How changes in brain activity and connectivity are associated with motor performance in people with MS.
How changes in brain activity and connectivity are associated with motor performance in people with MS.
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DOI：
10.1016/j.nicl.2017.09.019
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发表时间：
2018
期刊：
影响因子：
--
通讯作者：
Fling BW
中科院分区：
文献类型：
--
作者：
Peterson DS;Fling BW
多发性硬化症（MS）患者的大脑结构、活动和连通性都有明显的变化。虽然大量的工作已经开始阐明这些神经变化如何有助于行为，但症状和诊断的异质性使得对结果的解释和临床实践的应用具有挑战性。特别是，MS相关的大脑活动或大脑连接的变化是否会防止或导致运动症状恶化尚不清楚。随着最近出现的神经调节技术，可以改变在特定的大脑区域的神经活动，这是至关重要的，以确定是否局部脑激活模式是促进（即适应不良）或防止（即适应）运动症状的进展。在这份手稿中，我们巩固了最近的研究结果，关于MS患者的脊髓上结构和活动的变化，以及这些变化如何有助于运动表现。此外，我们还讨论了一个假设，即在运动过程中增加神经活动可能是适应性的或适应不良的，这取决于在大脑中观察到这种增加。具体而言，我们概述了初步证据表明，感觉运动皮层活动在同侧皮质可能是适应不良的人与MS。我们还讨论了未来的工作，可以提供数据来支持或反驳这一假设，从而提高我们对这一重要课题的理解。MS中大脑活动，连接和运动表现之间的联系知之甚少。目前的证据为适应性和适应不良的大脑变化进行了讨论。我们讨论了一个可能的机制，适应不良增加同侧大脑活动。
People with multiple sclerosis (MS) exhibit pronounced changes in brain structure, activity, and connectivity. While considerable work has begun to elucidate how these neural changes contribute to behavior, the heterogeneity of symptoms and diagnoses makes interpretation of findings and application to clinical practice challenging. In particular, whether MS related changes in brain activity or brain connectivity protect against or contribute to worsening motor symptoms is unclear. With the recent emergence of neuromodulatory techniques that can alter neural activity in specific brain regions, it is critical to establish whether localized brain activation patterns are contributing to (i.e. maladaptive) or protecting against (i.e. adaptive) progression of motor symptoms. In this manuscript, we consolidate recent findings regarding changes in supraspinal structure and activity in people with MS and how these changes may contribute to motor performance. Furthermore, we discuss a hypothesis suggesting that increased neural activity during movement may be either adaptive or maladaptive depending on where in the brain this increase is observed. Specifically, we outline preliminary evidence suggesting sensorimotor cortex activity in the ipsilateral cortices may be maladaptive in people with MS. We also discuss future work that could supply data to support or refute this hypothesis, thus improving our understanding of this important topic. The link between brain activity, connectivity, and motor performance in MS is poorly understood. Current evidence for adaptive and maladaptive brain changes is discussed. We discuss a possible mechanism for maladaptive increases in ipsilateral brain activity.