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Alkolfat F, Abdel Galeel A, Bassiouny AR, Eldeeb H, Radwan A, Ashram YA. Patterns of Visual Task-based Functional MRI Activation in Chronic Posterior Cerebral Artery Stroke Patients. Clin Neuroradiol 2023; 33:769-781. [PMID: 36867244 PMCID: PMC10449980 DOI: 10.1007/s00062-023-01274-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2022] [Accepted: 01/29/2023] [Indexed: 03/04/2023]
Abstract
PURPOSE Stroke is a principal cause of disability worldwide. In motor stroke, the tools for stratification and prognostication are plentiful. Conversely, in stroke causing mainly visual and cognitive problems, there is still no gold standard modality to use. The purpose of this study was to explore the fMRI recruitment pattern in chronic posterior cerebral artery (PCA) stroke patients and to investigate fMRI as a biomarker of disability in these patients. METHODS The study included 10 chronic PCA stroke patients and another 10 age-matched volunteer controls. The clinical presentation, cognitive state, and performance in visual perceptual skills battery (TVPS-3) were determined for both patients and control groups. Task-based fMRI scans were acquired while performing a passive visual task. Individual and group analyses of the fMRI scans as well as correlation analysis with the clinical and behavioral data were done. RESULTS At the level of behavioral assessment there was non-selective global impairment in all visual skills subtests. On visual task-based fMRI, patients recruited more brain areas than controls. These activations were present in the ipsilesional side distributed in the ipsilesional cerebellum, dorsolateral prefrontal cortex mainly Brodmann area (BA) 9, superior parietal lobule (somatosensory associative cortex, BA 7), superior temporal gyrus (BA 22), supramarginal gyrus (BA 40), and contralesional associative visual cortex (BA 19). Spearman's rank correlation was computed to assess the relationship between the TVPS scores and the numbers of fMRI neuronal clusters in each patient above the main control activations, there was a negative correlation between the two variables, r(10) = -0.85, p ≤ 0.001. CONCLUSION In chronic PCA stroke patients with residual visual impairments, the brain attempts to recruit more neighboring and distant functional areas for executing the impaired visual skill. This intense recruitment pattern in poorly recovering patients appears to be a sign of failed compensation. Consequently, fMRI has the potential for clinically relevant prognostic assessment in patients surviving PCA stroke; however, as this study included no longitudinal data, this potential should be further investigated in longitudinal imaging studies, with a larger cohort, and multiple time points.
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Affiliation(s)
- Fatma Alkolfat
- Department of Neurology, Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Aya Abdel Galeel
- Department of Radiology, Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Ahmad R. Bassiouny
- Department of Biochemistry, Faculty of Science, Alexandria University, Alexandria, Egypt
| | - Hany Eldeeb
- Department of Neurology, Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Ahmed Radwan
- Department of Imaging and Pathology, Translational MRI, KU Leuven, Leuven, Belgium
- Leuven Brain Institute (LBI), Department of Neurosciences, KU Leuven, Leuven, Belgium
| | - Yasmine A. Ashram
- Department of Physiology, Faculty of Medicine, Alexandria University, Alexandria, Egypt
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Tozlu C, Card S, Jamison K, Gauthier SA, Kuceyeski A. Larger lesion volume in people with multiple sclerosis is associated with increased transition energies between brain states and decreased entropy of brain activity. Netw Neurosci 2023; 7:539-556. [PMID: 37397885 PMCID: PMC10312270 DOI: 10.1162/netn_a_00292] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 11/07/2022] [Indexed: 01/10/2024] Open
Abstract
Quantifying the relationship between the brain's functional activity patterns and its structural backbone is crucial when relating the severity of brain pathology to disability in multiple sclerosis (MS). Network control theory (NCT) characterizes the brain's energetic landscape using the structural connectome and patterns of brain activity over time. We applied NCT to investigate brain-state dynamics and energy landscapes in controls and people with MS (pwMS). We also computed entropy of brain activity and investigated its association with the dynamic landscape's transition energy and lesion volume. Brain states were identified by clustering regional brain activity vectors, and NCT was applied to compute the energy required to transition between these brain states. We found that entropy was negatively correlated with lesion volume and transition energy, and that larger transition energies were associated with pwMS with disability. This work supports the notion that shifts in the pattern of brain activity in pwMS without disability results in decreased transition energies compared to controls, but, as this shift evolves over the disease, transition energies increase beyond controls and disability occurs. Our results provide the first evidence in pwMS that larger lesion volumes result in greater transition energy between brain states and decreased entropy of brain activity.
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Affiliation(s)
- Ceren Tozlu
- Department of Radiology, Weill Cornell Medicine, New York, NY, USA
| | - Sophie Card
- Horace Greeley High School, Chappaqua, NY, USA
| | - Keith Jamison
- Department of Radiology, Weill Cornell Medicine, New York, NY, USA
| | - Susan A. Gauthier
- Department of Radiology, Weill Cornell Medicine, New York, NY, USA
- Judith Jaffe Multiple Sclerosis Center, Weill Cornell Medicine, New York, NY, USA
- Department of Neurology, Weill Cornell Medical College, New York, NY, USA
| | - Amy Kuceyeski
- Department of Radiology, Weill Cornell Medicine, New York, NY, USA
- Brain and Mind Research Institute, Weill Cornell Medicine, New York, NY, USA
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3
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Yadikar H, Johnson C, Pafundi N, Nguyen L, Kurup M, Torres I, Al-Enezy A, Yang Z, Yost R, Kobeissy FH, Wang KKW. Neurobiochemical, Peptidomic, and Bioinformatic Approaches to Characterize Tauopathy Peptidome Biomarker Candidates in Experimental Mouse Model of Traumatic Brain Injury. Mol Neurobiol 2023; 60:2295-2319. [PMID: 36635478 DOI: 10.1007/s12035-022-03165-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Accepted: 12/10/2022] [Indexed: 01/14/2023]
Abstract
Traumatic brain injury (TBI) is a multidimensional damage, and currently, no FDA-approved medicine is available. Multiple pathways in the cell are triggered through a head injury (e.g., calpain and caspase activation), which truncate tau and generate variable fragment sizes (MW 400-45,000 K). In this study, we used an open-head TBI mouse model generated by controlled cortical impact (CCI) and collected ipsilateral (IC) and contralateral (CC) mice htau brain cortices at one (D1) three (D3), and seven (D7) days post-injury. We implemented immunological (antibody-based detection) and peptidomic approaches (nano-reversed-phase liquid chromatography/tandem mass spectrometry) to investigate proteolytic tau peptidome (low molecular weight (LMW) < 10 K)) and pathological phosphorylation sites (high-molecular-weight (HMW); > 10 K) derived from CCI-TBI animal models. Our immunoblotting analysis verified tau hyperphosphorylation, HMW, and HMW breakdown products (HMW-BDP) formation of tau (e.g., pSer202, pThr181, pThr231, pSer396, and pSer404), following CCI-TBI. Peptidomic data revealed unique sequences of injury-dependent proteolytic peptides generated from human tau protein. Among the N-terminal tau peptides, EIPEGTTAEEAGIGDTPSLEDEAAGHVTQA (a.a. 96-125) and AQPHTEIPEGTTAEEAGIGDTPSLEDEAAGHVTQARM (a.a. 91-127). Examples of tau C-terminal peptides identified include NVSSTGSIDMVDSPQLATLADEVSASLAKQGL (a.a. 410-441) and QLATLADEVSASLAKQGL (a.a. 424-441). Our peptidomic bioinformatic tools showed the association of proteases, such as CAPN1, CAPN2, and CTSL; CASP1, MMP7, and MMP9; and ELANE, GZMA, and MEP1A, in CCI-TBI tau peptidome. In clinical trials for novel TBI treatments, it might be useful to monitor a subset of tau peptidome as targets for biomarker utility and use them for a "theranostic" approach.
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Affiliation(s)
- Hamad Yadikar
- Department of Biological Sciences, Faculty of Science, Kuwait University, Kuwait, Kuwait.
| | - Connor Johnson
- Department of Biological Sciences, Faculty of Science, Kuwait University, Kuwait, Kuwait
| | - Niko Pafundi
- Department of Biological Sciences, Faculty of Science, Kuwait University, Kuwait, Kuwait
| | - Lynn Nguyen
- Department of Biological Sciences, Faculty of Science, Kuwait University, Kuwait, Kuwait
| | - Milin Kurup
- Department of Biological Sciences, Faculty of Science, Kuwait University, Kuwait, Kuwait
| | - Isabel Torres
- Department of Biological Sciences, Faculty of Science, Kuwait University, Kuwait, Kuwait
| | - Albandery Al-Enezy
- Department of Biological Sciences, Faculty of Science, Kuwait University, Kuwait, Kuwait
| | - Zhihui Yang
- Department of Biological Sciences, Faculty of Science, Kuwait University, Kuwait, Kuwait
| | - Richard Yost
- Department of Chemistry, Chemistry Laboratory Building, University of Florida, Gainesville, FL, 32611, USA
| | - Firas H Kobeissy
- Program for Neurotrauma, Neuroproteomics & Biomarkers Research, Departments of Emergency Medicine, Psychiatry, Neuroscience and Chemistry, University of Florida, Gainesville, FL, USA. .,Department of Biochemistry and Molecular Genetics, American University of Beirut, Beirut, Lebanon. .,Morehouse School of Medicine, Department of Neurobiology, Center for Neurotrauma, Multiomics & Biomarkers (CNMB), 720 Westview Dr. SW, Atlanta, GA, 30310, USA.
| | - Kevin K W Wang
- Program for Neurotrauma, Neuroproteomics & Biomarkers Research, Departments of Emergency Medicine, Psychiatry, Neuroscience and Chemistry, University of Florida, Gainesville, FL, USA. .,Morehouse School of Medicine, Department of Neurobiology, Center for Neurotrauma, Multiomics & Biomarkers (CNMB), 720 Westview Dr. SW, Atlanta, GA, 30310, USA. .,Brain Rehabilitation Research Center, Malcom Randall VA Medical Center, Gainesville, FL, 32608, USA.
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4
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Alahmadi AAS, Pardini M, Samson RS, D’Angelo E, Friston KJ, Toosy AT, Gandini Wheeler-Kingshott CAM. Blood Oxygenation Level-Dependent Response to Multiple Grip Forces in Multiple Sclerosis: Going Beyond the Main Effect of Movement in Brodmann Area 4a and 4p. Front Cell Neurosci 2021; 15:616028. [PMID: 33981201 PMCID: PMC8109244 DOI: 10.3389/fncel.2021.616028] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2020] [Accepted: 03/08/2021] [Indexed: 11/13/2022] Open
Abstract
This study highlights the importance of looking beyond the main effect of movement to study alterations in functional response in the presence of central nervous system pathologies such as multiple sclerosis (MS). Data show that MS selectively affects regional BOLD (blood oxygenation level dependent) responses to variable grip forces (GF). It is known that the anterior and posterior BA 4 areas (BA 4a and BA 4p) are anatomically and functionally distinct. It has also been shown in healthy volunteers that there are linear (first order, typical of BA 4a) and nonlinear (second to fourth order, typical of BA 4p) BOLD responses to different levels of GF applied during a dynamic motor paradigm. After modeling the BOLD response with a polynomial expansion of the applied GFs, the particular case of BA 4a and BA 4p were investigated in healthy volunteers (HV) and MS subjects. The main effect of movement (zeroth order) analysis showed that the BOLD signal is greater in MS compared with healthy volunteers within both BA 4 subregions. At higher order, BOLD-GF responses were similar in BA 4a but showed a marked alteration in BA 4p of MS subjects, with those with greatest disability showing the greatest deviations from the healthy response profile. Therefore, the different behaviors in HV and MS could only be uncovered through a polynomial analysis looking beyond the main effect of movement into the two BA 4 subregions. Future studies will investigate the source of this pathophysiology, combining the present fMRI paradigm with blood perfusion and nonlinear neuronal response analysis.
