title: Changes in functional network centrality underlie cognitive dysfunction and physical disability in multiple sclerosis.
abstract: Cognitive dysfunction in multiple sclerosis (MS) has a large impact on the quality of life and is poorly understood.
  
  
  
  The aim of this study was to investigate functional network integrity in MS, and relate this to cognitive dysfunction and physical disability.
  
  
  
  Resting state fMRI scans were included of 128 MS patients and 50 controls. Eigenvector centrality mapping (ECM) was applied, a graph analysis technique that ranks the importance of brain regions based on their connectivity patterns. Significant ECM changes were related to physical disability and cognitive dysfunction.
  
  
  
  In MS patients, ECM values were increased in bilateral thalamus and posterior cingulate (PCC) areas, and decreased in sensorimotor and ventral stream areas. Sensorimotor ECM decreases were related to higher EDSS (rho = -0.24, p = 0.007), while ventral stream decreases were related to poorer average cognition (rho = 0.23, p = 0.009). The thalamus displayed increased connectivity to sensorimotor and ventral stream areas.
  
  
  
  In MS, areas in the ventral stream and sensorimotor cortex appear to become less central in the entire functional network of the brain, which is associated with clinico-cognitive dysfunction. The thalamus, however, displays increased connectivity with these areas. These findings may aid in further elucidating the function of functional reorganization processes in MS.
authors.affiliation: Department of Radiology and Nuclear Medicine, VU University Medical Center, The Netherlands Department of Anatomy and Neurosciences, VU University Medical Center, The Netherlands m.schoonheim@vumc.nl.
authors.forename: M M
authors.initials: MM
authors.lastname: Schoonheim
authors.affiliation: Department of Anatomy and Neurosciences, VU University Medical Center, The Netherlands.
authors.forename: Jjg
authors.initials: J
authors.lastname: Geurts
authors.affiliation: Department of Radiology and Nuclear Medicine, VU University Medical Center, The Netherlands.
authors.forename: O T
authors.initials: OT
authors.lastname: Wiebenga
authors.affiliation: Department of Physics and Medical Technology, VU University Medical Center, The Netherlands.
authors.forename: J C
authors.initials: JC
authors.lastname: De Munck
authors.affiliation: Department of Neurology, VU University Medical Center, The Netherlands.
authors.forename: C H
authors.initials: CH
authors.lastname: Polman
authors.affiliation: Department of Clinical Neurophysiology, VU University Medical Center, The Netherlands.
authors.forename: C J
authors.initials: CJ
authors.lastname: Stam
authors.affiliation: Department of Radiology and Nuclear Medicine, VU University Medical Center, The Netherlands.
authors.forename: F
authors.initials: F
authors.lastname: Barkhof
authors.affiliation: Department of Radiology and Nuclear Medicine, VU University Medical Center, The Netherlands.
authors.forename: A M
authors.initials: AM
authors.lastname: Wink
mesh_terms: D000328:Adult; D001921:Brain / Q000000981:diagnostic imaging / Q000503:physiopathology*; D001931:Brain Mapping / Q000379:methods; D016022:Case-Control Studies; D003071:Cognition; D003072:Cognition Disorders / Q000175:diagnosis / Q000503:physiopathology* / Q000523:psychology; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009043:Motor Activity; D009103:Multiple Sclerosis / Q000175:diagnosis / Q000503:physiopathology* / Q000523:psychology; D009415:Nerve Net / Q000000981:diagnostic imaging / Q000503:physiopathology*; D011788:Quality of Life; D066191:Sensorimotor Cortex / Q000503:physiopathology; D013788:Thalamus / Q000503:physiopathology
keywords: Multiple sclerosis; cognition; connectivity; functional reorganization; hippocampus; thalamus