A Widespread Pattern of Cortical Activations in Patients at Presentation with Clinically Isolated Symptoms Is Associated with Evolution to Definite Multiple Sclerosis

Abstract

BACKGROUND AND PURPOSE: Movement-associated cortical changes have been detected at the earlier clinical stage multiple sclerosis. Our purpose was to assess whether different patterns of cortical recruitment are associated with the short-term evolution of definite multiple sclerosis (MS).

METHODS: We followed for 1 year a group of patients with clinically isolated syndromes (CISs) suggestive of MS and compared the baseline movement-associated patterns of cortical activations between those patients with and those without evolution to definite MS.

RESULTS: Those patients in whom MS did not evolve had more significant activations of several areas part of the “classic” motor network; those who went on to develop MS had more significant activations of several regions in the frontal, parietal, temporal, and occipital lobes.

CONCLUSION: In CIS patients, the extent of early cortical reorganization following tissue injury might be a factor associated with a different disease evolution.