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Affiliation(s)
- Adnan A. S. Alahmadi
- Department of Diagnostic Radiology, Faculty of Applied Medical Science, King Abdulaziz University, Jeddah, Saudi Arabia
- NMR Research Unit, Department of Neuroinflammation, Queen Square MS Centre, UCL Queen Square Institute of Neurology, London, United Kingdom
| | - Matteo Pardini
- NMR Research Unit, Department of Neuroinflammation, Queen Square MS Centre, UCL Queen Square Institute of Neurology, London, United Kingdom
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, Genoa, Italy
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Rebecca S. Samson
- NMR Research Unit, Department of Neuroinflammation, Queen Square MS Centre, UCL Queen Square Institute of Neurology, London, United Kingdom
| | - Egidio D’Angelo
- Brain Connectivity Center, IRCCS Mondino Foundation, Pavia, Italy
- Department of Brain and Behavioural Sciences, University of Pavia, Pavia, Italy
| | - Karl J. Friston
- Wellcome Centre for Imaging Neuroscience, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom
| | - Ahmed T. Toosy
- NMR Research Unit, Department of Neuroinflammation, Queen Square MS Centre, UCL Queen Square Institute of Neurology, London, United Kingdom
| | - Claudia A. M. Gandini Wheeler-Kingshott
- NMR Research Unit, Department of Neuroinflammation, Queen Square MS Centre, UCL Queen Square Institute of Neurology, London, United Kingdom
- Brain Connectivity Center, IRCCS Mondino Foundation, Pavia, Italy
- Department of Brain and Behavioural Sciences, University of Pavia, Pavia, Italy
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5
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Strik M, Shanahan CJ, van der Walt A, Boonstra FMC, Glarin R, Galea MP, Kilpatrick TJ, Geurts JJG, Cleary JO, Schoonheim MM, Kolbe SC. Functional correlates of motor control impairments in multiple sclerosis: A 7 Tesla task functional MRI study. Hum Brain Mapp 2021; 42:2569-2582. [PMID: 33666314 PMCID: PMC8090767 DOI: 10.1002/hbm.25389] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 02/10/2021] [Accepted: 02/16/2021] [Indexed: 02/01/2023] Open
Abstract
Upper and lower limb impairments are common in people with multiple sclerosis (pwMS), yet difficult to clinically identify in early stages of disease progression. Tasks involving complex motor control can potentially reveal more subtle deficits in early stages, and can be performed during functional MRI (fMRI) acquisition, to investigate underlying neural mechanisms, providing markers for early motor progression. We investigated brain activation during visually guided force matching of hand or foot in 28 minimally disabled pwMS (Expanded Disability Status Scale (EDSS) < 4 and pyramidal and cerebellar Kurtzke Functional Systems Scores ≤ 2) and 17 healthy controls (HC) using ultra‐high field 7‐Tesla fMRI, allowing us to visualise sensorimotor network activity in high detail. Task activations and performance (tracking lag and error) were compared between groups, and correlations were performed. PwMS showed delayed (+124 s, p = .002) and more erroneous (+0.15 N, p = .001) lower limb tracking, together with lower cerebellar, occipital and superior parietal cortical activation compared to HC. Lower activity within these regions correlated with worse EDSS (p = .034), lower force error (p = .006) and higher lesion load (p < .05). Despite no differences in upper limb task performance, pwMS displayed lower inferior occipital cortical activation. These results demonstrate that ultra‐high field fMRI during complex hand and foot tracking can identify subtle impairments in lower limb movements and upper and lower limb brain activity, and differentiates upper and lower limb impairments in minimally disabled pwMS.
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Affiliation(s)
- Myrte Strik
- Department of Medicine and Radiology, University of Melbourne, Parkville, Australia.,Department of Anatomy and Neurosciences, MS Center Amsterdam, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Camille J Shanahan
- Department of Medicine and Radiology, University of Melbourne, Parkville, Australia
| | - Anneke van der Walt
- Department of Neurosciences, Central Clinical School, Monash University, Melbourne, Australia
| | - Frederique M C Boonstra
- Department of Neurosciences, Central Clinical School, Monash University, Melbourne, Australia
| | - Rebecca Glarin
- Department of Medicine and Radiology, University of Melbourne, Parkville, Australia
| | - Mary P Galea
- Department of Medicine and Radiology, University of Melbourne, Parkville, Australia
| | - Trevor J Kilpatrick
- Florey Institute of Neuroscience and Mental Health, Parkville, Australia.,Florey Department of Neuroscience and Mental Health, University of Melbourne, Parkville, Australia.,Department of Neurology, Royal Melbourne Hospital, Parkville, Australia
| | - Jeroen J G Geurts
- Department of Anatomy and Neurosciences, MS Center Amsterdam, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Jon O Cleary
- Department of Radiology, Guy's and St. Thomas' NHS Foundation Trust, London, UK
| | - Menno M Schoonheim
- Department of Anatomy and Neurosciences, MS Center Amsterdam, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Scott C Kolbe
- Department of Medicine and Radiology, University of Melbourne, Parkville, Australia.,Department of Neurosciences, Central Clinical School, Monash University, Melbourne, Australia
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6
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West KL, Sivakolundu DK, Zuppichini MD, Turner MP, Spence JS, Lu H, Okuda DT, Rypma B. Altered task-induced cerebral blood flow and oxygen metabolism underlies motor impairment in multiple sclerosis. J Cereb Blood Flow Metab 2021; 41:182-193. [PMID: 32126873 PMCID: PMC7747162 DOI: 10.1177/0271678x20908356] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2019] [Revised: 10/29/2019] [Accepted: 12/04/2019] [Indexed: 02/01/2023]
Abstract
The neural mechanisms underlying motor impairment in multiple sclerosis (MS) remain unknown. Motor cortex dysfunction is implicated in blood-oxygen-level-dependent (BOLD) functional magnetic resonance imaging (fMRI) studies, but the role of neural-vascular coupling underlying BOLD changes remains unknown. We sought to independently measure the physiologic factors (i.e., cerebral blood flow (ΔCBF), cerebral metabolic rate of oxygen (ΔCMRO2), and flow-metabolism coupling (ΔCBF/ΔCMRO2), utilizing dual-echo calibrated fMRI (cfMRI) during a bilateral finger-tapping task. We utilized cfMRI to measure physiologic responses in 17 healthy volunteers and 32 MS patients (MSP) with and without motor impairment during a thumb-button-press task in thumb-related (task-central) and surrounding primary motor cortex (task-surround) regions of interest (ROIs). We observed significant ΔCBF and ΔCMRO2 increases in all MSP compared to healthy volunteers in the task-central ROI and increased flow-metabolism coupling (ΔCBF/ΔCMRO2) in the MSP without motor impairment. In the task-surround ROI, we observed decreases in ΔCBF and ΔCMRO2 in MSP with motor impairment. Additionally, ΔCBF and ΔCMRO2 responses in the task-surround ROI were associated with motor function and white matter damage in MSP. These results suggest an important role for task-surround recruitment in the primary motor cortex to maintain motor dexterity and its dependence on intact white matter microstructure and neural-vascular coupling.
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Affiliation(s)
- Kathryn L West
- School of Behavioral and Brain Sciences, University of Texas at Dallas, Richardson, TX, USA
| | - Dinesh K Sivakolundu
- School of Behavioral and Brain Sciences, University of Texas at Dallas, Richardson, TX, USA
| | - Mark D Zuppichini
- School of Behavioral and Brain Sciences, University of Texas at Dallas, Richardson, TX, USA
| | - Monroe P Turner
- School of Behavioral and Brain Sciences, University of Texas at Dallas, Richardson, TX, USA
| | - Jeffrey S Spence
- School of Behavioral and Brain Sciences, University of Texas at Dallas, Richardson, TX, USA
| | - Hanzhang Lu
- Department of Radiology, Johns Hopkins University, Baltimore, MD, USA
| | - Darin T Okuda
- Department of Neurology and Neurotherapeutics, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Bart Rypma
- School of Behavioral and Brain Sciences, University of Texas at Dallas, Richardson, TX, USA
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
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7
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Wang X, Li L, Wei W, Zhu T, Huang GF, Li X, Ma HB, Lv Y. Altered activation in sensorimotor network after applying rTMS over the primary motor cortex at different frequencies. Brain Behav 2020; 10:e01670. [PMID: 32506744 PMCID: PMC7375128 DOI: 10.1002/brb3.1670] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Revised: 04/20/2020] [Accepted: 05/07/2020] [Indexed: 12/31/2022] Open
Abstract
INTRODUCTION Repetitive transcranial magnetic stimulation (rTMS) over the primary motor cortex (M1) can modulate brain activity both in the stimulated site and remote brain areas of the sensorimotor network. However, the modulatory effects of rTMS at different frequencies remain unclear. Here, we employed finger-tapping task-based fMRI to investigate alterations in activation of the sensorimotor network after the application of rTMS over the left M1 at different frequencies. MATERIALS AND METHODS Forty-five right-handed healthy participants were randomly divided into three groups by rTMS frequency (HF, high-frequency, 3 Hz; LF, low-frequency, 1 Hz; and SHAM) and underwent two task-fMRI sessions (RH, finger-tapping with right index finger; LH, finger-tapping with left index finger) before and after applying rTMS over the left M1. We defined regions of interest (ROIs) in the sensorimotor network based on group-level activation maps (pre-rTMS) from RH and LH tasks and calculated the percentage signal change (PSC) for each ROI. We then assessed the differences of PSC within HF or LF groups and between groups. RESULTS Application of rTMS at different frequencies resulted in a change in activation of several areas of the sensorimotor network. We observed the increased PSC in M1 after high-frequency stimulation, while we detected the reduced PSC in the primary sensory cortex (S1), ventral premotor cortex (PMv), supplementary motor cortex (SMA), and putamen after low-frequency stimulation. Moreover, the PSC in the SMA, dorsal premotor cortex (PMd), and putamen in the HF group was higher than in the LF group after stimulation. CONCLUSION Our findings suggested that activation alterations within sensorimotor network are dependent on the frequency of rTMS. Therefore, our findings contribute to understanding the effects of rTMS on brain activation in healthy individuals and ultimately may further help to suggest mechanisms of how rTMS could be employed as a therapeutic tool.
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Affiliation(s)
- Xiaoyu Wang
- Institute of Psychological Sciences, Hangzhou Normal University, Hangzhou, China.,Zhejiang Key Laboratory for Research in Assessment of Cognitive Impairments, Hangzhou, China
| | - Lingyu Li
- Institute of Psychological Sciences, Hangzhou Normal University, Hangzhou, China.,Zhejiang Key Laboratory for Research in Assessment of Cognitive Impairments, Hangzhou, China.,Shandong Huayu University of Technology, Dezhou, China
| | - Wei Wei
- Institute of Psychological Sciences, Hangzhou Normal University, Hangzhou, China.,Zhejiang Key Laboratory for Research in Assessment of Cognitive Impairments, Hangzhou, China
| | - Tingting Zhu
- Institute of Psychological Sciences, Hangzhou Normal University, Hangzhou, China.,Zhejiang Key Laboratory for Research in Assessment of Cognitive Impairments, Hangzhou, China
| | - Guo-Feng Huang
- School of Information and Electronics Technology, Jiamusi University, Jiamusi, China
| | - Xue Li
- School of Information and Electronics Technology, Jiamusi University, Jiamusi, China
| | - Hui-Bin Ma
- School of Information and Electronics Technology, Jiamusi University, Jiamusi, China.,Integrated Medical Research School, Jiamusi University, Jiamusi, China
| | - Yating Lv
- Institute of Psychological Sciences, Hangzhou Normal University, Hangzhou, China.,Zhejiang Key Laboratory for Research in Assessment of Cognitive Impairments, Hangzhou, China
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8
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Péran P, Nemmi F, Dutilleul C, Finamore L, Falletta Caravasso C, Troisi E, Iosa M, Sabatini U, Grazia Grasso M. Neuroplasticity and brain reorganization associated with positive outcomes of multidisciplinary rehabilitation in progressive multiple sclerosis: A fMRI study. Mult Scler Relat Disord 2020; 42:102127. [PMID: 32438326 DOI: 10.1016/j.msard.2020.102127] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Revised: 04/06/2020] [Accepted: 04/12/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND Multiple sclerosis (MS) is characterized by a range of symptoms, including motor, sensorimotor and cognitive impairments, that limit the quality of life. A multidisciplinary rehabilitation approach in people affected by multiple sclerosis was recently reported to improve the functional abilities of MS patients in daily activities. The purpose of the study was to assess the effect of multidisciplinary rehabilitation on the whole brain of MS patients by means of functional magnetic resonance imaging (fMRI). METHODS Thirty individuals affected by MS (49.9 ± 12.1 years; disease duration: 16.0 ± 8.5 years) with a medium-high severity of disease were enrolled. The fMRI examination assessed a range of action-related tasks involving passive movement, mental simulation of action and miming of action triggered by external stimuli, such as object photography. The three tasks were performed using each arm separately. The fMRI acquisitions were performed at T1 (inclusion in the study), T2 (3 months later, at the start of rehabilitation) and T3 (after 3 months of multidisciplinary rehabilitation). RESULTS The fMRI results revealed a significant reduction in the activity of brain areas related to task-specific networks as well as the activation of cerebral regions not usually involved in task-specific related network, such as the medial prefrontal area. CONCLUSIONS The effectiveness of multidisciplinary rehabilitation on activity and participation has been established in previous studies. Our study sheds new light on the effect of such treatment on brain reorganization.
