Impaired cortical deactivation during hand movement in the relapsing phase of multiple sclerosis: A cross-sectional and longitudinal fMRI study

Department of Neurology and Psychiatry, Sapienza University of Rome, Italy.
Multiple Sclerosis (Impact Factor: 4.82). 06/2011; 17(10):1177-84. DOI: 10.1177/1352458511411757
Source: PubMed


Little is known about the cortical activation changes during clinical relapses in multiple sclerosis (MS).
To assess cross-sectional and longitudinal differences in functional magnetic resonance imaging (fMRI) cortical patterns between the relapsing and stable phases of MS.
We studied 32 patients with relapsing-remitting MS with mild disability: 19 within 48 h of symptom onset of a new relapse (G1) and 13 in the stable phase, relapse-free for at least 6 months (G2). All patients underwent fMRI twice, upon entry (time 1) and 30-50 days later (time 2), during right-hand movement.
No between-group differences were observed in age, disability or T2 lesion load. Between-group analysis showed a significant difference in the ipsilateral precentral gyrus (IPG) activation at time 1. Activity differences in the IPG expressed reduced deactivation in G1 compared with G2. Longitudinal changes in brain activity in the IPG were significantly greater in G1 than G2. G1 patients with a slow clinical recovery (n = 8) showed different activity at baseline and greater activity changes over time in the IPG than patients with a fast recovery (n = 11).
This study shows that the relapsing phase is associated with reduced brain deactivation in the IPG, which is more marked in patients with a slow clinical recovery. Increased cortical excitability associated with inflammation may determine functional modifications within the ipsilateral motor area.

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    • "In MS, periventricular radial lesions, known as “Dawson's fingers,” track along the deep medullary veins that course perpendicularly to the wall of the ventricles [19, 20]. Dawson's fingers help to differentiate MS from other white matter diseases [10, 21, 22]. Presence of central venule is a hallmark of periventricular MS lesions on ultra-high-field MRI, where it is present in ~80% of lesions [23]. "
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    ABSTRACT: Objective. To compare periventricular lesions in multiple sclerosis (MS) and neuromyelitis optica spectrum disorders (NMOsd). Materials and Methods. Sagittal and axial fluid attenuated inversion recovery (FLAIR) sequences of 20 NMOsd and 40 group frequency-matched MS patients were evaluated by two neuroradiologists. On axial FLAIR, periventricular area was characterized as free of lesions/smooth-bordered (“type A”) or jagged-bordered (“type B”) pattern. On sagittal FLAIR, the images were evaluated for presence of “Dawson’s fingers.” Results. Type A pattern was observed in 80% of NMOsd patients by Reader 1 and 85% by Reader 2 but only in 5% MS patients by either Reader. Type B was seen in 15% NMOsd patients by Reader 1 and 20% by Reader 2 and in 95% MS patients by either Reader. Dawson’s fingers were observed in no NMOsd patients by Reader 1 and 5% by Reader 2. In MS, Dawson’s fingers were seen in 92.5% patients by Reader 1 and 77.5% by Reader 2. The differences in periventricular patterns and Dawson’s finger detection between NMOsd and MS were highly significant ( P < 0.001 ). Conclusions. Dawson’s fingers and “jagged-bordered” periventricular hyperintensities are typical of MS and almost never seen in NMOsd, which suggests a practical method for differentiating the two diseases.
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    Full-text · Article · Jun 2015 · PLoS ONE
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