The degree of cortical plasticity correlates with cognitive performance in patients with Multiple Sclerosis

Balloff, Carolin; Penner, Iris‐Katharina; Ma, Meng; Georgiades, Iason; Scala, Lina; Troullinakis, Nina; Graf, Jonas; Kremer, David; Aktaş, Orhan; Hartung, Hans‐Peter; Meuth, Sven G.; Schnitzler, Alfons; Groiss, Stefan Jun; Albrecht, Philipp

doi:10.1016/j.brs.2022.02.007

Cited by 12 publications

(18 citation statements)

References 55 publications

(58 reference statements)

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“…These results can show the role of functional reorganization in compensating for the damage and abnormalities in these cases. Moreover, results from a recent study showed a correlation between cortical plasticity and cognitive impairment in which the plasticity is reduced in cases with cognitive impairment compared to the cases with preserved cognitive function, and second, generally, the RRMS group did not show reduced cortical plasticity compared to the control group (Balloff et al, 2022). Although this study used a specific approach to investigate cortical reorganization and does not illustrate the difference between RRMS patients with normal cases, it shows that in RRMS cases without cognitive impairment, brain cortical reorganization compensates for structural damage.…”

Section: Discussionmentioning

confidence: 95%

Brain functional connectivity analysis in patients with relapsing-remitting multiple sclerosis: A graph theory approach of EEG resting state

Shirani

Mohebbi

2022

Front. Neurosci.

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Multiple sclerosis (MS) is an autoimmune disease related to the central nervous system (CNS). This study aims to investigate the effects of MS on the brain's functional connectivity network using the electroencephalogram (EEG) resting-state signals and graph theory approach. Resting-state eyes-closed EEG signals were recorded from 20 patients with relapsing-remitting MS (RRMS) and 18 healthy cases. In this study, the prime objective is to calculate the connectivity between EEG channels to assess the differences in brain functional network global features. The results demonstrated lower cortical activity in the alpha frequency bands and higher activity for the gamma frequency bands in patients with RRMS compared to the healthy group. In this study, graph metric calculations revealed a significant difference in the diameter of the functional brain network based on the directed transfer function (DTF) measure between the two groups, indicating a higher diameter in RRMS cases for the alpha frequency band. A higher diameter for the functional brain network in MS cases can result from anatomical damage. In addition, considerable differences between the networks' global efficiency and transitivity based on the imaginary part of the coherence (iCoh) measure were observed, indicating higher global efficiency and transitivity in the delta, theta, and beta frequency bands for RRMS cases, which can be related to the compensatory functional reaction from the brain. This study indicated that in RRMS cases, some of the global characteristics of the brain's functional network, such as diameter and global efficiency, change and can be illustrated even in the resting-state condition when the brain is not under cognitive load.

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Section: Discussionmentioning

confidence: 95%

Brain functional connectivity analysis in patients with relapsing-remitting multiple sclerosis: A graph theory approach of EEG resting state

Shirani

Mohebbi

2022

Front. Neurosci.

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“…We will apply TMS single pulses [ 74 ] via figure-eight coil (C-B60; inner diameter: 35mm, outer diameter: 75mm), connected to the MagPro R20 (MagVenture User Guide, United Kingdom edition, MagVenture A/S, Denmark). The coil will be oriented tangentially over the contralateral motor area of the brain, relative to the target muscle (i.e., APB), with a posterolateral handle pointing in approximately 45 degrees angle to the sagittal plane, as a result to induce current in a posterior-anterior direction in the brain [ 75 ].…”

Section: Methodsmentioning

confidence: 99%

Investigation of in-phase bilateral exercise effects on corticospinal plasticity in relapsing remitting multiple sclerosis: A registered report single-case concurrent multiple baseline design across five subjects

et al. 2023

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Relapsing-remitting Multiple Sclerosis is the most common demyelinating neurodegenerative disease and is characterized by periods of relapses and generation of various motor symptoms. These symptoms are associated with the corticospinal tract integrity, which is quantified by means of corticospinal plasticity which can be probed via transcranial magnetic stimulation and assessed with corticospinal excitability measures. Several factors, such as exercise and interlimb coordination, can influence corticospinal plasticity. Previous work in healthy and in chronic stroke survivors showed that the greatest improvement in corticospinal plasticity occurred during in-phase bilateral exercises of the upper limbs. During in-phase bilateral movement, both upper limbs are moving simultaneously, activating the same muscle groups and triggering the same brain region respectively. Altered corticospinal plasticity due to bilateral cortical lesions is common in MS, yet, the impact of these type of exercises in this cohort is unclear. The aim of this concurrent multiple baseline design study is to investigate the effects of in-phase bilateral exercises on corticospinal plasticity and on clinical measures using transcranial magnetic stimulation and standardized clinical assessment in five people with relapsing-remitting MS. The intervention protocol will last for 12 consecutive weeks (30–60 minutes /session x 3 sessions/week) and include in-phase bilateral movements of the upper limbs, adapted to different sports activities and to functional training. To define functional relation between the intervention and the results on corticospinal plasticity (central motor conduction time, resting motor threshold, motor evoked potential amplitude and latency) and on clinical measures (balance, gait, bilateral hand dexterity and strength, cognitive function), we will perform a visual analysis and if there is a potential sizeable effect, we will perform statistical analysis. A possible effect from our study, will introduce a proof-of-concept for this type of exercise that will be effective during disease progression. Trial registration: ClinicalTrials.gov NCT05367947.

