Open AccessFunctional cortical changes of the sensorimotor network are associated with clinical recovery in multiple sclerosis
Author(s) -
Mezzapesa Domenico M.,
Rocca Maria A.,
Rodegher Mariaemma,
Comi Giancarlo,
Filippi Massimo
Publication year - 2008
Publication title -
human brain mapping
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.005
H-Index - 191
eISSN - 1097-0193
pISSN - 1065-9471
DOI - 10.1002/hbm.20418
Subject(s) - lesion , cerebellar hemisphere , multiple sclerosis , primary motor cortex , neuroscience , medicine , psychology , motor cortex , supplementary motor area , cerebellum , right hemisphere , physical medicine and rehabilitation , audiology , pathology , functional magnetic resonance imaging , psychiatry , stimulation
Objective: To assess the early cortical changes following an acute motor relapse secondary to a pseudotumoral lesion in MS patients, the longitudinal cortical functional correlates of clinical recovery, and the evolution over time of cortical reorganization. Methods: FMRI during the performance of a simple motor task were obtained from 12 MS patients (after a clinical attack involving the motor system secondary to a pseudotumoral lesion) and 15 matched controls. In six patients and five controls, a longitudinal fMRI study was also performed. Results: In patients, at baseline, the primary sensorimotor cortex (SMC) of the ipsilateral (contralesional) hemisphere was significantly more active during task performance with the impaired than the unimpaired hand. During task performance with the unimpaired hand, the ipsilateral cerebellum and several motor areas in the contralateral hemisphere were significantly more active. Pseudotumoral lesion volume was correlated with activation of the primary SMC bilaterally ( r = −0.86 and −0.85) and the nine‐hole peg test score with activation of the primary SMC of the affected hemisphere ( r = 0.88). A recovery of function of the primary SMC of the affected hemisphere was found in the four patients with clinical improvement. In the two patients without clinical recovery, there was a persistent recruitment of the primary SMC of the unaffected hemisphere. Conclusions: Pseudotumoral MS lesions affecting the motor system can determine short‐term cortical changes characterized by the recruitment of pathways in the unaffected hemisphere. The regain of function of motor areas of the affected hemisphere seems to be a critical factor for a favorable recovery. Hum Brain Mapp 2008. © 2007 Wiley‐Liss, Inc.