TY - JOUR
T1 - Functional correlates of motor control impairments in multiple sclerosis
T2 - A 7 Tesla task functional MRI study
AU - Strik, Myrte
AU - Shanahan, Camille J.
AU - van der Walt, Anneke
AU - Boonstra, Frederique M.C.
AU - Glarin, Rebecca
AU - Galea, Mary P.
AU - Kilpatrick, Trevor J.
AU - Geurts, Jeroen J.G.
AU - Cleary, Jon O.
AU - Schoonheim, Menno M.
AU - Kolbe, Scott C.
PY - 2021/6/1
Y1 - 2021/6/1
N2 - Upper and lower limb impairments are common in people with multiple sclerosis (pwMS), yet difficult to clinically identify in early stages of disease progression. Tasks involving complex motor control can potentially reveal more subtle deficits in early stages, and can be performed during functional MRI (fMRI) acquisition, to investigate underlying neural mechanisms, providing markers for early motor progression. We investigated brain activation during visually guided force matching of hand or foot in 28 minimally disabled pwMS (Expanded Disability Status Scale (EDSS) < 4 and pyramidal and cerebellar Kurtzke Functional Systems Scores ≤ 2) and 17 healthy controls (HC) using ultra-high field 7-Tesla fMRI, allowing us to visualise sensorimotor network activity in high detail. Task activations and performance (tracking lag and error) were compared between groups, and correlations were performed. PwMS showed delayed (+124 s, p =.002) and more erroneous (+0.15 N, p =.001) lower limb tracking, together with lower cerebellar, occipital and superior parietal cortical activation compared to HC. Lower activity within these regions correlated with worse EDSS (p =.034), lower force error (p =.006) and higher lesion load (p <.05). Despite no differences in upper limb task performance, pwMS displayed lower inferior occipital cortical activation. These results demonstrate that ultra-high field fMRI during complex hand and foot tracking can identify subtle impairments in lower limb movements and upper and lower limb brain activity, and differentiates upper and lower limb impairments in minimally disabled pwMS.
AB - Upper and lower limb impairments are common in people with multiple sclerosis (pwMS), yet difficult to clinically identify in early stages of disease progression. Tasks involving complex motor control can potentially reveal more subtle deficits in early stages, and can be performed during functional MRI (fMRI) acquisition, to investigate underlying neural mechanisms, providing markers for early motor progression. We investigated brain activation during visually guided force matching of hand or foot in 28 minimally disabled pwMS (Expanded Disability Status Scale (EDSS) < 4 and pyramidal and cerebellar Kurtzke Functional Systems Scores ≤ 2) and 17 healthy controls (HC) using ultra-high field 7-Tesla fMRI, allowing us to visualise sensorimotor network activity in high detail. Task activations and performance (tracking lag and error) were compared between groups, and correlations were performed. PwMS showed delayed (+124 s, p =.002) and more erroneous (+0.15 N, p =.001) lower limb tracking, together with lower cerebellar, occipital and superior parietal cortical activation compared to HC. Lower activity within these regions correlated with worse EDSS (p =.034), lower force error (p =.006) and higher lesion load (p <.05). Despite no differences in upper limb task performance, pwMS displayed lower inferior occipital cortical activation. These results demonstrate that ultra-high field fMRI during complex hand and foot tracking can identify subtle impairments in lower limb movements and upper and lower limb brain activity, and differentiates upper and lower limb impairments in minimally disabled pwMS.
KW - disability
KW - lower limb
KW - motor control
KW - multiple sclerosis
KW - task functional MRI
KW - ultra-high field MRI
KW - upper limb
UR - http://www.scopus.com/inward/record.url?scp=85101993966&partnerID=8YFLogxK
U2 - 10.1002/hbm.25389
DO - 10.1002/hbm.25389
M3 - Article
C2 - 33666314
AN - SCOPUS:85101993966
SN - 1065-9471
VL - 42
JO - Human Brain Mapping
JF - Human Brain Mapping
IS - 8
ER -