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Affiliation(s)
- Patrice Péran
- ToNIC, Toulouse NeuroImaging Center, Université de Toulouse, Inserm, UPS, France
| | - Federico Nemmi
- ToNIC, Toulouse NeuroImaging Center, Université de Toulouse, Inserm, UPS, France; Santa Lucia Foundation IRCCS, Rome, Italy
| | - Charlotte Dutilleul
- ToNIC, Toulouse NeuroImaging Center, Université de Toulouse, Inserm, UPS, France
| | - Licia Finamore
- Santa Lucia Foundation IRCCS, Rome, Italy; Neurology Department, Cittadella Hospital, Padua, Italy
| | | | | | - Marco Iosa
- Santa Lucia Foundation IRCCS, Rome, Italy.
| | - Umberto Sabatini
- Santa Lucia Foundation IRCCS, Rome, Italy; Neuroradiology Unit, University "Magna Graecia", Catanzaro, Italy
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9
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Embury CM, Heinrichs-Graham E, Lord GH, Drincic AT, Desouza CV, Wilson TW. Altered motor dynamics in type 1 diabetes modulate behavioral performance. NEUROIMAGE-CLINICAL 2019; 24:101977. [PMID: 31466021 PMCID: PMC6718822 DOI: 10.1016/j.nicl.2019.101977] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Revised: 08/05/2019] [Accepted: 08/06/2019] [Indexed: 12/13/2022]
Abstract
Type 1 diabetes (T1D) has been linked to alterations in both brain structure and function. However, the neural basis of the most commonly reported neuropsychological deficit in T1D, psychomotor speed, remains severely understudied. To begin to address this, the current study focuses on the neural dynamics underlying motor control using magnetoencephalographic (MEG) imaging. Briefly, 40 young adults with T1D who were clear of common comorbidities (e.g., vascular disease, retinopathy, etc.) and a demographically-matched group of 40 controls without T1D completed an arrow-based flanker movement task during MEG. The resulting signals were examined in the time-frequency domain and imaged using a beamforming approach, and then voxel time series were extracted from peak responses to evaluate the dynamics. The resulting time series were statistically examined for group and conditional effects using a rigorous permutation testing approach. Our primary hypothesis was that participants with T1D would have altered beta and gamma oscillatory dynamics within the primary motor cortex during movement, and that these alterations would reflect compensatory processing to maintain adequate performance. Our results indicated that the group with T1D had a significantly stronger post-movement beta rebound (PMBR) contralateral to movement compared to controls, and a smaller neural flanker effect (i.e., difference in neural activity between conditions). In addition, a significant group-by-condition interaction was observed in the ipsilateral beta event-related desynchronization (bERD) and the ipsilateral PMBR. We also examined the relationship between oscillatory motor response amplitude and reaction time, finding a differential effect of the driving oscillatory responses on behavioral performance by group. Overall, our findings suggest compensatory activity in the motor cortices is detectable early in the disease in a relatively healthy sample of adults with T1D. Future studies are needed to examine how these subtle effects on neural activity in young, otherwise healthy patients affect outcomes in aging. Type 1 diabetes has been repeatedly associated with deficits in psychomotor speed. These deficits may reflect the impact of diabetes or common comorbidities. A large group of otherwise healthy patients and matched controls underwent MEG. Motor-related neural oscillations were imaged and statistically examined. Two key oscillations were aberrant in type 1 diabetics and impacted performance.
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Affiliation(s)
- Christine M Embury
- Department of Neurological Sciences, University of Nebraska Medical Center (UNMC), Omaha, NE, USA; Center for Magnetoencephalography, UNMC, Omaha, NE, USA; Department of Psychology, University of Nebraska Omaha, Omaha, NE, USA
| | - Elizabeth Heinrichs-Graham
- Department of Neurological Sciences, University of Nebraska Medical Center (UNMC), Omaha, NE, USA; Center for Magnetoencephalography, UNMC, Omaha, NE, USA
| | - Grace H Lord
- Department of Internal Medicine, Division of Diabetes, Endocrinology, and Metabolism, UNMC, Omaha, NE, USA
| | - Andjela T Drincic
- Department of Internal Medicine, Division of Diabetes, Endocrinology, and Metabolism, UNMC, Omaha, NE, USA
| | - Cyrus V Desouza
- Department of Internal Medicine, Division of Diabetes, Endocrinology, and Metabolism, UNMC, Omaha, NE, USA
| | - Tony W Wilson
- Department of Neurological Sciences, University of Nebraska Medical Center (UNMC), Omaha, NE, USA; Center for Magnetoencephalography, UNMC, Omaha, NE, USA; Department of Psychology, University of Nebraska Omaha, Omaha, NE, USA.
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10
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Bonzano L, Pedullà L, Tacchino A, Brichetto G, Battaglia MA, Mancardi GL, Bove M. Upper limb motor training based on task-oriented exercises induces functional brain reorganization in patients with multiple sclerosis. Neuroscience 2019; 410:150-159. [DOI: 10.1016/j.neuroscience.2019.05.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Revised: 05/02/2019] [Accepted: 05/03/2019] [Indexed: 10/26/2022]
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11
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Turner MP, Hubbard NA, Sivakolundu DK, Himes LM, Hutchison JL, Hart J, Spence JS, Frohman EM, Frohman TC, Okuda DT, Rypma B. Preserved canonicality of the BOLD hemodynamic response reflects healthy cognition: Insights into the healthy brain through the window of Multiple Sclerosis. Neuroimage 2019; 190:46-55. [PMID: 29454932 DOI: 10.1016/j.neuroimage.2017.12.081] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2017] [Revised: 12/18/2017] [Accepted: 12/22/2017] [Indexed: 10/18/2022] Open
Abstract
The hemodynamic response function (HRF), a model of brain blood-flow changes in response to neural activity, reflects communication between neurons and the vasculature that supplies these neurons in part by means of glial cell intermediaries (e.g., astrocytes). Intact neural-vascular communication might play a central role in optimal cognitive performance. This hypothesis can be tested by comparing healthy individuals to those with known white-matter damage and impaired performance, as seen in Multiple Sclerosis (MS). Glial cell intermediaries facilitate the ability of neurons to adequately convey metabolic needs to cerebral vasculature for sufficient oxygen and nutrient perfusion. In this study, we isolated measurements of the HRF that could quantify the extent to which white-matter affects neural-vascular coupling and cognitive performance. HRFs were modeled from multiple brain regions during multiple cognitive tasks using piecewise cubic spline functions, an approach that minimized assumptions regarding HRF shape that may not be valid for diseased populations, and were characterized using two shape metrics (peak amplitude and time-to-peak). Peak amplitude was reduced, and time-to-peak was longer, in MS patients relative to healthy controls. Faster time-to-peak was predicted by faster reaction time, suggesting an important role for vasodilatory speed in the physiology underlying processing speed. These results support the hypothesis that intact neural-glial-vascular communication underlies optimal neural and cognitive functioning.
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Affiliation(s)
- Monroe P Turner
- School of Behavioral and Brain Sciences, University of Texas at Dallas, Richardson, TX, USA
| | - Nicholas A Hubbard
- McGovern Institute for Brain Research, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Dinesh K Sivakolundu
- School of Behavioral and Brain Sciences, University of Texas at Dallas, Richardson, TX, USA
| | - Lyndahl M Himes
- School of Behavioral and Brain Sciences, University of Texas at Dallas, Richardson, TX, USA
| | - Joanna L Hutchison
- School of Behavioral and Brain Sciences, University of Texas at Dallas, Richardson, TX, USA
| | - John Hart
- School of Behavioral and Brain Sciences, University of Texas at Dallas, Richardson, TX, USA; Department of Neurology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Jeffrey S Spence
- School of Behavioral and Brain Sciences, University of Texas at Dallas, Richardson, TX, USA
| | - Elliot M Frohman
- Department of Neurology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Teresa C Frohman
- Department of Neurology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Darin T Okuda
- Department of Neurology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Bart Rypma
- School of Behavioral and Brain Sciences, University of Texas at Dallas, Richardson, TX, USA; Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA.
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12
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Schweisfurth MA, Frahm J, Farina D, Schweizer R. Comparison of fMRI Digit Representations of the Dominant and Non-dominant Hand in the Human Primary Somatosensory Cortex. Front Hum Neurosci 2018; 12:492. [PMID: 30618677 PMCID: PMC6295472 DOI: 10.3389/fnhum.2018.00492] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2018] [Accepted: 11/21/2018] [Indexed: 11/13/2022] Open
Abstract
The tactile digit representations in the primary somatosensory cortex have so far been mapped for either the left or the right hand. This study localized all ten digit representations in right-handed subjects and compared them within and across the left and right hands to assess potential differences in the functional organization of the digit map between hands and in the structural organization between hemispheres. Functional magnetic resonance imaging of tactile stimulation of each fingertip in BA 3b confirmed the expected lateral-anterior-inferior to medial-posterior-superior succession from thumb to little-finger representation, located in the post-central gyrus opposite to the motor hand knob. While the more functionally related measures, such as the extent and strength of activation as well as the Euclidean distance between neighboring digit representations, showed significant differences between the digits, no side difference was detected: the layout of the functional digit-representation map did not consistently differ between the left, non-dominant, and the right, dominant hand. Comparing the absolute spatial coordinates also revealed a significant difference for the digits, but not between the left and right hand digits. Estimating the individual subject's digit coordinates of one hand by within-subject mirroring of the other-hand digit coordinates across hemispheres yielded a larger estimation error distance than using averaged across-subjects coordinates from within the same hemisphere. However, both methods should only be used with care for single-subject clinical evaluation, as an average estimation error of around 9 mm was observed, being slightly higher than the average distance between neighboring digits.
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Affiliation(s)
- Meike A Schweisfurth
- Biomedizinische NMR, Max-Planck-Institut für biophysikalische Chemie, Göttingen, Germany.,Fakultät Life Sciences, Hochschule für Angewandte Wissenschaften Hamburg, Hamburg, Germany
| | - Jens Frahm
- Biomedizinische NMR, Max-Planck-Institut für biophysikalische Chemie, Göttingen, Germany
| | - Dario Farina
- Department of Bioengineering, Imperial College London, Royal School of Mines, London, United Kingdom
| | - Renate Schweizer
- Biomedizinische NMR, Max-Planck-Institut für biophysikalische Chemie, Göttingen, Germany.,Leibniz-ScienceCampus Primate Cognition, Göttingen, Germany
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13
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Tommasin S, De Giglio L, Ruggieri S, Petsas N, Giannì C, Pozzilli C, Pantano P. Relation between functional connectivity and disability in multiple sclerosis: a non-linear model. J Neurol 2018; 265:2881-2892. [PMID: 30276520 DOI: 10.1007/s00415-018-9075-5] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2018] [Revised: 09/21/2018] [Accepted: 09/25/2018] [Indexed: 01/12/2023]
Abstract
OBJECTIVE To characterize the relation between brain functional connectivity and disability in patients with multiple sclerosis; to investigate the existence of critical values of both disability and functional connectivity corresponding to exhaustion of functional adaptive mechanisms. METHODS Hundred-and-nineteen patients with no-to-severe disability and 42 healthy subjects were studied via 3T resting state functional MRI. Out of 116 regions extracted from Automated Anatomical Labeling atlas, pairs of regions whose functional connectivity correlated with Expanded Disability Status Score were identified. In patients, mathematical modeling was applied to find the best models describing Expanded-Disability-Status-Score vs structural or functional measures. Functional vs structural models intersecting points were identified. RESULTS Disability had direct linear relation with lesion load (r = 0.40, p < 5E-6), inverse of thalamic volume (r = 0.31 p < 1E-3) and functional connectivity in bi-frontal pairs of regions (r > 0.40, p < 0.04), while being non-linearly associated with functional connectivity in cerebello-temporal and cerebello-frontal pairs of regions (F > 1.73, p < 0.02). Structural vs functional models intersecting points corresponded to Expanded Disability Status Score of 3.0. 85% of patients scoring more than 3.0 showed functional connectivity in cerebello-temporal and cerebello-frontal pairs of regions below confidence intervals (z = [2.28-2.88] 95% CI) measured in healthy subjects. CONCLUSIONS Functional brain connectivity changes may represent mechanisms of adaptation to structural damage and inflammation and may be not always clinically beneficial. Functional connectivity decreases in comparison with structural measure at Expanded Disability Status Score greater than 3.0, which may be critical and indicate exhaustion of compensatory mechanisms.
