腹側注意ネットワークの接続性が画像診断的孤発症候群と多発性硬化症を鑑別する：縦断的安静時fMRI研究

María Díez-Cirarda¹, Jordi A Matías-Guiu¹, Mariano Ruiz-Ortiz¹

¹From the Departments of Neurology (M.D.-C., J.A.M.-G.,C.C., J.M.-G., P.M.-E.), Radiology (L.G.-M., M.Y.-F.), Hospital Universitario Clínico San Carlos. Health Research Institute "San Carlos" (IdISCC), Madrid, Spain; Department of Medicine (J.A.M.-G., J.M.-G., P.M.-E., J.B.-L.), Departamento de Psicobiología y Metodología en Ciencias del Comportamiento (H.M.), Faculty of Psychology, Complutense University of Madrid, Madrid, Spain; Department of Neurology (M.R.-O.,A.D.-S., V.G.S.-S., A.L.-F., A.G.-L., P.S.-C., J.B.-L.), Hospital Universitario 12 de Octubre Research Institute (imas12) (M.R.-O., J.B.-L.), Madrid, Spain; Department of Neurology (Y.A.), Getafe University Hospital, Madrid, Spain; Faculty of Biomedical and Health Sciences (Y.A.), European University of Madrid, Villaciosa de Odón (Madrid), Spain; Department of Neurology (L.C.-F., E.M., S.S.M.), Hospital Universitario Ramón y Cajal, Red Española de Esclerosis Múltiple (REEM), Red de Enfermedades Inflamatorias (REI), Madrid, Spain; Department of Medicine (E.M.), University of Alcalá de Henares, Neurology (L.A.-P.), Príncipe de Asturias University, Alcalá de Henares (Madrid), Spain; Department of Neurology (M.L.M.-G.), Gregorio Marañón General University Hospital, Madrid, Spain; Medical Image Analysis Laboratory (LAIMBIO) (N.M.), Rey Juan Carlos University, Móstoles, Madrid, Spain; Network Center for Biomedical Research in Neurodegenerative Diseases (CIBERNED) (J.B.-L.), Madrid, Spain.

AJNR. American journal of neuroradiology

|February 9, 2026

要旨

Background:

Radiologically Isolated Syndrome (RIS) entails incidental Multiple Sclerosis (MS)-like MRI lesions. Longitudinal fMRI could clarify brain-symptom links; however, no longitudinal resting-state fMRI studies in RIS existed until now.

Objectives:

Compare 14-month clinical, neuropsychological, and resting-state functional connectivity (FC) trajectories in RIS, MS, and healthy controls (HC), and relate FC change to fatigue.

Methods:

Nineteen RIS, 20 MS, and 22 HC completed baseline and 14-month assessments (fatigue, neuropsychology) and 3T MRI (rs-fMRI, 3D T1, FLAIR). FC within canonical networks and the ventral attention network (VAN) seed-to-voxel (CONN) connections were tested with a repeated-measures ANOVA (FWE-corrected). Regression analysis related to FC to fatigue; ROC curves evaluated discrimination.

Results:

Fatigue rose in MS but was stable in RIS. VAN connectivity showed opposing trajectories (group × time, p < 0.001): RIS increased within-VAN (and within-DAN vs. HC), whereas MS decreased within-VAN. In MS, VAN connectivity increased with orbitofrontal and striatal regions and decreased with thalamus/caudate (FWE p<0.05). Greater increases in within-VAN and VAN-thalamus/caudate connectivity were predicted to lead to fatigue reduction. A composite VAN metric differentiated RIS from MS (AUC=0.919). Lesion volumes were unchanged.

Conclusions:

RIS and MS exhibit divergent, VAN-centered FC trajectories paralleling fatigue evolution. VAN-based longitudinal FC metrics may provide sensitive, noninvasive biomarkers that complement lesion measures in early MS.

キーワード:

画像診断的孤発症候群多発性硬化症安静時機能的接続性腹側注意ネットワーク疲労バイオマーカー

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