title: Impaired cortical deactivation during hand movement in the relapsing phase of multiple sclerosis: a cross-sectional and longitudinal fMRI study.
abstract: BACKGROUND
  Little is known about the cortical activation changes during clinical relapses in multiple sclerosis (MS).
  
  
  OBJECTIVE
  To assess cross-sectional and longitudinal differences in functional magnetic resonance imaging (fMRI) cortical patterns between the relapsing and stable phases of MS.
  
  
  METHODS
  We studied 32 patients with relapsing-remitting MS with mild disability: 19 within 48 h of symptom onset of a new relapse (G1) and 13 in the stable phase, relapse-free for at least 6 months (G2). All patients underwent fMRI twice, upon entry (time 1) and 30-50 days later (time 2), during right-hand movement.
  
  
  RESULTS
  No between-group differences were observed in age, disability or T2 lesion load. Between-group analysis showed a significant difference in the ipsilateral precentral gyrus (IPG) activation at time 1. Activity differences in the IPG expressed reduced deactivation in G1 compared with G2. Longitudinal changes in brain activity in the IPG were significantly greater in G1 than G2. G1 patients with a slow clinical recovery (n = 8) showed different activity at baseline and greater activity changes over time in the IPG than patients with a fast recovery (n = 11).
  
  
  CONCLUSIONS
  This study shows that the relapsing phase is associated with reduced brain deactivation in the IPG, which is more marked in patients with a slow clinical recovery. Increased cortical excitability associated with inflammation may determine functional modifications within the ipsilateral motor area.
authors.affiliation: Department of Neurology and Psychiatry, Sapienza University of Rome, Italy. patrizia.pantano@uniroma1.it
authors.forename: Patrizia
authors.initials: P
authors.lastname: Pantano
authors.forename: Silvia
authors.initials: S
authors.lastname: Bernardi
authors.forename: Emanuele
authors.initials: E
authors.lastname: Tinelli
authors.forename: Simona
authors.initials: S
authors.lastname: Pontecorvo
authors.forename: Delia
authors.initials: D
authors.lastname: Lenzi
authors.forename: Eytan
authors.initials: E
authors.lastname: Raz
authors.forename: Francesca
authors.initials: F
authors.lastname: Tona
authors.forename: Claudio
authors.initials: C
authors.lastname: Gasperini
authors.forename: Carlo
authors.initials: C
authors.lastname: Pozzilli
mesh_terms: D000328:Adult; D001931:Brain Mapping; D002540:Cerebral Cortex / Q000473:pathology / Q000503:physiopathology*; D003430:Cross-Sectional Studies; D005260:Female; D006225:Hand / Q000503:physiopathology; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D008137:Longitudinal Studies; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009068:Movement / Q000502:physiology*; D020529:Multiple Sclerosis, Relapsing-Remitting / Q000473:pathology / Q000503:physiopathology*; D055815:Young Adult