential as an imaging biomarker to monitor disease progression and cognitive changes in MS.