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Clinically Relevant Patterns of Co-Fluctuating Structure and Function in Multiple Sclerosis
Jian Zhang1, Marco Battaglini1,2, Rosa Cortese1
1Department of Medicine, Surgery and Neuroscience, University of Siena, Siena, Italy.
European Journal of Neurology
|September 29, 2025
Summary
This study reveals how structural and functional brain changes co-fluctuate in multiple sclerosis (MS). This multimodal MRI approach better explains clinical disability than traditional measures.
Area of Science:
- Neuroimaging
- Radiology
- Neurology
Background:
- Multiple Sclerosis (MS) involves complex structural and functional brain changes.
- The interplay between these changes and clinical outcomes in MS is not fully understood.
Purpose of the Study:
- To identify co-fluctuating patterns of structural and functional brain changes in MS using a multimodal MRI fusion approach.
- To assess the added value of these patterns in explaining clinical outcomes.
Main Methods:
- Linked independent component analysis (ICA) was used on white matter (WM) lesions, fractional anisotropy (FA), gray matter (GM) volume, and functional connectivity.
- Graph theory (GT) identified interconnected brain regions.
- Linear mixed-effect models and multivariate stepwise regressions analyzed associations with disability.
Main Results:
- MS patients showed distinct co-fluctuating patterns compared to healthy controls (HC), including decreased FA, increased WM lesions, GM atrophy, and enhanced temporal parietal network connectivity.
- Graph theory identified eight brain sub-networks.
- These multimodal patterns explained physical and cognitive disability more effectively than traditional MRI metrics.
Conclusions:
- A multimodal MRI approach reveals co-fluctuating regional patterns of lesions, structural disconnection, and functional hyperconnectivity in MS.
- This comprehensive approach offers better explanation of clinical outcomes compared to traditional MRI metrics.
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