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Affiliation(s)
- Silvia Tommasin
- Department of Human Neuroscience, Sapienza University of Rome, Viale dell'Università, 30, 00185, Rome, Italy
| | - Laura De Giglio
- Department of Human Neuroscience, Sapienza University of Rome, Viale dell'Università, 30, 00185, Rome, Italy
- Sant'Andrea Hospital, MS Centre, Sapienza University of Rome, Viale di Grottarossa 1035, 00189, Rome, Italy
| | - Serena Ruggieri
- Department of Human Neuroscience, Sapienza University of Rome, Viale dell'Università, 30, 00185, Rome, Italy
| | - Nikolaos Petsas
- IRCCS Neuromed, Via Atinense, 18, 86077, Pozzilli, IS, Italy
| | - Costanza Giannì
- Department of Human Neuroscience, Sapienza University of Rome, Viale dell'Università, 30, 00185, Rome, Italy
| | - Carlo Pozzilli
- Department of Human Neuroscience, Sapienza University of Rome, Viale dell'Università, 30, 00185, Rome, Italy
- Sant'Andrea Hospital, MS Centre, Sapienza University of Rome, Viale di Grottarossa 1035, 00189, Rome, Italy
| | - Patrizia Pantano
- Department of Human Neuroscience, Sapienza University of Rome, Viale dell'Università, 30, 00185, Rome, Italy.
- IRCCS Neuromed, Via Atinense, 18, 86077, Pozzilli, IS, Italy.
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14
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Tavazzi E, Bergsland N, Cattaneo D, Gervasoni E, Laganà MM, Dipasquale O, Grosso C, Saibene FL, Baglio F, Rovaris M. Effects of motor rehabilitation on mobility and brain plasticity in multiple sclerosis: a structural and functional MRI study. J Neurol 2018; 265:1393-1401. [DOI: 10.1007/s00415-018-8859-y] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2018] [Revised: 04/03/2018] [Accepted: 04/03/2018] [Indexed: 10/17/2022]
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15
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Wirsching I, Buttmann M, Odorfer T, Volkmann J, Classen J, Zeller D. Altered motor plasticity in an acute relapse of multiple sclerosis. Eur J Neurosci 2018; 47:251-257. [PMID: 29285814 DOI: 10.1111/ejn.13818] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2017] [Revised: 12/16/2017] [Accepted: 12/18/2017] [Indexed: 11/30/2022]
Abstract
In relapsing-remitting MS (RRMS), the symptoms of a clinical relapse subside over time. Neuroplasticity is believed to play an important compensatory role. In this study, we assessed excitability-decreasing plasticity during an acute relapse of MS and 12 weeks afterwards. Motor plasticity was examined in 19 patients with clinically isolated syndrome or RRMS during a steroid-treated relapse (t1) and 12 weeks afterwards (t2) using paired-associative stimulation (PAS10). This method combines repetitive electric nerve stimulation with transcranial magnetic stimulation of the contralateral motor cortex to model long-term synaptic depression in the human cortex. Additionally, 19 age-matched healthy controls were assessed. Motor-evoked potentials of the abductor pollicis brevis muscle were recorded before and after intervention. Clinical disability was assessed by the multiple sclerosis functional composite and the subscore of the nine-hole peg test taken as a measure of hand function. The effect of PAS10 was significantly different between controls and patients; at t1, but not at t2, baseline-normalized postinterventional amplitudes were significantly higher in patients (106 [IQR 98-137] % post10-15 and 111 [IQR 88-133] % post20-25) compared to controls (92 [IQR 85-111] % and 90 [IQR 75-102] %). Additional exploratory analysis indicated a potentially excitability-enhancing effect of PAS10 in patients as opposed to controls. Significant clinical improvement between t1 and t2 was not correlated with PAS10 effects. Our results indicate an alteration of PAS10-induced synaptic plasticity during relapse, presumably reflecting a polarity shift due to metaplastic processes within the motor cortex. Further studies will need to elucidate the functional significance of such changes for the clinical course of MS.
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Affiliation(s)
- Isabelle Wirsching
- Department of Neurology, University of Würzburg, Josef-Schneider-Str. 11, 97080, Würzburg, Germany
| | - Mathias Buttmann
- Department of Neurology, University of Würzburg, Josef-Schneider-Str. 11, 97080, Würzburg, Germany
| | - Thorsten Odorfer
- Department of Neurology, University of Würzburg, Josef-Schneider-Str. 11, 97080, Würzburg, Germany
| | - Jens Volkmann
- Department of Neurology, University of Würzburg, Josef-Schneider-Str. 11, 97080, Würzburg, Germany
| | - Joseph Classen
- Department of Neurology, University of Leipzig, 04103, Leipzig, Germany
| | - Daniel Zeller
- Department of Neurology, University of Würzburg, Josef-Schneider-Str. 11, 97080, Würzburg, Germany
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16
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Lasek-Bal A, Kidoń J, Błaszczyszyn M, Stasiów B, Żak A. BOLD fMRI signal in stroke patients and its importance for prognosis in the subacute disease period - Preliminary report. Neurol Neurochir Pol 2017; 52:341-346. [PMID: 29329693 DOI: 10.1016/j.pjnns.2017.12.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2017] [Revised: 11/09/2017] [Accepted: 12/19/2017] [Indexed: 10/18/2022]
Abstract
Functional magnetic resonance imaging (fMRI) allows for the assessment of neuronal activity through the blood-level-dependent signal. The purpose of study was to evaluate the pattern of brain activity in fMRI in patients with ischemic stroke and to assess the potential relationship between the activity pattern and the neurological/functional status. METHODS The fMRI was performed in patients up to 4th day of stroke. All the patients were analyzed according to NIHSS on 1st day and mRankin scale on 14th day of stroke, followed by analyzing of fMRI signal. RESULTS The study enrolled 13 patients at a mean age of 64.3years. Eight (61.5%) showed cerebellar activation and 2 (15.38%)- insular activation. In those who scored 0-2 on mRankin scale, the most frequently observed activity was located in the regions: the M1, SMA and PMC in the stroke hemisphere and the cerebellum. In those cases, the non-stroke hemisphere was more frequently involved in the areas: the M1 and PMC. There was a tendency for a better prognosis in relation to age <65years and activation of the SMA in the stroke hemisphere. CONCLUSION There are differences observed in the activation areas of the cerebral cortex both in the stroke and non-stroke hemispheres. More than half of the patients with hemispheric stroke but all with good outcome showed cerebellar activation. There is probable positive correlation between the BOLD-signal size, young age, activation of supplementary motor area in stroke hemisphere and good functional status of patients in the subacute period of stroke.
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Affiliation(s)
- Anetta Lasek-Bal
- Department of Neurology, School of Health Sciences, Medical University of Silesia in Katowice, Poland.
| | - Joanna Kidoń
- Invasive Cardiology and Electrocardiology, 3rd Department of Cardiology, Medical University of Silesia, Poland
| | - Monika Błaszczyszyn
- Opole University of Technology, Faculty of Physical Education and Physiotherapy, Poland
| | - Bartłomiej Stasiów
- Department of Radiology, Medical University of Silesia Hospital No. 7, Professor Leszek Giec Upper Silesian Medical Centre, Poland
| | - Amadeusz Żak
- Department of Neurology, School of Health Sciences, Medical University of Silesia in Katowice, Poland
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17
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Peterson DS, Fling BW. How changes in brain activity and connectivity are associated with motor performance in people with MS. Neuroimage Clin 2017; 17:153-162. [PMID: 29071209 PMCID: PMC5651557 DOI: 10.1016/j.nicl.2017.09.019] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2017] [Revised: 09/22/2017] [Accepted: 09/25/2017] [Indexed: 01/18/2023]
Abstract
People with multiple sclerosis (MS) exhibit pronounced changes in brain structure, activity, and connectivity. While considerable work has begun to elucidate how these neural changes contribute to behavior, the heterogeneity of symptoms and diagnoses makes interpretation of findings and application to clinical practice challenging. In particular, whether MS related changes in brain activity or brain connectivity protect against or contribute to worsening motor symptoms is unclear. With the recent emergence of neuromodulatory techniques that can alter neural activity in specific brain regions, it is critical to establish whether localized brain activation patterns are contributing to (i.e. maladaptive) or protecting against (i.e. adaptive) progression of motor symptoms. In this manuscript, we consolidate recent findings regarding changes in supraspinal structure and activity in people with MS and how these changes may contribute to motor performance. Furthermore, we discuss a hypothesis suggesting that increased neural activity during movement may be either adaptive or maladaptive depending on where in the brain this increase is observed. Specifically, we outline preliminary evidence suggesting sensorimotor cortex activity in the ipsilateral cortices may be maladaptive in people with MS. We also discuss future work that could supply data to support or refute this hypothesis, thus improving our understanding of this important topic.
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Affiliation(s)
- Daniel S Peterson
- Arizona State University, Tempe, AZ, USA; Veterans Affairs Phoenix Medical Center Phoenix, AZ, USA.
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18
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Filippi M, Rovaris M, Rocca MA. Imaging primary progressive multiple sclerosis: the contribution of structural, metabolic, and functional MRI techniques. Mult Scler 2017; 10 Suppl 1:S36-44; discussion S44-5. [PMID: 15218808 DOI: 10.1191/1352458504ms1029oa] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Patients with primary progressive multiple sclerosis (PPMS) typically experience a progressive disease course from onset, leading to the accumulation of severe neurological disability. This is in contrast with the observation that the burden and activity of lesions on conventional magnetic resonance imaging (MRI) scans of the brain are much lower in patients with PPMS than in those with other less disabling forms of the disease. Studies with structural and functional MRI techniques are providing relevant contributions to the understanding of the mechanisms underlying the accumulatio n of irreversible neurological deficits in patients with PPMS. The results of these studies underpin that the main factors possibly explaining the clinical/MRI discrepancy observed in patients with PPMS include the presence of a diffuse tissue damage that is beyond the resolution of conventional imaging, the extent of cervical cord damage, and the impairment of the adaptive capacity of the cortex to limit the functional consequences of subcortical pathology.
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Affiliation(s)
- Massimo Filippi
- Department of Neurology, Neuroimaging Research Unit, Scientific Institute and University Ospedale San Raffaele, Via Olgettina 60, 20132 Milan, Italy.
