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  • Title: Two-year dynamic functional network connectivity in clinically isolated syndrome.
    Author: Rocca MA, Hidalgo de La Cruz M, Valsasina P, Mesaros S, Martinovic V, Ivanovic J, Drulovic J, Filippi M.
    Journal: Mult Scler; 2020 May; 26(6):645-658. PubMed ID: 30887875.
    Abstract:
    BACKGROUND: The features of functional network connectivity reorganization at the earliest stages of MS have not been investigated yet. OBJECTIVE: To combine static and dynamic analysis of resting state (RS) functional connectivity (FC) to identify mechanisms of clinical dysfunction and recovery occurring in clinically isolated syndrome (CIS) patients. METHODS: RS functional magnetic resonance imaging (fMRI) and clinical data were prospectively acquired from 50 CIS patients and 13 healthy controls (HC) at baseline, month 12 and month 24. Between-group differences and longitudinal evolution of network FC were analysed across 41 functionally relevant networks. RESULTS: At follow-up, 47 patients developed MS. Disability remained stable (and relatively low). CIS and HC exhibited two recurring RS FC states (states 1 and 2, showing low and high internetwork connectivity, respectively). At baseline, patients showed reduced state 2 connectivity strength in the default-mode and cerebellar networks, and no differences in global dynamism versus HC. A selective FC reduction in networks affected by the clinical attack was also detected. At follow-up, increased state 2 connectivity strength and global connectivity dynamism was observed in patients versus HC. CONCLUSION: Longitudinal FC modifications occurring relatively early in the course of multiple sclerosis may represent a protective mechanism contributing to preserve clinical function over time.
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