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Increased connectivity of hub networks and cognitive impairment in multiple sclerosis.
Neurology 2017; 88(22):2107-2114Neur

Abstract

OBJECTIVE

To investigate default-mode network (DMN) and frontoparietal network (FPN) dysfunction in cognitively impaired (CI) patients with multiple sclerosis (MS) because these networks strongly relate to cognition and contain most of the hubs of the brain.

METHODS

Resting-state fMRI and neuropsychological assessments were performed in 322 patients with MS and 96 healthy controls (HCs). Patients with MS were classified as CI (z score < -2.0 on at least 2 tests; n = 87), mildly cognitively impaired (z score < -1.5 on at least 2 tests and not CI; n = 65), and cognitively preserved (CP; n = 180). Within-network connectivity, connectivity with the rest of the brain, and between-network connectivity were calculated and compared between groups. Connectivity values were normalized for individual means and SDs.

RESULTS

Only in CI, both the DMN and FPN showed increased connectivity with the rest of the brain compared to HCs and CP, with no change in within- or between-network connectivity. Regionally, this increased connectivity was driven by the inferior parietal, posterior cingulate, and angular gyri. Increased connectivity with the rest of the brain correlated with worse cognitive performance, namely attention for the FPN as well as information processing speed and working memory for both networks.

CONCLUSIONS

In CI patients with MS, the DMN and FPN showed increased connectivity with the rest of the brain, while normal within- and between-network connectivity levels were maintained. These findings indicate that cognitive impairment in MS features disturbed communication of hub-rich networks, but only with the more peripheral (i.e., nonhub) regions of the brain.

Authors+Show Affiliations

From the Departments of Anatomy and Neurosciences (K.A.M., A.J.C.E., L.D., J.J.G.G., M.M.S.), Neurology (B.M.J.U.), and Radiology and Nuclear Medicine (F.B.), VUmc MS Center Amsterdam, Amsterdam Neuroscience Campus, VU University Medical Center, the Netherlands; and Institutes of Neurology and Healthcare Engineering (F.B.), University College London, London, UK. k.meijer@vumc.nl.From the Departments of Anatomy and Neurosciences (K.A.M., A.J.C.E., L.D., J.J.G.G., M.M.S.), Neurology (B.M.J.U.), and Radiology and Nuclear Medicine (F.B.), VUmc MS Center Amsterdam, Amsterdam Neuroscience Campus, VU University Medical Center, the Netherlands; and Institutes of Neurology and Healthcare Engineering (F.B.), University College London, London, UK.From the Departments of Anatomy and Neurosciences (K.A.M., A.J.C.E., L.D., J.J.G.G., M.M.S.), Neurology (B.M.J.U.), and Radiology and Nuclear Medicine (F.B.), VUmc MS Center Amsterdam, Amsterdam Neuroscience Campus, VU University Medical Center, the Netherlands; and Institutes of Neurology and Healthcare Engineering (F.B.), University College London, London, UK.From the Departments of Anatomy and Neurosciences (K.A.M., A.J.C.E., L.D., J.J.G.G., M.M.S.), Neurology (B.M.J.U.), and Radiology and Nuclear Medicine (F.B.), VUmc MS Center Amsterdam, Amsterdam Neuroscience Campus, VU University Medical Center, the Netherlands; and Institutes of Neurology and Healthcare Engineering (F.B.), University College London, London, UK.From the Departments of Anatomy and Neurosciences (K.A.M., A.J.C.E., L.D., J.J.G.G., M.M.S.), Neurology (B.M.J.U.), and Radiology and Nuclear Medicine (F.B.), VUmc MS Center Amsterdam, Amsterdam Neuroscience Campus, VU University Medical Center, the Netherlands; and Institutes of Neurology and Healthcare Engineering (F.B.), University College London, London, UK.From the Departments of Anatomy and Neurosciences (K.A.M., A.J.C.E., L.D., J.J.G.G., M.M.S.), Neurology (B.M.J.U.), and Radiology and Nuclear Medicine (F.B.), VUmc MS Center Amsterdam, Amsterdam Neuroscience Campus, VU University Medical Center, the Netherlands; and Institutes of Neurology and Healthcare Engineering (F.B.), University College London, London, UK.From the Departments of Anatomy and Neurosciences (K.A.M., A.J.C.E., L.D., J.J.G.G., M.M.S.), Neurology (B.M.J.U.), and Radiology and Nuclear Medicine (F.B.), VUmc MS Center Amsterdam, Amsterdam Neuroscience Campus, VU University Medical Center, the Netherlands; and Institutes of Neurology and Healthcare Engineering (F.B.), University College London, London, UK.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

