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

Tom A. Fuchs, Stefano Ziccardi, Ralph H.B. Benedict, Alexander Bartnik, Amy Kuceyeski, Leigh E. Charvet, Devon Oship, Bianca Weinstock-Guttman, Curtis Wojcik, David Hojnacki, Channa Kolb, Jose Escobar, Rebecca Campbell, Hoan Duc Tran, Niels Bergsland, Dejan Jakimovski, Robert Zivadinov, Michael G. Dwyer

Research output: Contribution to journalArticle

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 (R2 =.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.

Original languageEnglish
JournalJournal of Neuroimaging
DOIs
Publication statusAccepted/In press - Jan 1 2020

Keywords

  • Cognitive rehabilitation
  • functional MRI
  • multiple sclerosis
  • network
  • prediction

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Clinical Neurology

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    Fuchs, T. A., Ziccardi, S., Benedict, R. H. B., Bartnik, A., Kuceyeski, A., Charvet, L. E., Oship, D., Weinstock-Guttman, B., Wojcik, C., Hojnacki, D., Kolb, C., Escobar, J., Campbell, R., Tran, H. D., Bergsland, N., Jakimovski, D., Zivadinov, R., & Dwyer, M. G. (Accepted/In press). Functional Connectivity and Structural Disruption in the Default-Mode Network Predicts Cognitive Rehabilitation Outcomes in Multiple Sclerosis. Journal of Neuroimaging. https://doi.org/10.1111/jon.12723