ECTRIMS eLearning

Longitudinal fMRI
ECTRIMS Learn. Rocca M. 10/11/18; 231929; 180
Dr. Maria Assunta Rocca
Dr. Maria Assunta Rocca
Contributions
Abstract

Abstract: 180

Type: Hot Topic

Abstract Category: N/A

The extensive application of functional magnetic resonance imaging (fMRI) in patients with multiple sclerosis (MS) has significantly contributed to filling the gap between clinical and MRI measures in this condition. It is now recognized that the presence and effectiveness of functional reorganization mechanisms in response to central nervous system (CNS) disease-related structural damage might contribute to explain preserved clinical function or recovery of deficits following an acute relapse. There is also evidence that the inefficiency of functional reorganization is another mechanism (in addition to structural CNS damage) influencing the presence of clinical disability, cognitive impairment and specific symptoms, such as fatigue. However, most of our knowledge regarding brain plasticity and repair in MS as evidenced by fMRI comes from cross-sectional studies, which give just a snapshot of a dynamic process. Only a few studies have applied fMRI to track fMRI changes over time. Interestingly enough, the majority of these studies used serial fMRI to monitor response to therapies or rehabilitation interventions.
Overall, fMRI offers a promising venue to investigate the functional impact of MS pathology, complementing structural conventional and quantitative MRI techniques, in order to understand better MS pathophysiology from the earliest clinical stages of the disease. Moreover, alterations of fMRI patterns seem to correlate with disability progression. Therefore, fMRI may be profitably used in clinical settings to classify disease state of individual MS patients with the ultimate aim to identify novel biomarkers useful in the context of the diagnostic workup, establishing prognosis and monitoring treatment. However, fMRI still requires a careful standardization of acquisition and analysis protocols, a careful assessment of scanner stability over time, and normative values as a reference. As a consequence, additional studies are needed to further evaluate the applicability of this approach in multicenter studies, as well as its sensitivity to disease progression and ability to monitor response to treatment in individual patients.
Disclosure: Dr. Maria A. Rocca received speakers honoraria from Biogen Idec, TEVA Neuroscience, Merck Serono, Genzyme, Novartis and Roche and receives research support from the Italian Ministry of Health and Fondazione Italiana Sclerosi Multipla.

Abstract: 180

Type: Hot Topic

Abstract Category: N/A

The extensive application of functional magnetic resonance imaging (fMRI) in patients with multiple sclerosis (MS) has significantly contributed to filling the gap between clinical and MRI measures in this condition. It is now recognized that the presence and effectiveness of functional reorganization mechanisms in response to central nervous system (CNS) disease-related structural damage might contribute to explain preserved clinical function or recovery of deficits following an acute relapse. There is also evidence that the inefficiency of functional reorganization is another mechanism (in addition to structural CNS damage) influencing the presence of clinical disability, cognitive impairment and specific symptoms, such as fatigue. However, most of our knowledge regarding brain plasticity and repair in MS as evidenced by fMRI comes from cross-sectional studies, which give just a snapshot of a dynamic process. Only a few studies have applied fMRI to track fMRI changes over time. Interestingly enough, the majority of these studies used serial fMRI to monitor response to therapies or rehabilitation interventions.
Overall, fMRI offers a promising venue to investigate the functional impact of MS pathology, complementing structural conventional and quantitative MRI techniques, in order to understand better MS pathophysiology from the earliest clinical stages of the disease. Moreover, alterations of fMRI patterns seem to correlate with disability progression. Therefore, fMRI may be profitably used in clinical settings to classify disease state of individual MS patients with the ultimate aim to identify novel biomarkers useful in the context of the diagnostic workup, establishing prognosis and monitoring treatment. However, fMRI still requires a careful standardization of acquisition and analysis protocols, a careful assessment of scanner stability over time, and normative values as a reference. As a consequence, additional studies are needed to further evaluate the applicability of this approach in multicenter studies, as well as its sensitivity to disease progression and ability to monitor response to treatment in individual patients.
Disclosure: Dr. Maria A. Rocca received speakers honoraria from Biogen Idec, TEVA Neuroscience, Merck Serono, Genzyme, Novartis and Roche and receives research support from the Italian Ministry of Health and Fondazione Italiana Sclerosi Multipla.

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