Introduction. Functional magnetic resonance imaging (fMRI) is a promising technique to clarify the mechanisms of cortical plasticity following brain injury. Objective. To evaluate, using fMRI, the pattern of cortical activations in patients with primary progressive multiple sclerosis (PPMS). Methods. fMRI was performed in 15 right-handed PPMS patients, with a progressive spastic paraparesis, and 13 sex- and age-matched healthy volunteers. All subjects were scanned in three different conditions: (a) while they flexed and extended the last four fingers of their right hand (COND1); (b) while they flexed and extended their right feet (COND2); and (c) while they performed the first two tasks at the same time (COND3). Image analysis was performed using SPM99. Results. In healthy volunteers, during COND1 and COND2, significant cortical activations were detected on the right side at the level of the vermis and on the left side at the level of the primary and supplementary motor cortex (with a somatotopic representation). For COND1, the same activations were found in PPMS patients, but they were more widespread. An activation at the level of the superior temporal gyrus was also observed. During COND2, there was no activation in the cerebellum and the cluster of activation at the level of the primary motor cortex devoted to the foot movement was smaller than in the control group. Another activated area was identified at the level of the superior temporal gyrus. During COND 3, in healthy volunteers we found significant activations on the left side at the level of the thalamus, the primary motor cortices devoted to the movements of the hand and the foot and at the level of the supplementary motor cortices. In PPMS patients, the activations were located at the level of the right cerebellum, of the left superior temporal gyrus, and the left primary motor cortex. Conclusions. This study shows that, in patients with PPMS, there is a significant reorganization of the cortical and subcortical structures responsible for the hand and foot movements.
|Issue number||4 SUPPL.|
|Publication status||Published - 2000|
ASJC Scopus subject areas
- Clinical Neurology