Functional Connectivity and Structural Disruption in the Default-Mode Network Predicts Cognitive Rehabilitation Outcomes in Multiple Sclerosis.

TitleFunctional Connectivity and Structural Disruption in the Default-Mode Network Predicts Cognitive Rehabilitation Outcomes in Multiple Sclerosis.
Publication TypeJournal Article
Year of Publication2020
AuthorsFuchs TA, Ziccardi S, Benedict RHB, Bartnik A, Kuceyeski A, Charvet LE, Oship D, Weinstock-Guttman B, Wojcik C, Hojnacki D, Kolb C, Escobar J, Campbell R, Tran HDuc, Bergsland N, Jakimovski D, Zivadinov R, Dwyer MG
JournalJ Neuroimaging
Volume30
Issue4
Pagination523-530
Date Published2020 07
ISSN1552-6569
KeywordsAdult, Aged, Brain, Cognition, Default Mode Network, Female, Humans, Magnetic Resonance Imaging, Male, Middle Aged, Multiple Sclerosis, Neuropsychological Tests, Treatment Outcome, White Matter
Abstract

BACKGROUND AND PURPOSE: Efficacy of restorative cognitive rehabilitation can be predicted from baseline patient factors. In addition, patient profiles of functional connectivity are associated with cognitive reserve and moderate the structure-cognition relationship in people with multiple sclerosis (PwMS). Such interactions may help predict which PwMS will benefit most from cognitive rehabilitation. Our objective was to determine whether patient response to restorative cognitive rehabilitation is predictable from baseline structural network disruption and whether this relationship is moderated by functional connectivity.

METHODS: For this single-arm repeated measures study, we recruited 25 PwMS for a 12-week program. Following magnetic resonance imaging, participants were tested using the Symbol Digit Modalities Test (SDMT) pre- and postrehabilitation. Baseline patterns of structural and functional connectivity were characterized relative to healthy controls.

RESULTS: Lower white matter tract disruption in a network of region-pairs centered on the precuneus and posterior cingulate (default-mode network regions) predicted greater postrehabilitation SDMT improvement (P = .048). This relationship was moderated by profiles of functional connectivity within the network (R = .385, P = .017, Interaction β = -.415).

CONCLUSION: Patient response to restorative cognitive rehabilitation is predictable from the interaction between structural network disruption and functional connectivity in the default-mode network. This effect may be related to cognitive reserve.

DOI10.1111/jon.12723
Alternate JournalJ Neuroimaging
PubMed ID32391981
Related Institute: 
Brain Health Imaging Institute (BHII)

Weill Cornell Medicine
Department of Radiology
525 East 68th Street New York, NY 10065