Open AccessFunctional correlates of cognitive dysfunction in multiple sclerosis: A multicenter fMRI Study
Author(s) -
Rocca Maria A.,
Valsasina Paola,
Hulst Hanneke E.,
AbdelAziz Khaled,
Enzinger Christian,
Gallo Antonio,
Pareto Debora,
Riccitelli Gianna,
Muhlert Nils,
Ciccarelli Olga,
Barkhof Frederik,
Fazekas Franz,
Tedeschi Gioacchino,
Arévalo Maria J.,
Filippi Massimo
Publication year - 2014
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.22586
Subject(s) - functional magnetic resonance imaging , neuropsychology , multiple sclerosis , default mode network , cognition , neuroimaging , prefrontal cortex , psychology , audiology , medicine , magnetic resonance imaging , neuroscience , physical medicine and rehabilitation , psychiatry , radiology
In this multicenter study, we applied functional magnetic resonance imaging (fMRI) to define the functional correlates of cognitive dysfunction in patients with multiple sclerosis (MS). fMRI scans during the performance of the N‐back task were acquired from 42 right‐handed relapsing remitting (RR) MS patients and 52 sex‐matched right‐handed healthy controls, studied at six European sites using 3.0 Tesla scanners. Patients with at least two abnormal (<2 standard deviations from the normative values) neuropsychological tests at a standardized evaluation were considered cognitively impaired (CI). FMRI data were analyzed using the SPM8 software, modeling regions showing load‐dependent activations/deactivations with increasing task difficulty. Twenty (47%) MS patients were CI. During the N‐back load condition, compared to controls and CI patients, cognitively preserved (CP) patients had increased recruitment of the right dorsolateral prefrontal cortex. As a function of increasing task difficulty, CI MS patients had reduced activations of several areas located in the fronto‐parieto‐temporal lobes as well as reduced deactivations of regions which are part of the default mode network compared to the other two groups. Significant correlations were found between abnormal fMRI patterns of activations and deactivations and behavioral measures, cognitive performance, and brain T2 and T1 lesion volumes. This multicenter study supports the theory that a preserved fMRI activity of the frontal lobe is associated with a better cognitive profile in MS patients. It also indicates the feasibility of fMRI to monitor disease evolution and treatment effects in future studies. Hum Brain Mapp 35:5799–5814, 2014 . © 2014 Wiley Periodicals, Inc.