Is a preserved functional reserve a mechanism limiting clinical impairment in pediatric MS patients?

Full Abstract

We evaluated the functional magnetic resonance imaging (fMRI) correlates of simple movement performance in patients with pediatric multiple sclerosis (MS) and their relation with the extent of T2 lesion volume (LV), to improve our understanding of the mechanisms leading to their short/medium term favorable clinical course. We obtained fMRI during repetitive flexion-extension of the last four fingers of the right hand and brain dual-echo scans from 17 right-handed patients with pediatric relapsing-remitting MS and 9 sex- and age-matched right-handed healthy controls. T2 LV was measured using a local thresholding segmentation technique. fMRI activations and functional connectivity analysis were performed using SPM2. Compared to controls, pediatric MS patients had an increased recruitment of the left (L) primary sensorimotor cortex (SMC). They also showed reduced functional connectivity between the L primary SMC and the L thalamus (P = 0.03), the L insula and the L secondary sensorimotor cortex (SII) (P = 0.02), the supplementary motor area and the L SII (P = 0.02), the L thalamus and the L insula (P = 0.01) and the L thalamus and the L SII (P = 0.003). In patients with pediatric MS, the activity of the L primary SMC was significantly correlated with brain T2 LV (r = 0.78). No correlation was found between coefficients of abnormal connectivity and structural MRI measures. The maintenance of a selective and strictly lateralized pattern of movement-associated brain activations and a modulation of its functional connections suggest a preserved functional reserve in patients with pediatric MS, which, in turn, might contribute to explain their favorable clinical evolution at short/medium term. 2008 Wiley-Liss, Inc.

Author information

Author/s: Rocca, Maria A (MA); Absinta, Martina (M); Ghezzi, Angelo (A); Moiola, Lucia (L); Comi, Giancarlo (G); Filippi, Massimo (M);

Affiliation: Neuroimaging Research Unit, Scientific Institute and University Ospedale San Raffaele, Milan, Italy.

Journal and publication information

Publication Type: Journal Article; Research Support, Non-U.S. Gov't

Journal: Human brain mapping (Hum Brain Mapp), published in United States. (Language: eng)

Reference: 2009-Sep; vol 30 (issue 9) : pp 2844-51

Dates: Created 2009/08/27; Completed 2009/11/13;

PMID: 19107755, status: MEDLINE (last retrieved date: 11/15/2009)

Sourced from the National Library of Medicine. Abstract text and other information may be subject to copyright.

External Links for this article
(including full text providers, if available):

Click Electronic Full-text Provider Links to see options for finding the electronic full text links to this article. Note there may be a subscription or fee required for access to the full text. See our FAQ for information on finding FREE full text articles.

This article may also be located in paper journal collections available in many libraries. Use the Journal and Publication Information above to find the full article.