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Related Concept Videos

Multiple Sclerosis l: Introduction01:19

Multiple Sclerosis l: Introduction

Multiple sclerosis is a chronic autoimmune disease of the central nervous system (CNS) that affects the brain, spinal cord, and optic nerves. It is an inflammatory demyelinating disorder and a leading cause of neurological disability in young adults.EpidemiologyMS commonly begins between 20 and 40 years of age and is twice as common in women. Its exact cause remains unclear, but genetic susceptibility contributes, with higher risk in first-degree relatives and identical twins. A greater...

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Magnetic Resonance Imaging of Multiple Sclerosis at 7.0 Tesla
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Published on: February 19, 2021

Perturbational complexity index detects subclinical cortical changes in early multiple sclerosis.

Elisabetta Cecconi1, Piergiuseppe Liuzzi2, Camilla Bruscagli3

  • 1University of Florence, NEUROFARBA Department, Italy.

Clinical Neurophysiology : Official Journal of the International Federation of Clinical Neurophysiology
|June 14, 2026
PubMed
Summary

The Perturbational Complexity Index (PCI) detects subtle brain network changes in early Multiple Sclerosis (MS) patients. This advanced measure shows promise for identifying early synaptic dysfunction missed by standard tests.

Keywords:
EEGEarly Multiple SclerosisPerturbational ComplexityTMSfMRI

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Last Updated: Jun 16, 2026

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Area of Science:

  • Neuroscience
  • Neurology
  • Biophysics

Background:

  • Subtle cortical dysfunction in early Multiple Sclerosis (MS) may not be detected by standard clinical measures.
  • Transcranial magnetic stimulation combined with EEG (TMS-EEG) can assess cortical excitability and synaptic function.

Purpose of the Study:

  • To investigate if TMS-EEG-derived indices can reveal early cortical network alterations in minimally disabled relapsing MS patients.
  • To determine if the Perturbational Complexity Index (PCI) is sensitive to early changes in MS.

Main Methods:

  • Prospective recruitment of 28 persons with early relapsing MS and 25 healthy controls.
  • Single-pulse TMS over the left motor cortex with simultaneous 19-channel EEG recording.
  • Comparison of TMS-evoked potentials (TEPs), Global Field Power (GFP), and PCI between groups; correlation with clinical, MEP, and MRI data.

Main Results:

  • Conventional TEP and GFP measures did not significantly differ between groups.
  • PCI was significantly reduced in persons with MS (pwMS) compared to healthy controls (HCs).
  • Reduced PCI was associated with normalized grey matter, white matter, thalamic volumes, and right MEP latency.

Conclusions:

  • PCI is sensitive to subtle cortical network alterations in early MS.
  • PCI offers a quantitative index of reduced global spatiotemporal complexity.
  • This may reflect early synaptic dysfunction linked to demyelination and neuroinflammation in MS.