Document Detail

Cortical adaptation in patients with MS: a cross-sectional functional MRI study of disease phenotypes.
MedLine Citation:
PMID:  16168930     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Movement-associated cortical reorganisation is known to occur in multiple sclerosis (MS). We aimed to define the development of such cortical reorganisation by comparing data from patients with different disease phenotypes.
METHODS: We studied patients with different phenotypes of MS: 16 patients with a clinically isolated syndrome (CIS), 14 patients with relapsing-remitting MS (RRMS) and no disability, 15 patients with RRMS and mild clinical disability, and 12 patients with secondary progressive MS (SPMS). Patients did a simple motor task with their unimpaired dominant hand during MRI, which was compared across the phenotype groups.
FINDINGS: Patients with a CIS activated more of the contralateral primary sensorimotor cortex than those with RRMS and no disability, whereas patients with RRMS and no disability activated more of the supplementary motor area than those with a CIS. Patients with RRMS and no disability activated more of the primary sensorimotor cortex, bilaterally, and more of the ipsilateral supplementary motor area than patients with RRMS and mild clinical disability. Conversely, patients with RRMS and mild clinical disability activated more of the contralateral secondary somatosensory cortex and inferior frontal gyrus, and the ipsilateral precuneus. Patients with RRMS and mild clinical disability activated more of the contralateral thalamus and of the ipsilateral secondary somatosensory cortex than those with SPMS. However, patients with SPMS activated more of the inferior frontal gyrus, bilaterally, the middle frontal gyrus, bilaterally, the contralateral precuneus, and the ipsilateral cingulate motor area and inferior parietal lobule.
INTERPRETATION: Movement-associated cortical reorganisation in patients with MS seems to vary across individuals at different stages of disease. Our study suggests that early in the disease course more areas typically devoted to motor tasks are recruited. Then bilateral activation of these regions is seen, and late in the disease course, areas that healthy people recruit to do novel or complex tasks are activated.
Maria A Rocca; Bruno Colombo; Andrea Falini; Angelo Ghezzi; Vittorio Martinelli; Giuseppe Scotti; Giancarlo Comi; Massimo Filippi
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Lancet. Neurology     Volume:  4     ISSN:  1474-4422     ISO Abbreviation:  Lancet Neurol     Publication Date:  2005 Oct 
Date Detail:
Created Date:  2005-09-19     Completed Date:  2005-11-08     Revised Date:  2014-08-15    
Medline Journal Info:
Nlm Unique ID:  101139309     Medline TA:  Lancet Neurol     Country:  England    
Other Details:
Languages:  eng     Pagination:  618-26     Citation Subset:  IM    
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MeSH Terms
Adaptation, Physiological*
Brain Mapping
Cerebral Cortex / pathology,  physiopathology*
Cross-Sectional Studies
Fingers / physiology,  physiopathology
Functional Laterality / physiology*
Magnetic Resonance Imaging
Middle Aged
Motor Cortex / pathology,  physiopathology
Motor Skills / physiology
Movement Disorders / diagnosis,  etiology,  physiopathology*
Multiple Sclerosis / complications,  physiopathology*
Neural Pathways / pathology,  physiopathology
Neuronal Plasticity / physiology*
Recovery of Function / physiology
Comment In:
Lancet Neurol. 2005 Oct;4(10):589-90   [PMID:  16168924 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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