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19
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Matthews PM. Advanced MRI measures like DTI or fMRI should be outcome measures in future clinical trials – NO. Mult Scler 2017; 23:1456-1458. [DOI: 10.1177/1352458517713345] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Paul M Matthews
- Division of Brain Sciences, Department of Medicine, Imperial College London, Hammersmith Hospital, London, UK/Centre for Neurotechnology, Imperial College London, London, UK/UK Dementia Research Institute, Imperial College London, London, UK
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20
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Chaparro G, Balto JM, Sandroff BM, Holtzer R, Izzetoglu M, Motl RW, Hernandez ME. Frontal brain activation changes due to dual-tasking under partial body weight support conditions in older adults with multiple sclerosis. J Neuroeng Rehabil 2017; 14:65. [PMID: 28662727 PMCID: PMC5493004 DOI: 10.1186/s12984-017-0280-8] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2017] [Accepted: 06/22/2017] [Indexed: 11/30/2022] Open
Abstract
Background Gait impairments present while dual-tasking in older adults with multiple sclerosis (MS) have been associated with an increased risk of falls. Prior studies have examined prefrontal cortex (PFC) activity using functional near infrared spectroscopy (fNIRS) while dual-tasking in older adults with and without cognitive impairment. While the benefits of partial body weight support (PBWS) on gait have been clearly outlined in the literature, the potential use of PBWS to improve the ability to dual task in older adults with and without MS has not been examined. The aim of this study was to examine the effects of PBWS on the PFC activation while dual-tasking in older adults with and without MS. Methods Ten individuals with MS (mean 56.2 ± 5.1 yrs., 8 females) and 12 healthy older adults (HOA) (mean 63.1 ± 4.4 yrs., 9 females) participated in this study. PFC activation (i.e., oxygenated hemoglobin-HbO2) was measured using fNIRS. Assessments were done under two treadmill walking conditions: no body weight support (NBWS) and PBWS. Under each condition, participants were asked to walk at a comfortable speed (W) or walk and talk (WT). Linear mixed models were used to test for differences between cohorts, conditions, and tasks. Results HbO2 levels differed significantly between task (p < .001), cohort (p < .001), and BWS (p = .02). HbO2 levels increased under higher cognitive demands (i.e., W vs WT), in individuals with MS, and under different conditions (i.e., NBWS vs PBWS). Post-hoc analysis demonstrated a significant difference between cohorts during the WT and NBWS condition (p = .05). When examining the relative change in HbO2 levels during each task, a significant interaction between task, BWS, and cohort across time was observed (p < 0.01). While HOA increased PFC activation across time, MS exhibited a maintenance of PFC activation patterns during the WT under PBWS condition. Conclusions This study establishes the potential impact of PBWS on PFC activation patterns under dual-tasking conditions and sheds light on the ability for PBWS to be used as a therapeutic tool in individuals with neurological conditions to decrease cognitive demands while dual-tasking and thus decrease the risk of falls.
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Affiliation(s)
- Gioella Chaparro
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Champaign, IL, USA
| | - Julia M Balto
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Champaign, IL, USA
| | - Brian M Sandroff
- Department of Physical Therapy, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Roee Holtzer
- Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, USA.,Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY, USA
| | - Meltem Izzetoglu
- School of Biomedical Engineering, Science and Health Systems, Drexel University, Philadelphia, PA, USA
| | - Robert W Motl
- Department of Physical Therapy, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Manuel E Hernandez
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Champaign, IL, USA. .,Present address: University of Illinois at Urbana-Champaign, 209 Louise Freer Hall, 906 S. Goodwin Avenue, Urbana, IL, 61801, USA.
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21
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Hubbard NA, Turner M, Hutchison JL, Ouyang A, Strain J, Oasay L, Sundaram S, Davis S, Remington G, Brigante R, Huang H, Hart J, Frohman T, Frohman E, Biswal BB, Rypma B. Multiple sclerosis-related white matter microstructural change alters the BOLD hemodynamic response. J Cereb Blood Flow Metab 2016; 36:1872-1884. [PMID: 26661225 PMCID: PMC5094308 DOI: 10.1177/0271678x15615133] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2015] [Accepted: 09/15/2015] [Indexed: 01/21/2023]
Abstract
Multiple sclerosis (MS) results in inflammatory damage to white matter microstructure. Prior research using blood-oxygen-level dependent (BOLD) imaging indicates MS-related alterations to brain function. What is currently unknown is the extent to which white matter microstructural damage influences BOLD signal in MS. Here we assessed changes in parameters of the BOLD hemodynamic response function (HRF) in patients with relapsing-remitting MS compared to healthy controls. We also used diffusion tensor imaging to assess whether MS-related changes to the BOLD-HRF were affected by changes in white matter microstructural integrity. Our results showed MS-related reductions in BOLD-HRF peak amplitude. These MS-related amplitude decreases were influenced by individual differences in white matter microstructural integrity. Other MS-related factors including altered reaction time, limited spatial extent of BOLD activity, elevated lesion burden, or lesion proximity to regions of interest were not mediators of group differences in BOLD-HRF amplitude. Results are discussed in terms of functional hyperemic mechanisms and implications for analysis of BOLD signal differences.
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Affiliation(s)
- Nicholas A Hubbard
- School of Behavioral and Brain Sciences, University of Texas at Dallas, Richardson, TX, USA
| | - Monroe Turner
- School of Behavioral and Brain Sciences, University of Texas at Dallas, Richardson, TX, USA
| | - Joanna L Hutchison
- School of Behavioral and Brain Sciences, University of Texas at Dallas, Richardson, TX, USA.,Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Austin Ouyang
- Advanced Imaging Research Center, University of Texas Southwestern Medical Center, Dallas, TX, USA.,Department of Radiology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Jeremy Strain
- School of Behavioral and Brain Sciences, University of Texas at Dallas, Richardson, TX, USA
| | - Larry Oasay
- School of Behavioral and Brain Sciences, University of Texas at Dallas, Richardson, TX, USA
| | - Saranya Sundaram
- School of Behavioral and Brain Sciences, University of Texas at Dallas, Richardson, TX, USA
| | - Scott Davis
- Department of Applied Physiology and Wellness, Southern Methodist University, Dallas, TX, USA
| | - Gina Remington
- Department of Neurology and Neurotherapeutics, University of Texas Southwestern Medical Center, Dallas, TX, USA.,Department of Ophthalmology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Ryan Brigante
- School of Behavioral and Brain Sciences, University of Texas at Dallas, Richardson, TX, USA
| | - Hao Huang
- Advanced Imaging Research Center, University of Texas Southwestern Medical Center, Dallas, TX, USA.,Department of Radiology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - John Hart
- School of Behavioral and Brain Sciences, University of Texas at Dallas, Richardson, TX, USA.,Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA.,Department of Neurology and Neurotherapeutics, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Teresa Frohman
- Department of Neurology and Neurotherapeutics, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Elliot Frohman
- Department of Neurology and Neurotherapeutics, University of Texas Southwestern Medical Center, Dallas, TX, USA.,Department of Ophthalmology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Bharat B Biswal
- Department of Biomedical Engineering, New Jersey Institute of Technology, Newark, NJ, USA
| | - Bart Rypma
- School of Behavioral and Brain Sciences, University of Texas at Dallas, Richardson, TX, USA .,Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
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22
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Dogonowski AM, Blinkenberg M, Paulson OB, Sellebjerg F, Sørensen PS, Siebner HR, Madsen KH. Recovery from an acute relapse is associated with changes in motor resting-state connectivity in multiple sclerosis. J Neurol Neurosurg Psychiatry 2016; 87:912-4. [PMID: 26668202 PMCID: PMC4975821 DOI: 10.1136/jnnp-2015-311375] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2015] [Accepted: 10/26/2015] [Indexed: 11/03/2022]
Affiliation(s)
- Anne-Marie Dogonowski
- Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital, Hvidovre, Denmark
| | - Morten Blinkenberg
- Danish Multiple Sclerosis Center, Department of Neurology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Olaf B Paulson
- Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital, Hvidovre, Denmark Neurobiology Research Unit, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Finn Sellebjerg
- Danish Multiple Sclerosis Center, Department of Neurology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Per Soelberg Sørensen
- Danish Multiple Sclerosis Center, Department of Neurology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Hartwig R Siebner
- Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital, Hvidovre, Denmark Department of Neurology, Copenhagen University Hospital Bispebjerg, Copenhagen, Denmark
| | - Kristoffer H Madsen
- Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital, Hvidovre, Denmark Cognitive Systems, Department of Applied Mathematics and Computer Science, Technical University of Denmark, Kgs. Lyngby, Denmark
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23
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Lazeron RHC, Rombouts SARB, Scheltens P, Polman CH, Barkhof F. An fMRI study of planning-related brain activity in patients with moderately advanced multiple sclerosis. Mult Scler 2016; 10:549-55. [PMID: 15471372 DOI: 10.1191/1352458504ms1072oa] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Introduction: Cognitive impairment occurs in a substantial number of multiple sclerosis (MS) patients and often includes frontal lobe dysfunction. We used functional magnetic resonance imaging (fMRI) to study planning, an executive function, in moderately impaired MS patients. Methods: An fMRI version of the Tower of London (ToL) test was used to study patterns of brain activation in 23 MS patients and 18 healthy controls. The median score on the Expanded Disability Status Scale (EDSS) for the MS patients was 4. fMRI data were analysed using whole brain random effects analysis as well as region of interest (ROI)-based methods to assess group effects. Within the MS group, associations with behavioural data and measures of disease severity (lesion load from structural MRI) were examined. Results: Test performance in MS patients was significantly worse than in controls. Group analysis for the MS patients and the controls showed for both groups globally the same areas of activation, located in the frontal and parietal lobes bilaterally and the cerebellum. Although visual inspection suggested a larger extent of activation in the MS group, no statistically significant differences between groups were found. In the ROI analysis, statistically significant larger extent of activation was only found in the cerebellum. No association between disease severity and brain activity could be determined in the MS group. Conclusion: In MS patients with moderate disability and structural damage, the pattern and extent of brain activation during planning were maintained despite poorer performance. In contrast to other studies showing increased activity, the failure to do so in our group may reflect exhaustion of adaptive mechanisms.
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Affiliation(s)
- Richard H C Lazeron
- Department of Radiology and the MS-MRI Centre, Vrije Universiteit Medical Center, Amsterdam, The Netherlands.
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24
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Tomassini V, d'Ambrosio A, Petsas N, Wise RG, Sbardella E, Allen M, Tona F, Fanelli F, Foster C, Carnì M, Gallo A, Pantano P, Pozzilli C. The effect of inflammation and its reduction on brain plasticity in multiple sclerosis: MRI evidence. Hum Brain Mapp 2016; 37:2431-45. [PMID: 26991559 PMCID: PMC5069650 DOI: 10.1002/hbm.23184] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2015] [Revised: 03/04/2016] [Accepted: 03/07/2016] [Indexed: 12/29/2022] Open
Abstract
Brain plasticity is the basis for systems‐level functional reorganization that promotes recovery in multiple sclerosis (MS). As inflammation interferes with plasticity, its pharmacological modulation may restore plasticity by promoting desired patterns of functional reorganization. Here, we tested the hypothesis that brain plasticity probed by a visuomotor adaptation task is impaired with MS inflammation and that pharmacological reduction of inflammation facilitates its restoration. MS patients were assessed twice before (sessions 1 and 2) and once after (session 3) the beginning of Interferon beta (IFN beta), using behavioural and structural MRI measures. During each session, 2 functional MRI runs of a visuomotor task, separated by 25‐minutes of task practice, were performed. Within‐session between‐run change in task‐related functional signal was our imaging marker of plasticity. During session 1, patients were compared with healthy controls. Comparison of patients' sessions 2 and 3 tested the effect of reduced inflammation on our imaging marker of plasticity. The proportion of patients with gadolinium‐enhancing lesions reduced significantly during IFN beta. In session 1, patients demonstrated a greater between‐run difference in functional MRI activity of secondary visual areas and cerebellum than controls. This abnormally large practice‐induced signal change in visual areas, and in functionally connected posterior parietal and motor cortices, was reduced in patients in session 3 compared with 2. Our results suggest that MS inflammation alters short‐term plasticity underlying motor practice. Reduction of inflammation with IFN beta is associated with a restoration of this plasticity, suggesting that modulation of inflammation may enhance recovery‐oriented strategies that rely on patients' brain plasticity. Hum Brain Mapp 37:2431–2445, 2016. © 2016 The Authors Human Brain Mapping Published by Wiley Periodicals, Inc.