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“…The copyright holder for this preprint this version posted July 15, 2022. ; https://doi.org/10.1101/2022.07.14.22277636 doi: medRxiv preprint motor area of the brain, relative to the target muscle (i.e., Abductor Pollicis Brevis), with a posterolateral handle pointing in approximately 45 degrees angle to the sagittal plane, as a result to induce current in a posterior-anterior direction in the brain (73).…”

Section: (Which Was Not Certified By Peer Review)mentioning

confidence: 99%

“…We will apply TMS single pulses (72) via figure-eight coil (C-B60; inner diameter: 35mm, outer diameter: 75mm), connected to the MagPro R20 (MagVenture User Guide, United Kingdom edition, MagVenture A/S, Denmark). The coil will be oriented tangentially over the contralateral motor area of the brain, relative to the target muscle (i.e., Abductor Pollicis Brevis), with a posterolateral handle pointing in approximately 45 degrees angle to the sagittal plane, as a result to induce current in a posterior-anterior direction in the brain (73).…”

Section: Data Acquisition Of Outcome Measuresmentioning

confidence: 99%

“…Any changes in all measures across time points, will indicate alterations in corticospinal plasticity (89). We will evaluate resting motor threshold using MTAT 2.0 (76) (available at http://clinicalresearcher.org/software.htm) and to investigate possible changes in individual corticospinal plasticity of each participant, we will calculate bilaterally the difference between the mean values of each phase (73,90). On the other hand, from each stimulus response during the suprathreshold stimulation (i.e., 120% of resting motor threshold) (89), we will calculate offline the MEP peak-to-peak amplitude and latency.…”

Section: Data Acquisition Of Outcome Measuresmentioning

confidence: 99%

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Investigation of in-phase bilateral exercise effects on corticospinal plasticity in relapsing remitting multiple sclerosis: a multiple baseline design

Sokratous

2022

Preprint

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Relapsing-remitting multiple sclerosis is the most common type of multiple sclerosis characterized by periods of relapses and generating various motor symptoms. These symptoms are associated with the corticospinal tract integrity, which is quantified by means of corticospinal plasticity which can be probed via transcranial magnetic stimulation and assessed with motor threshold, motor evoked potential and central motor conduction time. Several factors, such as exercise and interlimb coordination, can influence corticospinal plasticity. Previous work in healthy and in stroke patients showed that the greatest improvement in corticospinal plasticity occurred during in-phase bilateral arm exercises. Altered corticospinal plasticity due to bilateral cortical lesions is common in multiple sclerosis, yet, the impact of these type of exercises in this cohort is unclear. The aim of this concurrent multiple baseline design study is to investigate the effects of in-phase bilateral exercises on corticospinal plasticity and on clinical measures using transcranial magnetic stimulation and standardized clinical assessment, in five people with relapsing-remitting multiple sclerosis. The intervention protocol will last for 12 consecutive weeks (30-60 minutes /session x 3 sessions/week) and include in-phase bilateral movements of the upper limbs, adapted to different sports activities and to functional training. To define functional relation between the intervention and the results on corticospinal plasticity (i.e., resting motor threshold, motor evoked potential amplitude, latency) and on clinical measures (i.e., balance, gait, bilateral hand dexterity and strength, cognitive function), we will perform a visual analysis followed by multilevel modelling and the single case educational design specific mean difference in order to estimate the magnitude of the effect size across cases. We assume that possible effects from our study, will introduce a type of exercise that will be effective during the disease progression.

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The degree of cortical plasticity correlates with cognitive performance in patients with Multiple Sclerosis

Cited by 12 publications

References 55 publications

Brain functional connectivity analysis in patients with relapsing-remitting multiple sclerosis: A graph theory approach of EEG resting state

Brain functional connectivity analysis in patients with relapsing-remitting multiple sclerosis: A graph theory approach of EEG resting state

Investigation of in-phase bilateral exercise effects on corticospinal plasticity in relapsing remitting multiple sclerosis: A registered report single-case concurrent multiple baseline design across five subjects

Investigation of in-phase bilateral exercise effects on corticospinal plasticity in relapsing remitting multiple sclerosis: a multiple baseline design

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