Cognitive rehabilitation correlates with the functional connectivity of the anterior cingulate cortex in patients with multiple sclerosis

Abstract

We investigated how resting state (RS) functional connectivity (FC) of the anterior cingulate cortex (ACC) correlates with cognitive rehabilitation in relapsing remitting multiple sclerosis (RRMS) patients. A neuropsychological assessment and RS fMRI at baseline and after 12 weeks were obtained from 20 RRMS patients, who were assigned randomly to undergo treatment (n = 10) (treatment group-TG), which entailed computer-assisted cognitive rehabilitation of attention/information processing and executive functions for 3 days/week, or not to receive any cognitive rehabilitation (n = 10) (control group-CG). Voxel-wise changes of ACC RS FC were assessed using SPM8. In both groups, at the two study time points, ACC activity was correlated with the bilateral middle and inferior frontal gyrus, basal ganglia, posterior cingulate cortex, cerebellum, precuneus, middle temporal gyrus, and inferior parietal lobule (IPL). At follow up, compared to baseline, the TG showed an increased FC of the ACC with the right middle frontal gyrus (MFG) and right IPL, while the CG showed a decreased FC of the ACC with the right cerebellum and right inferior temporal gyrus (ITG). A significant "treatment × time" interaction was found for the increased FC of the right IPL and for the decreased FC of the right ITG. In the TG only, significant correlations (p < 0.001) were found between improvement of PASAT performance and RS FC of the ACC with the right MFG (r = 0.88) and right IPL (r = 0.76). In MS, cognitive rehabilitation correlates with changes in RS FC of brain regions subserving the trained functions. fMRI might be useful to monitor rehabilitative strategies in MS.

Changes of brain resting state functional connectivity predict the persistence of cognitive rehabilitation effects in patients with multiple sclerosis

“…In the control group, a decreased RS FC between the ACC and the right cerebellum and right inferior temporal gyrus (ITG) was detected. 3 A recent neuropsychological re-assessment of these patients showed that the positive effect on neuropsychological performance was still detectable six months after treatment termination and resulted in an improvement measured on quality of life and depression scales. 11 The aim of this study was to investigate the relationship between fMRI changes observed during the rehabilitation period, and neuropsychological performance at six-month follow-up.…”

Sex Differences in Resting-State Functional Connectivity in Multiple Sclerosis

“…21 Pa-tients with MS show differences in both the pattern and magnitude of fcMRI values, and there is some indication that these changes are related to the level of disease burden and cognitive deficits. 20,[22][23][24][25][26] In particular, connectivity between the posterior cingulate and other structures in the default mode network has shown a relationship with cognition. 23,27 It is unclear whether fcMRI values are affected by sex.…”

Neurorehabilitation in Persons with Multiple Sclerosis: Scientific Basis and Options of Treatment

“…Subsequently, the same research group investigated how resting state functional connectivity (FC) of anterior cingulated cortex correlates with cognitive training. At follow-up, the anterior cingulum showed an increased FC with the right inferior parietal lobule and decreased FC with the right inferior temporal gyrus in the treated group only; some of these FC modifications significantly correlated to enhanced PASAT scores after the training [79].…”