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Affiliation(s)
- Valentina Tomassini
- Institute of Psychological Medicine and Clinical Neurosciences, Cardiff University School of Medicine, United Kingdom.,Cardiff University Brain Research Imaging Centre (CUBRIC), Cardiff University School of Psychology, United Kingdom.,IRCCS Fondazione Santa Lucia, Rome, Italy
| | - Alessandro d'Ambrosio
- Institute of Psychological Medicine and Clinical Neurosciences, Cardiff University School of Medicine, United Kingdom.,Cardiff University Brain Research Imaging Centre (CUBRIC), Cardiff University School of Psychology, United Kingdom.,Department of Medical, Surgical, Neurological, Metabolic and Aging Sciences, Second University of Naples, Italy
| | - Nikolaos Petsas
- Department of Neurology and Psychiatry, Sapienza University of Rome, Italy
| | - Richard G Wise
- Cardiff University Brain Research Imaging Centre (CUBRIC), Cardiff University School of Psychology, United Kingdom
| | - Emilia Sbardella
- Department of Neurology and Psychiatry, Sapienza University of Rome, Italy
| | - Marek Allen
- Cardiff University Brain Research Imaging Centre (CUBRIC), Cardiff University School of Psychology, United Kingdom
| | - Francesca Tona
- Department of Neurology and Psychiatry, Sapienza University of Rome, Italy
| | - Fulvia Fanelli
- Department of Neurology and Psychiatry, Sapienza University of Rome, Italy
| | - Catherine Foster
- Cardiff University Brain Research Imaging Centre (CUBRIC), Cardiff University School of Psychology, United Kingdom
| | - Marco Carnì
- Department of Neurology and Psychiatry, Sapienza University of Rome, Italy
| | - Antonio Gallo
- Department of Medical, Surgical, Neurological, Metabolic and Aging Sciences, Second University of Naples, Italy
| | - Patrizia Pantano
- Department of Neurology and Psychiatry, Sapienza University of Rome, Italy.,IRCCS NeuroMed, Pozzilli, IS
| | - Carlo Pozzilli
- Department of Neurology and Psychiatry, Sapienza University of Rome, Italy
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25
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Zhuang Y, Zhou F, Gong H. Intrinsic functional plasticity of the sensorimotor network in relapsing-remitting multiple sclerosis: evidence from a centrality analysis. PLoS One 2015; 10:e0130524. [PMID: 26110420 PMCID: PMC4482320 DOI: 10.1371/journal.pone.0130524] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2014] [Accepted: 05/21/2015] [Indexed: 12/13/2022] Open
Abstract
Background and Purpose Advanced MRI studies have revealed regional alterations in the sensorimotor cortex of patients with relapsing-remitting multiple sclerosis (RRMS). However, the organizational features underlying the relapsing phase and the subsequent remitting phase have not been directly shown at the functional network or the connectome level. Therefore, this study aimed to characterize MS-related centrality disturbances of the sensorimotor network (SMN) and to assess network integrity and connectedness. Methods Thirty-four patients with clinically definite RRMS and well-matched healthy controls participated in the study. Twenty-three patients in the remitting phase underwent one resting-state functional MRI, and 11 patients in the relapsing-remitting phase underwent two different MRIs. We measured voxel-wise centrality metrics to determine direct (degree centrality, DC) and global (eigenvector centrality, EC) functional relationships across the entire SMN. Results In the relapsing phase, DC was significantly decreased in the bilateral primary motor and somatosensory cortex (M1/S1), left dorsal premotor (PMd), and operculum-integrated regions. However, DC was increased in the peripheral SMN areas. The decrease in DC in the bilateral M1/S1 was associated with the expanded disability status scale (EDSS) and total white matter lesion loads (TWMLLs), suggesting that this adaptive response is related to the extent of brain damage in the rapid-onset attack stage. During the remission process, these alterations in centrality were restored in the bilateral M1/S1 and peripheral SMN areas. In the remitting phase, DC was reduced in the premotor, supplementary motor, and operculum-integrated regions, reflecting an adaptive response due to brain atrophy. However, DC was enhanced in the right M1 and left parietal-integrated regions, indicating chronic reorganization. In both the relapsing and remitting phases, the changes in EC and DC were similar. Conclusions The alterations in centrality within the SMN indicate rapid plasticity and chronic reorganization with a biased impairment of specific functional areas in RRMS patients.
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Affiliation(s)
- Ying Zhuang
- Department of Radiology, the First Affiliated Hospital, Nanchang University, Nanchang, Jiangxi Province, China
- Department of Oncology, the Second Hospital of Nanchang, Nanchang, Jiangxi Province, China
| | - Fuqing Zhou
- Department of Radiology, the First Affiliated Hospital, Nanchang University, Nanchang, Jiangxi Province, China
- Jiangxi Province Medical Imaging Research Institute, Nanchang, Jiangxi Province, China
- * E-mail:
| | - Honghan. Gong
- Department of Radiology, the First Affiliated Hospital, Nanchang University, Nanchang, Jiangxi Province, China
- Jiangxi Province Medical Imaging Research Institute, Nanchang, Jiangxi Province, China
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26
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Plasticity of the motor system in multiple sclerosis. Neuroscience 2014; 283:222-30. [DOI: 10.1016/j.neuroscience.2014.05.043] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2014] [Revised: 05/20/2014] [Accepted: 05/21/2014] [Indexed: 11/20/2022]
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27
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Wolkorte R, Heersema DJ, Zijdewind I. Reduced Dual-Task Performance in MS Patients Is Further Decreased by Muscle Fatigue. Neurorehabil Neural Repair 2014; 29:424-35. [PMID: 25288582 DOI: 10.1177/1545968314552529] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Multiple sclerosis (MS) can be accompanied by motor, cognitive, and sensory impairments. Additionally, MS patients often report fatigue as one of their most debilitating symptoms. It is, therefore, expected that MS patients will have difficulties in performing cognitive-motor dual tasks (DTs), especially in a fatiguing condition. OBJECTIVE To determine whether MS patients are more challenged by a DT than controls in a fatiguing and less-fatiguing condition and whether DT performance is associated with perceived fatigue. METHODS A group of 19 MS patients and 19 age-, sex-, and education-matched controls performed a cognitive task (2-choice reaction time task) separately or concurrent with a low-force or a high-force motor task (index finger abduction at 10% or 30% maximal voluntary contraction). RESULTS MS patients performed less well on a cognitive task than controls. Cognitive task performance under DT conditions decreased more for MS patients. Moreover, under high-force DT conditions, cognitive performance declined in both groups but to a larger degree for MS patients. Besides a decline in cognitive task performance, MS patients also showed a stronger decrease in motor performance under high-force DT conditions. DT costs were positively related to perceived fatigue as measured by questionnaires. CONCLUSIONS Compared with controls, MS patients performed less well on DTs as demonstrated by a reduction in both cognitive and motor performances. This performance decrease was stronger under fatiguing conditions and was related to the sense of fatigue of MS patients. These data illustrate problems that MS patients may encounter in daily life because of their fatigue.
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Affiliation(s)
- Ria Wolkorte
- Department of Neuroscience, University Medical Center Groningen, University of Groningen, The Netherlands
| | - Dorothea J Heersema
- Department of Neurology, University Medical Center Groningen, The Netherlands
| | - Inge Zijdewind
- Department of Neuroscience, University Medical Center Groningen, University of Groningen, The Netherlands
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28
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Weiss S, Mori F, Rossi S, Centonze D. Disability in multiple sclerosis: When synaptic long-term potentiation fails. Neurosci Biobehav Rev 2014; 43:88-99. [DOI: 10.1016/j.neubiorev.2014.03.023] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2013] [Revised: 02/11/2014] [Accepted: 03/31/2014] [Indexed: 12/13/2022]
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29
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Guerrera S, Morabito R, Baglieri A, Corallo F, Ciurleo R, De Luca R, De Salvo S, Marino MA, Spadaro L, Timpano F, Bramanti P, Marino S. Cortical reorganization in multiple sclerosis after intrathecal baclofen therapy. Neurocase 2014; 20:225-9. [PMID: 23548099 DOI: 10.1080/13554794.2013.770872] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Our objective was to assess the role of Intrathecal Baclofen Therapy (ITB) in the cortical reorganization in a patient affected by multiple sclerosis (MS) undergoing physical therapy. We reported a case of a woman affected by MS and severe spasticity, who performed an fMRI examination, before and after the ITB implantation. The subject showed controlateral motor cortex activation after motor task. After a month of ITB implantation, patient showed ipsilateral and controlateral motor cortex activation although with a broader extension. fMRI examination supported the hypothesis of a central influence in patients who undergo physiotherapy and therapy with ITB.
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Affiliation(s)
- S Guerrera
- a Neurobioimaging Laboratory, IRCCS Centro Neurolesi "Bonino-Pulejo," , Messina , Italy
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30
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Affiliation(s)
- Paul M Matthews
- Division of Brain Sciences, Department of Medicine, Imperial College London, Burlington Danes, Hammersmith Hospital, London, UK
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31
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Matthews PM, Comley R. Advances in the molecular imaging of multiple sclerosis. Expert Rev Clin Immunol 2014; 5:765-77. [DOI: 10.1586/eci.09.66] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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32
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Derosière G, Alexandre F, Bourdillon N, Mandrick K, Ward T, Perrey S. Similar scaling of contralateral and ipsilateral cortical responses during graded unimanual force generation. Neuroimage 2014; 85 Pt 1:471-7. [DOI: 10.1016/j.neuroimage.2013.02.006] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2012] [Revised: 01/31/2013] [Accepted: 02/06/2013] [Indexed: 10/27/2022] Open
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33
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Mori F, Kusayanagi H, Nicoletti CG, Weiss S, Marciani MG, Centonze D. Cortical plasticity predicts recovery from relapse in multiple sclerosis. Mult Scler 2013; 20:451-7. [DOI: 10.1177/1352458513512541] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background: Relapsing–remitting multiple sclerosis (RRMS) is characterized by the occurrence of clinical relapses, followed by remitting phases of a neurological deficit. Clinical remission after a relapse can be complete, with a return to baseline function that was present before, but is sometimes only partial or absent. Remyelination and repair of the neuronal damage do contribute to recovery, but they are usually incomplete. Objective: We tested the hypothesis that synaptic plasticity, namely long-term potentiation (LTP), may represent an additional substrate for compensating the clinical defect that results from the incomplete repair of neuronal damage. Methods: We evaluated the correlation between a measure of LTP, named paired associative stimulation (PAS), at the time of relapse and symptom recovery, in a cohort of 22 newly-diagnosed MS patients. Results: PAS-induced LTP was normal in patients with complete recovery, and reduced in patients showing incomplete or absent recovery, 12 weeks after the relapse onset. A multivariate regression model showed that PAS-induced LTP and age may contribute to predict null, partial or complete symptom recovery after a relapse. Conclusion: Synaptic plasticity may contribute to symptom recovery after a relapse in MS; and PAS, measured during a relapse, may be used as a predictor of recovery.
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Affiliation(s)
- Francesco Mori
- Dipartimento di Medicina dei Sistemi, Università Tor Vergata, Rome, Italy
- Centro Europeo per la Ricerca sul Cervello (CERC), Rome, Italy
| | - Hajime Kusayanagi
- Dipartimento di Medicina dei Sistemi, Università Tor Vergata, Rome, Italy
- Centro Europeo per la Ricerca sul Cervello (CERC), Rome, Italy
| | - Carolina Gabri Nicoletti
- Dipartimento di Medicina dei Sistemi, Università Tor Vergata, Rome, Italy
- Centro Europeo per la Ricerca sul Cervello (CERC), Rome, Italy
| | - Sagit Weiss
- Dipartimento di Medicina dei Sistemi, Università Tor Vergata, Rome, Italy
- Centro Europeo per la Ricerca sul Cervello (CERC), Rome, Italy
| | - Maria Grazia Marciani
- Dipartimento di Medicina dei Sistemi, Università Tor Vergata, Rome, Italy
- Centro Europeo per la Ricerca sul Cervello (CERC), Rome, Italy
| | - Diego Centonze
- Dipartimento di Medicina dei Sistemi, Università Tor Vergata, Rome, Italy
- Centro Europeo per la Ricerca sul Cervello (CERC), Rome, Italy
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34
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Engström M, Flensner G, Landtblom AM, Ek AC, Karlsson T. Thalamo-striato-cortical determinants to fatigue in multiple sclerosis. Brain Behav 2013; 3:715-28. [PMID: 24363974 PMCID: PMC3868176 DOI: 10.1002/brb3.181] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2012] [Revised: 09/06/2013] [Accepted: 09/09/2013] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND The aim was to explore the thalamo-striato-cortical theory of central fatigue in multiple sclerosis (MS) patients with self-reported fatigue. If the theory correctly predicted fatigue based on disruptions of the thalamo-striato-cortical network, we expected altered brain activation in this network in MS participants while performing a complex cognitive task that challenged fatigue. METHODS MS participants with self-reported fatigue were examined by functional magnetic resonance imaging (fMRI) during the performance of a complex working memory task. In this task, cognitive effort was challenged by a parametric design, which modeled the cerebral responses at increasing cognitive demands. In order to explore the theory of central fatigue in MS we also analyzed the cerebral responses by adding perceived fatigue scores as covariates in the analysis and by calculating the functional connectivity between regions in the thalamo-striatocortical network. The main findings were that MS participants elicited altered brain responses in the thalamo-striato-cortical network, and that brain activation in the left posterior parietal cortex and the right substantia nigra was positively correlated to perceived fatigue ratings. MS participants had stronger cortical-to-cortical and subcortical-to-subcortical connections, whereas they had weaker cortical-to-subcortical connections. CONCLUSIONS The findings of the present study indicate that the thalamo-striato-cortical network is involved in the pathophysiology of fatigue in MS, and provide support for the theory of central fatigue. However, due to the limited number of participants and the somewhat heterogeneous sample of MS participants, these results have to be regarded as tentative, though they might serve as a basis for future studies.
