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This version was published on July 1, 2008
Multiple Sclerosis, Vol. 14, No. 6, 786-792 (2008)
DOI: 10.1177/1352458508089360

research-article

Efficiency of cognitive control recruitment in the very early stage of multiple sclerosis: a one-year fMRI follow-up study

B Audoin

Centre de Résonance Magnétique Biologique et Médicale, CRMBM UMR CNRS 6612, Faculté de Médecine, Université de la Méditerranée, Marseille, France; Pôle de Neurosciences cliniques, Service de Neurologie, CHU Timone, Marseille, France, bertrand.audoin{at}ap-hm.fr

F Reuter

Centre de Résonance Magnétique Biologique et Médicale, CRMBM UMR CNRS 6612, Faculté de Médecine, Université de la Méditerranée, Marseille, France

MVA Duong

Centre de Résonance Magnétique Biologique et Médicale, CRMBM UMR CNRS 6612, Faculté de Médecine, Université de la Méditerranée, Marseille, France

I Malikova

Centre de Résonance Magnétique Biologique et Médicale, CRMBM UMR CNRS 6612, Faculté de Médecine, Université de la Méditerranée, Marseille, France; Pôle de Neurosciences cliniques, Service de Neurologie, CHU Timone, Marseille, France

S Confort-Gouny

Centre de Résonance Magnétique Biologique et Médicale, CRMBM UMR CNRS 6612, Faculté de Médecine, Université de la Méditerranée, Marseille, France

AA Cherif

Pôle de Neurosciences cliniques, Service de Neurologie, CHU Timone, Marseille, France

PJ Cozzone

Centre de Résonance Magnétique Biologique et Médicale, CRMBM UMR CNRS 6612, Faculté de Médecine, Université de la Méditerranée, Marseille, France

J Pelletier

Centre de Résonance Magnétique Biologique et Médicale, CRMBM UMR CNRS 6612, Faculté de Médecine, Université de la Méditerranée, Marseille, France; Pôle de Neurosciences cliniques, Service de Neurologie, CHU Timone, Marseille, France

JP Ranjeva

Centre de Résonance Magnétique Biologique et Médicale, CRMBM UMR CNRS 6612, Faculté de Médecine, Université de la Méditerranée, Marseille, France

Functional magnetic resonance imaging (FMRI) studies have established that patients with multiple sclerosis show stronger activation in the lateral prefrontal cortices (LPFC) than healthy control subjects during effortful cognitive tasks. The aim of the present study was to assess the impact of these activation changes on cognitive performances. In addition to 19 controls, who were tested at a single time-point to define a standard pattern of fMRI activation during the performance of the Paced Auditory Serial Addition Task (PASAT), 13 patients with clinically isolated syndrome underwent a longitudinal fMRI examination while performing the PASAT at the beginning of the study (M0) and one year later (M12). Relative to the M0 scores, PASAT performances improved in eight patients (group A) and either decreased (n = 4) or remained unchanged (n = 1) (group B) in five patients at M12. Random effect analyses (SPM2; Wellcome Institute, London, England) were performed to compare intra-group time-related effects on brain activation (paired t-test between M0 and M12), and inter-group differences were also compared between the two groups of patients (analysis of covariance with PASAT performances as the covariate). Relative to group B, group A showed larger increase in activation between M0 and M12 in the right LPFC. In the whole group of patients, interaction analyses showed that the differences in the PASAT scores between M0 and M12 were correlated with the differences in activation observed in the right LPFC. This longitudinal study shows that in patients with early multiple sclerosis, the increased levels of activation in the right LPFC was associated with improved individual working memory and processing speed performances.

Key Words: clinically isolated syndrome • cognitive control • cortical reorganization • fMRI • longitudinal study • multiple sclerosis


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