Impaired connectivity within neuromodulatory networks in multiple sclerosis and clinical implications
Impaired connectivity within neuromodulatory networks in multiple sclerosis and clinical implications
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DOI：
10.1007/s00415-020-09806-3
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发表时间：
2020-03-26
影响因子：
6
通讯作者：
Politis, Marios
中科院分区：
文献类型：
--
作者：
Carotenuto, Antonio;Wilson, Heather;Politis, Marios
越来越多的证据表明，神经调节网络的损伤在神经退行性疾病（如帕金森病和阿尔茨海默病）中的作用。然而，神经调节网络在多发性硬化症（MS）中的作用尚未得到评估。我们应用静息态功能连接和图论来研究神经调节网络中功能连接的变化，包括MS中的肾上腺素能、去甲肾上腺素能、胆碱能和多巴胺能系统。29名MS患者和24名年龄和性别匹配的健康对照者进行了临床和认知评估，包括扩展残疾状态评分、符号数字模式测试、和汉密尔顿抑郁量表。我们证实MS患者的肾上腺素能、胆碱能、去甲肾上腺素能和多巴胺能网络拓扑结构的弥漫性重组（P < 0.01）。血清素能、去甲肾上腺素能和胆碱能网络功能连接紊乱与疾病持续时间、EDSS和抑郁症状相关（P <0.01）。肾上腺素能、去甲肾上腺素能、胆碱能和多巴胺能神经网络的紊乱与认知能力有关（P < 0.01）。我们的研究结果表明，神经调节网络内的功能连接变化可能是预测随时间推移的残疾负担的有用工具，并可作为替代终点，以评估对症治疗的疗效。
There is mounting evidence regarding the role of impairment in neuromodulatory networks for neurodegenerative diseases, such as Parkinson's and Alzheimer's disease. However, the role of neuromodulatory networks in multiple sclerosis (MS) has not been assessed. We applied resting-state functional connectivity and graph theory to investigate the changes in the functional connectivity within neuromodulatory networks including the serotonergic, noradrenergic, cholinergic, and dopaminergic systems in MS. Twenty-nine MS patients and twenty-four age- and gender-matched healthy controls performed clinical and cognitive assessments including the expanded disability status score, symbol digit modalities test, and Hamilton Depression rating scale. We demonstrated a diffuse reorganization of network topography (P < 0.01) in serotonergic, cholinergic, noradrenergic, and dopaminergic networks in patients with MS. Serotonergic, noradrenergic, and cholinergic network functional connectivity derangement was associated with disease duration, EDSS, and depressive symptoms (P < 0.01). Derangements in serotonergic, noradrenergic, cholinergic, and dopaminergic network impairment were associated with cognitive abilities (P < 0.01). Our results indicate that functional connectivity changes within neuromodulatory networks might be a useful tool in predicting disability burden over time, and could serve as a surrogate endpoint to assess efficacy for symptomatic treatments.