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Affiliation(s)
- Maria Engström
- Radiology, Department of Medical and Health Sciences, Linköping University Linköping, Sweden ; Center for Medical Image Science and Visualization (CMIV), Linköping University Linköping, Sweden
| | - Gullvi Flensner
- Nursing Science, Department of Medical and Health Sciences, Linköping University Linköping, Sweden ; Department of Nursing, Health and Culture, University West Trollhättan, Sweden
| | - Anne-Marie Landtblom
- Center for Medical Image Science and Visualization (CMIV), Linköping University Linköping, Sweden ; Neuroscience, Department of Clinical and Experimental Medicine (IKE), Department of Neurology, Linköping University, County Council of Östergötland Linköping, Sweden
| | - Anna-Christina Ek
- Nursing Science, Department of Medical and Health Sciences, Linköping University Linköping, Sweden
| | - Thomas Karlsson
- Center for Medical Image Science and Visualization (CMIV), Linköping University Linköping, Sweden ; Department of Behavioural Science and Learning, Linköping University Linköping, Sweden
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35
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Dogonowski AM, Siebner HR, Soelberg Sørensen P, Paulson OB, Dyrby TB, Blinkenberg M, Madsen KH. Resting-state connectivity of pre-motor cortex reflects disability in multiple sclerosis. Acta Neurol Scand 2013; 128:328-35. [PMID: 23461607 DOI: 10.1111/ane.12121] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/05/2013] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To characterize the relationship between motor resting-state connectivity of the dorsal pre-motor cortex (PMd) and clinical disability in patients with multiple sclerosis (MS). MATERIALS AND METHODS A total of 27 patients with relapsing-remitting MS (RR-MS) and 15 patients with secondary progressive MS (SP-MS) underwent functional resting-state magnetic resonance imaging. Clinical disability was assessed using the Expanded Disability Status Scale (EDSS). Independent component analysis was used to characterize motor resting-state connectivity. Multiple regression analysis was performed in SPM8 between the individual expression of motor resting-state connectivity in PMd and EDSS scores including age as covariate. Separate post hoc analyses were performed for patients with RR-MS and SP-MS. RESULTS The EDSS scores ranged from 0 to 7 with a median score of 4.3. Motor resting-state connectivity of left PMd showed a positive linear relation with clinical disability in patients with MS. This effect was stronger when considering the group of patients with RR-MS alone, whereas patients with SP-MS showed no increase in coupling strength between left PMd and the motor resting-state network with increasing clinical disability. No significant relation between motor resting-state connectivity of the right PMd and clinical disability was detected in MS. CONCLUSIONS The increase in functional coupling between left PMd and the motor resting-state network with increasing clinical disability can be interpreted as adaptive reorganization of the motor system to maintain motor function, which appears to be limited to the relapsing-remitting stage of the disease.
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Affiliation(s)
- A.-M. Dogonowski
- Danish Research Centre for Magnetic Resonance; Copenhagen University Hospital Hvidovre; Hvidovre; Denmark
| | - H. R. Siebner
- Danish Research Centre for Magnetic Resonance; Copenhagen University Hospital Hvidovre; Hvidovre; Denmark
| | - P. Soelberg Sørensen
- Danish Multiple Sclerosis Center; Department of Neurology; Copenhagen University Hospital Rigshospitalet; Copenhagen; Denmark
| | | | - T. B. Dyrby
- Danish Research Centre for Magnetic Resonance; Copenhagen University Hospital Hvidovre; Hvidovre; Denmark
| | - M. Blinkenberg
- Danish Multiple Sclerosis Center; Department of Neurology; Copenhagen University Hospital Rigshospitalet; Copenhagen; Denmark
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36
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Long-term TENS treatment decreases cortical motor representation in multiple sclerosis. Neuroscience 2013; 250:1-7. [PMID: 23831423 DOI: 10.1016/j.neuroscience.2013.06.046] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2013] [Revised: 06/02/2013] [Accepted: 06/20/2013] [Indexed: 11/21/2022]
Abstract
This study investigated the effects of a long-term transcutaneous electrical nerve stimulation (TENS) treatment on cortical motor representation in patients with multiple sclerosis (MS). In this double-blind crossover design, patients received either TENS or sham stimulation for 3 weeks (1h per day) on the median nerve region of the most impaired hand, followed by the other stimulation condition after a washout period of 6 months. Cortical motor representation was mapped using transcranial magnetic stimulation (TMS) at the baseline and after the 3-week stimulation protocol. Our results revealed that 3 weeks of daily stimulation with TENS significantly decreased the cortical motor representation of the stimulated muscle in MS patients. Although the mechanisms underlying this decrease remain unclear, our findings indicate that TENS has the ability to induce long-term reorganization in the motor cortex of MS patients.
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37
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Tacchino A, Bove M, Pedullà L, Battaglia MA, Papaxanthis C, Brichetto G. Imagined actions in multiple sclerosis patients: evidence of decline in motor cognitive prediction. Exp Brain Res 2013; 229:561-70. [PMID: 23811731 DOI: 10.1007/s00221-013-3617-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2013] [Accepted: 06/10/2013] [Indexed: 10/26/2022]
Abstract
Motor imagery is a mental process during which subjects internally simulate a movement without any motor output. Mental and actual movement durations are similar in healthy adults (isochrony) while temporal discrepancies (anisochrony) could be an expression of neurological deficits on action representation. It is unclear whether patients with multiple sclerosis (PwMS) preserve the capacity to simulate their own movements. This study investigates the ability of PwMS to predict their own actions by comparing temporal features of dominant and non-dominant actual and mental actions. Fourteen PwMS and nineteen healthy subjects (HS) were asked to execute and to imagine pointing arm movements among four pairs of targets of different sizes. Task duration was calculated for both actual and mental movements by an optoelectronic device. Results showed temporal consistency and target-by-target size modulation in actual movements through the four cycles for both groups with significantly longer actual and mental movement durations in PwMS with respect to HS. An index of performance (IP) was used to examine actual/mental isochrony properties in the two groups. Statistical analysis on IP showed in PwMS significantly longer actual movement durations with respect to mental movement durations (anisochrony), more relevant for the non-dominant than dominant arm. Mental prediction of motor actions is not well preserved in MS where motor and cognitive functional changes are present. Differences in performing imagined task with dominant and non-dominant arm could be related to increased cognitive effort required for performing non-dominant movements.
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Affiliation(s)
- Andrea Tacchino
- Scientific Research Area, Italian Multiple Sclerosis Foundation (FISM), Via Operai 40, 16149 Genoa, Italy
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38
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Petsas N, Tinelli E, Lenzi D, Tomassini V, Sbardella E, Tona F, Raz E, Nucciarelli V, Pozzilli C, Pantano P. Evidence of impaired brain activity balance after passive sensorimotor stimulation in multiple sclerosis. PLoS One 2013; 8:e65315. [PMID: 23799005 PMCID: PMC3682993 DOI: 10.1371/journal.pone.0065315] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2012] [Accepted: 04/29/2013] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVES Examination of sensorimotor activation alone in multiple sclerosis (MS) patients may not yield a comprehensive view of cerebral response to task stimulation. Additional information may be obtained by examining the negative BOLD response (deactivation). Aim of this work was to characterize activation and deactivation patterns during passive hand movements in MS patients. METHODS 13 relapsing remitting-MS patients (RRMS), 18 secondary progressive-MS patients (SPMS) and 15 healthy controls (HC) underwent an fMRI study during passive right-hand movements. Activation and deactivation contrasts in the three groups were entered into ANOVA, age and gender corrected. Post-hoc analysis was performed with one-sample and two-sample t-tests. For each patient we obtained lesion volume (LV) from both T1- and T2-weighted images. RESULTS Activations showed a progressive extension to the ipsilateral brain hemisphere according to the group and the clinical form (HC<RRMS<SPMS). Significant deactivation of the ipsilateral cortical sensorimotor areas was reduced in both patient groups with respect to HC. Deactivation of posterior cortical areas belonging to the default mode network (DMN), was increased in RRMS, but not in SPMS, with respect to HC. The amount of activation in the contralateral sensorimotor cortex was significantly correlated with that of deactivation in the DMN in HC and RRMS, but not in SPMS. Both increased activation and decreased deactivation patterns correlated with LV. CONCLUSION In RRMS patients, increased cortical activation was associated with increased deactivation of the posterior cortex suggesting a greater resting-state activity in the DMN, probably aimed at facilitating sensorimotor circuit engagement during task performance. In SPMS the coupling between increased sensorimotor activation/increased DMN deactivation was not observed suggesting disorganization between anticorrelated functional networks as a consequence of a higher level of disconnection.
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Affiliation(s)
- Nikolaos Petsas
- Department of Neurology and Psychiatry, Sapienza University of Rome, Rome, Italy.
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Investigating the role of the corpus callosum in regulating motor overflow in multiple sclerosis. J Neurol 2013; 260:1997-2004. [DOI: 10.1007/s00415-013-6914-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2013] [Revised: 03/31/2013] [Accepted: 04/02/2013] [Indexed: 12/13/2022]
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Schlaeger R, Hardmeier M, Fuhr P. Superficial brain stimulation in multiple sclerosis. HANDBOOK OF CLINICAL NEUROLOGY 2013; 116:577-84. [PMID: 24112925 DOI: 10.1016/b978-0-444-53497-2.00046-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Central motor conduction time (CMCT) is the most frequently studied measure derived from transcranial magnetic stimulation (TMS) in multiple sclerosis (MS); it is abnormal in 57-93% of patients. Addition of the triple stimulation technique and combining motor with other evoked potentials (EPs) increases sensitivity. Cross-sectional correlations of TMS measures with clinical assessments of motor dysfunction or global disability are high. Longitudinally, CMCT is sensitive to both worsening and improvement of motor function, showing its potential to detect therapeutic responses. Moreover, combined multimodal EPs are valid quantitative predictors of the clinical course over periods ranging from 2 to 14 years. Measures of transcallosal connectivity (ipsilateral silent period and interhemispheric inhibition) are altered even in early MS, and yield complementary information on subclinical changes. Pathological brain plasticity in MS has been demonstrated by paired associative stimulation studies revealing a compensatory role of the ipsilateral motor and premotor areas. Central motor fatigue is associated with reduced motor EP amplitudes and increased cortical silent periods in normal controls, whereas patients with MS suffering from subjective fatigue show various abnormalities in cortical modulation of the motor system.
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Affiliation(s)
- Regina Schlaeger
- Department of Neurology, Hospitals of the University of Basel, Basel, Switzerland
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Vigeveno RM, Wiebenga OT, Wattjes MP, Geurts JJG, Barkhof F. Shifting imaging targets in multiple sclerosis: from inflammation to neurodegeneration. J Magn Reson Imaging 2012; 36:1-19. [PMID: 22696123 DOI: 10.1002/jmri.23578] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Classically multiple sclerosis (MS) has been regarded as an auto-immune disease of the white matter in the central nervous system leading to severe disability over the course of several decades. Current therapeutic strategies in MS are mostly based on either immune suppression or immune modulation. Although effective in decreasing relapse frequency and severity as well as delaying disease progression, MS pathology ensues nonetheless. In the last decade it became evident that gray matter pathology plays an important role in disease progression and helps explaining certain aspects of MS-related disability such as cognitive decline. Conventional MRI outcome measures commonly used in clinical trials are sufficient to demonstrate an anti-inflammatory drug-effect but lack pathological specificity and are poor to moderate predictors of disability. In this article, we review new insights in gray matter pathology and functional reorganization in MS and how these novel fields in MS research may validate and establish new MRI outcome measures, aid in the development of new therapeutic strategies for neuroprotection and neurorepair, and may lead to development of novel predictive measures of disability and disease progression in MS.
