title: Motor cortical reorganization is present after a single attack of multiple sclerosis devoid of cortico-spinal dysfunction.
abstract: OBJECTIVE
  While occurrence of motor cortical reorganization has been clearly demonstrated in patients with multiple sclerosis (MS), it is not yet clear whether this cortical reorganization constitutes a response to cortico-spinal lesions or to more diffuse damage affecting the neuronal network involved in motor act preparation, or both. We proposed to investigate the changes in the activation pattern during a simple motor task devoid of cortico-spinal dysfunction occurring in patients with clinically isolated syndrome (CIS) suggestive of MS.
  
  
  METHODS
  Among 15 right-handed CIS patients, we selected eight patients with a preserved central motor pathway established by motor evoked potentials. Ten healthy right-handed gender- and age-matched volunteers were also included. After morphological MRI, subjects performed calibrated conjugated finger flexion and extension movements during fMRI acquisition.
  
  
  RESULTS
  In CIS patients, simple movements of the non-dominant hand induced recruitment of the anterior cingulate cortex (BA32) usually involved in complex motor movements. This reorganization was correlated with the diffuse brain tissue damage (brain T₂ lesion load).
  
  
  CONCLUSIONS
  These results suggest that at least part of the cortical reorganization observed during very simple tasks in the earliest stage of MS occurs whether or not the efferent pathways are intact.
authors.affiliation: Centre de Résonance Magnétique Biologique et Médicale UMR CNRS 6612 Facultéde Médecine, Université de la Méditerranée, Marseille, France. audrey.rico@ap-hm.fr
authors.forename: Audrey
authors.initials: A
authors.lastname: Rico
authors.forename: Wafaa
authors.initials: W
authors.lastname: Zaaraoui
authors.forename: Jerome
authors.initials: J
authors.lastname: Franques
authors.forename: Shahram
authors.initials: S
authors.lastname: Attarian
authors.forename: Françoise
authors.initials: F
authors.lastname: Reuter
authors.forename: Irina
authors.initials: I
authors.lastname: Malikova
authors.forename: Sylviane
authors.initials: S
authors.lastname: Confort-Gouny
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Soulier
authors.forename: Jean
authors.initials: J
authors.lastname: Pouget
authors.forename: Patrick J
authors.initials: PJ
authors.lastname: Cozzone
authors.forename: Jean
authors.initials: J
authors.lastname: Pelletier
authors.forename: Jean-Philippe
authors.initials: JP
authors.lastname: Ranjeva
authors.forename: Bertrand
authors.initials: B
authors.lastname: Audoin
mesh_terms: D000328:Adult; D001931:Brain Mapping; D003711:Demyelinating Diseases / Q000473:pathology / Q000503:physiopathology; D019054:Evoked Potentials, Motor; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009043:Motor Activity / Q000502:physiology; D009044:Motor Cortex / Q000473:pathology / Q000503:physiopathology*; D009103:Multiple Sclerosis / Q000175:diagnosis / Q000473:pathology / Q000503:physiopathology*; D011712:Pyramidal Tracts / Q000473:pathology / Q000503:physiopathology*; D055815:Young Adult