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Abstract
Objective: This study explores default-mode network (DMN) abnormalities in patients with secondary progressive (SP) and primary progressive (PP) multiple sclerosis (MS) and whether such abnormalities correlate with cognitive impairment and damage to selected white matter (WM) fiber bundles, quantified using diffusion tensor (DT) MRI tractography.
Methods: Resting state (RS) functional MRI and DT MRI data were acquired from 33 patients with SPMS, 24 patients with PPMS, and 24 controls. Independent component analysis (ICA) was used to identify the DMN. SPM5 was used to assess within- and between-group activations.
Results: Between-group differences in DMN activity were found in the left medial prefrontal cortex (mPFC), left precentral gyrus (PcG), and anterior cingulate cortex (ACC). Compared to controls, patients with SPMS had reduced activity in the mPFC (p = 0.01) and PcG (p = 0.02), while patients with PPMS had reduced activity in the PcG (p = 0.008) and the ACC (p = 0.002). Compared to patients with PPMS, patients with SPMS had increased ACC activity (p = 0.04). Reduction of RS activity in the ACC was more pronounced in cognitively impaired vs cognitively preserved patients with MS (p = 0.02). In patients with MS, DMN abnormalities correlated with the PASAT and word list test scores (r values ranging from 0.35 to 0.45) and DT MRI changes in the corpus callosum and the cingulum (r values ranging from 0.82 to 0.87).
Conclusion: These results suggest that a dysfunction of the anterior components of the default-mode network may be among the factors responsible for the accumulation of cognitive deficits in patients with progressive multiple sclerosis.
Glossary
- ACC=
- anterior cingulate cortex;
- ANOVA=
- analysis of variance;
- CC=
- corpus callosum;
- CST=
- corticospinal tract;
- DMN=
- default-mode network;
- DT=
- diffusion tensor;
- EDSS=
- Expanded Disability Status Scale;
- EPI=
- echoplanar imaging;
- FA=
- fractional anisotropy;
- fMRI=
- functional MRI;
- FOV=
- field of view;
- ICA=
- independent component analysis;
- LV=
- lesion volume;
- MD=
- mean diffusivity;
- MDL=
- minimum description length;
- mPFC=
- medial prefrontal cortex;
- MS=
- multiple sclerosis;
- PASAT=
- Paced Auditory Serial Attention Test;
- PCA=
- principal component analysis;
- PCC=
- posterior cingulate cortex;
- PcG=
- precentral gyrus;
- PFC=
- prefrontal cortex;
- PP=
- primary progressive;
- ROCF=
- Rey-Osterrieth Complex Figure;
- RS=
- resting state;
- RSN=
- resting-state network;
- SP=
- secondary progressive;
- TE=
- echo time;
- tICA=
- tensorial ICA;
- TR=
- repetition time;
- TSE=
- turbo spin echo;
- WM=
- white matter.
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