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Affiliation(s)
- René M Vigeveno
- VU University Medical Center, Department of Radiology, Amsterdam, the Netherlands
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Tomassini V, Matthews PM, Thompson AJ, Fuglø D, Geurts JJ, Johansen-Berg H, Jones DK, Rocca MA, Wise RG, Barkhof F, Palace J. Neuroplasticity and functional recovery in multiple sclerosis. Nat Rev Neurol 2012; 8:635-46. [PMID: 22986429 PMCID: PMC3770511 DOI: 10.1038/nrneurol.2012.179] [Citation(s) in RCA: 107] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
The development of therapeutic strategies that promote functional recovery is a major goal of multiple sclerosis (MS) research. Neuroscientific and methodological advances have improved our understanding of the brain's recovery from damage, generating novel hypotheses about potential targets and modes of intervention, and laying the foundation for development of scientifically informed recovery-promoting strategies in interventional studies. This Review aims to encourage the transition from characterization of recovery mechanisms to development of strategies that promote recovery in MS. We discuss current evidence for functional reorganization that underlies recovery and its implications for development of new recovery-oriented strategies in MS. Promotion of functional recovery requires an improved understanding of recovery mechanisms that can be modulated by interventions and the development of robust measurements of therapeutic effects. As imaging methods can be used to measure functional and structural alterations associated with recovery, this Review discusses their use to obtain reliable markers of the effects of interventions.
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Excitability decreasing central motor plasticity is retained in multiple sclerosis patients. BMC Neurol 2012; 12:92. [PMID: 22974055 PMCID: PMC3488470 DOI: 10.1186/1471-2377-12-92] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2012] [Accepted: 09/05/2012] [Indexed: 11/24/2022] Open
Abstract
Background Compensation of brain injury in multiple sclerosis (MS) may in part work through mechanisms involving neuronal plasticity on local and interregional scales. Mechanisms limiting excessive neuronal activity may have special significance for retention and (re-)acquisition of lost motor skills in brain injury. However, previous neurophysiological studies of plasticity in MS have investigated only excitability enhancing plasticity and results from neuroimaging are ambiguous. Thus, the aim of this study was to probe long-term depression-like central motor plasticity utilizing continuous theta-burst stimulation (cTBS), a non-invasive brain stimulation protocol. Because cTBS also may trigger behavioral effects through local interference with neuronal circuits, this approach also permitted investigating the functional role of the primary motor cortex (M1) in force control in patients with MS. Methods We used cTBS and force recordings to examine long-term depression-like central motor plasticity and behavioral consequences of a M1 lesion in 14 patients with stable mild-to-moderate MS (median EDSS 1.5, range 0 to 3.5) and 14 age-matched healthy controls. cTBS consisted of bursts (50 Hz) of three subthreshold biphasic magnetic stimuli repeated at 5 Hz for 40 s over the hand area of the left M1. Corticospinal excitability was probed via motor-evoked potentials (MEP) in the abductor pollicis brevis muscle over M1 before and after cTBS. Force production performance was assessed in an isometric right thumb abduction task by recording the number of hits into a predefined force window. Results cTBS reduced MEP amplitudes in the contralateral abductor pollicis brevis muscle to a comparable extent in control subjects (69 ± 22% of baseline amplitude, p < 0.001) and in MS patients (69 ± 18%, p < 0.001). In contrast, post-cTBS force production performance was only impaired in controls (2.2 ± 2.8, p = 0.011), but not in MS patients (2.0 ± 4.4, p = 0.108). The decline in force production performance following cTBS correlated with corticomuscular latencies (CML) in MS patients, but did not correlate with MEP amplitude reduction in patients or controls. Conclusions Long-term depression-like plasticity remains largely intact in mild-to-moderate MS. Increasing brain injury may render the neuronal networks less responsive toward lesion-induction by cTBS.
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Dinh JE, Lord RG. Implications of dispositional and process views of traits for individual difference research in leadership. LEADERSHIP QUARTERLY 2012. [DOI: 10.1016/j.leaqua.2012.03.003] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Tomassini V, Johansen-Berg H, Jbabdi S, Wise RG, Pozzilli C, Palace J, Matthews PM. Relating brain damage to brain plasticity in patients with multiple sclerosis. Neurorehabil Neural Repair 2012; 26:581-93. [PMID: 22328685 PMCID: PMC3674542 DOI: 10.1177/1545968311433208] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Failure of adaptive plasticity with increasing pathology is suggested to contribute to progression of disability in multiple sclerosis (MS). However, functional impairments can be reduced with practice, suggesting that brain plasticity is preserved even in patients with substantial damage. OBJECTIVE . Here, functional magnetic resonance imaging (fMRI) was used to probe systems-level mechanisms of brain plasticity associated with improvements in visuomotor performance in MS patients and related to measures of microstructural damage. METHODS 23 MS patients and 12 healthy controls underwent brain fMRI during the first practice session of a visuomotor task (short-term practice) and after 2 weeks of daily practice with the same task (longer-term practice). Participants also underwent a structural brain MRI scan. RESULTS Patients performed more poorly than controls at baseline. Nonetheless, with practice, patients showed performance improvements similar to controls and independent of the extent of MRI measures of brain pathology. Different relationships between performance improvements and activations were found between groups: greater short-term improvements were associated with lower activation in the sensorimotor, posterior cingulate, and parahippocampal cortices for patients, whereas greater long-term improvements correlated with smaller activation reductions in the visual cortex of controls. CONCLUSIONS Brain plasticity for visuomotor practice is preserved in MS patients despite a high burden of cerebral pathology. Cognitive systems different from those acting in controls contribute to this plasticity in patients. These findings challenge the notion that increasing pathology is accompanied by an outright failure of adaptive plasticity, supporting a neuroscientific rationale for recovery-oriented strategies even in chronically disabled patients.
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Affiliation(s)
- Valentina Tomassini
- Oxford Centre for Functional MRI of the Brain (FMRIB), University of Oxford, Oxford, UK.
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Richiardi J, Gschwind M, Simioni S, Annoni JM, Greco B, Hagmann P, Schluep M, Vuilleumier P, Van De Ville D. Classifying minimally disabled multiple sclerosis patients from resting state functional connectivity. Neuroimage 2012; 62:2021-33. [PMID: 22677149 DOI: 10.1016/j.neuroimage.2012.05.078] [Citation(s) in RCA: 62] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2012] [Revised: 05/25/2012] [Accepted: 05/28/2012] [Indexed: 01/21/2023] Open
Abstract
Multiple sclerosis (MS), a variable and diffuse disease affecting white and gray matter, is known to cause functional connectivity anomalies in patients. However, related studies published to-date are post hoc; our hypothesis was that such alterations could discriminate between patients and healthy controls in a predictive setting, laying the groundwork for imaging-based prognosis. Using functional magnetic resonance imaging resting state data of 22 minimally disabled MS patients and 14 controls, we developed a predictive model of connectivity alterations in MS: a whole-brain connectivity matrix was built for each subject from the slow oscillations (<0.11 Hz) of region-averaged time series, and a pattern recognition technique was used to learn a discriminant function indicating which particular functional connections are most affected by disease. Classification performance using strict cross-validation yielded a sensitivity of 82% (above chance at p<0.005) and specificity of 86% (p<0.01) to distinguish between MS patients and controls. The most discriminative connectivity changes were found in subcortical and temporal regions, and contralateral connections were more discriminative than ipsilateral connections. The pattern of decreased discriminative connections can be summarized post hoc in an index that correlates positively (ρ=0.61) with white matter lesion load, possibly indicating functional reorganisation to cope with increasing lesion load. These results are consistent with a subtle but widespread impact of lesions in white matter and in gray matter structures serving as high-level integrative hubs. These findings suggest that predictive models of resting state fMRI can reveal specific anomalies due to MS with high sensitivity and specificity, potentially leading to new non-invasive markers.
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Affiliation(s)
- Jonas Richiardi
- Department of Radiology and Medical Informatics, University of Geneva, Geneva, Switzerland.
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Mechanisms underlying muscle fatigue differ between multiple sclerosis patients and controls: A combined electrophysiological and neuroimaging study. Neuroimage 2012; 59:3110-8. [DOI: 10.1016/j.neuroimage.2011.11.038] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2011] [Revised: 10/23/2011] [Accepted: 11/11/2011] [Indexed: 11/30/2022] Open
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Döring A, Pfueller CF, Paul F, Dörr J. Exercise in multiple sclerosis -- an integral component of disease management. EPMA J 2011; 3:2. [PMID: 22738091 PMCID: PMC3375103 DOI: 10.1007/s13167-011-0136-4] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2011] [Accepted: 12/02/2011] [Indexed: 11/28/2022]
Abstract
Multiple sclerosis (MS) is the most common chronic inflammatory disorder of the central nervous system (CNS) in young adults. The disease causes a wide range of symptoms depending on the localization and characteristics of the CNS pathology. In addition to drug-based immunomodulatory treatment, both drug-based and non-drug approaches are established as complementary strategies to alleviate existing symptoms and to prevent secondary diseases. In particular, physical therapy like exercise and physiotherapy can be customized to the individual patient's needs and has the potential to improve the individual outcome. However, high quality systematic data on physical therapy in MS are rare. This article summarizes the current knowledge on the influence of physical activity and exercise on disease-related symptoms and physical restrictions in MS patients. Other treatment strategies such as drug treatments or cognitive training were deliberately excluded for the purposes of this article.
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Affiliation(s)
- Andrea Döring
- NeuroCure Clinical Research Center and Clinical and Experimental Research Center for Multiple Sclerosis, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, Germany.
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Peres I, Vetter C, Blautzik J, Reiser M, Pöppel E, Meindl T, Roenneberg, T, Gutyrchik E. Chronotype Predicts Activity Patterns in the Neural Underpinnings of the Motor System During the Day. Chronobiol Int 2011; 28:883-9. [DOI: 10.3109/07420528.2011.619084] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Kern KC, Ekstrom AD, Suthana NA, Giesser BS, Montag M, Arshanapalli A, Bookheimer SY, Sicotte NL. Fornix damage limits verbal memory functional compensation in multiple sclerosis. Neuroimage 2011; 59:2932-40. [PMID: 22001266 DOI: 10.1016/j.neuroimage.2011.09.071] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2011] [Revised: 08/30/2011] [Accepted: 09/24/2011] [Indexed: 11/29/2022] Open
Abstract
Selective atrophy of the hippocampus, in particular the left CA1 subregion, is detectable in relapsing-remitting MS (RRMS) and is correlated with verbal memory performance. We used novel high-resolution imaging techniques to assess the role that functional compensation and/or white matter integrity of mesial temporal lobe (MTL) structures may play in mediating verbal memory performance in RRMS. High-resolution cortical unfolding of structural MRI in conjunction with functional magnetic resonance imaging (fMRI) was used to localize MTL activity in 18 early RRMS patients and 16 healthy controls during an unrelated word-pairs memory task. Diffusion tensor imaging (DTI) and Tract-Based Spatial Statistics (TBSS) were used to assess the integrity of the fornix and the parahippocampal white matter (PHWM), the major efferents and afferents of the hippocampus. RRMS patients showed greater activity in hippocampal and extra-hippocampal areas during unrelated word-pair learning and recall. Increased hippocampal activity, particularly in the right anterior hippocampus and left anterior CA1 was associated with higher verbal memory scores. Furthermore, increased fractional anisotropy (FA) in the fornix was correlated with both greater fMRI activity in this region and better memory performance. Altered hippocampal fMRI activity in RRMS patients during verbal learning may result from both structural damage and compensatory mechanisms. Successful functional compensation for hippocampal involvement in RRMS may be limited in part by white matter damage to the fornix, consistent with the critical role of this pathway in the clinical expression of memory impairment in MS.
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Affiliation(s)
- Kyle C Kern
- Department of Neurology, David Geffen School of Medicine at University of California Los Angeles, CA 90048, USA
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