28468841

Citation

Meijer, Kim A., et al. "Increased Connectivity of Hub Networks and Cognitive Impairment in Multiple Sclerosis." Neurology, vol. 88, no. 22, 2017, pp. 2107-2114.
Meijer KA, Eijlers AJC, Douw L, et al. Increased connectivity of hub networks and cognitive impairment in multiple sclerosis. Neurology. 2017;88(22):2107-2114.
Meijer, K. A., Eijlers, A. J. C., Douw, L., Uitdehaag, B. M. J., Barkhof, F., Geurts, J. J. G., & Schoonheim, M. M. (2017). Increased connectivity of hub networks and cognitive impairment in multiple sclerosis. Neurology, 88(22), pp. 2107-2114. doi:10.1212/WNL.0000000000003982.
Meijer KA, et al. Increased Connectivity of Hub Networks and Cognitive Impairment in Multiple Sclerosis. Neurology. 2017 May 30;88(22):2107-2114. PubMed PMID: 28468841.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Increased connectivity of hub networks and cognitive impairment in multiple sclerosis. AU - Meijer,Kim A, AU - Eijlers,Anand J C, AU - Douw,Linda, AU - Uitdehaag,Bernard M J, AU - Barkhof,Frederik, AU - Geurts,Jeroen J G, AU - Schoonheim,Menno M, Y1 - 2017/05/03/ PY - 2016/07/28/received PY - 2017/03/06/accepted PY - 2017/5/5/pubmed PY - 2017/6/6/medline PY - 2017/5/5/entrez SP - 2107 EP - 2114 JF - Neurology JO - Neurology VL - 88 IS - 22 N2 - OBJECTIVE: To investigate default-mode network (DMN) and frontoparietal network (FPN) dysfunction in cognitively impaired (CI) patients with multiple sclerosis (MS) because these networks strongly relate to cognition and contain most of the hubs of the brain. METHODS: Resting-state fMRI and neuropsychological assessments were performed in 322 patients with MS and 96 healthy controls (HCs). Patients with MS were classified as CI (z score < -2.0 on at least 2 tests; n = 87), mildly cognitively impaired (z score < -1.5 on at least 2 tests and not CI; n = 65), and cognitively preserved (CP; n = 180). Within-network connectivity, connectivity with the rest of the brain, and between-network connectivity were calculated and compared between groups. Connectivity values were normalized for individual means and SDs. RESULTS: Only in CI, both the DMN and FPN showed increased connectivity with the rest of the brain compared to HCs and CP, with no change in within- or between-network connectivity. Regionally, this increased connectivity was driven by the inferior parietal, posterior cingulate, and angular gyri. Increased connectivity with the rest of the brain correlated with worse cognitive performance, namely attention for the FPN as well as information processing speed and working memory for both networks. CONCLUSIONS: In CI patients with MS, the DMN and FPN showed increased connectivity with the rest of the brain, while normal within- and between-network connectivity levels were maintained. These findings indicate that cognitive impairment in MS features disturbed communication of hub-rich networks, but only with the more peripheral (i.e., nonhub) regions of the brain. SN - 1526-632X UR - https://www.unboundmedicine.com/medline/citation/28468841/Increased_connectivity_of_hub_networks_and_cognitive_impairment_in_multiple_sclerosis_ L2 - http://www.neurology.org/cgi/pmidlookup?view=long&amp;pmid=28468841 DB - PRIME DP - Unbound Medicine ER -