title: Functional and structural cerebral changes in key brain regions after a facilitation programme for episodic future thought in relapsing-remitting multiple sclerosis patients.
abstract: Increasingly studied, episodic future thought (EFT) impairment negatively affects patients' daily life. Along these lines, working with relapsing-remitting multiple sclerosis (RR-MS) patients, we documented the clinical effectiveness of a mental visual imagery (MVI)-based facilitation programme on EFT impairment related to executive function difficulties. We aimed at improving the characterisation of the cognitive and neural underpinnings of RR-MS patients' EFT amelioration, by exploring the structural and functional brain changes following the MVI programme. Seventeen non-depressed RR-MS patients were recruited and randomly assigned in the (i) experimental group (n=10), who followed the MVI programme or in the control group (n=7), who followed a verbal control programme. Using an adapted version of the Autobiographical Interview to assess EFT, after facilitation, significant improvement was observed in the experimental group only. This was accompanied by increased activation in the prefrontal region during the generation of future events and was positively correlated with grey matter volume increase in this same brain area. Increased activations in the parahippocampal and the middle temporal gyri were also observed in the experimental group in post-facilitation. Likewise, functional connectivity changes were observed in the posterior brain regions after facilitation. Only minor cerebral changes were observed in the control group, likely reflecting practice effects. Our study showed that EFT improvement following the MVI programme led to functional and structural changes in brain regions sustaining contextual processing, visual imagery, the integration and maintenance of multimodal information. Taken together, these findings suggest that a cognitive intervention focusing on scene construction can be efficient to alleviate EFT impairment related to executive dysfunction. As such, this study opens the way to the development of tailor-made rehabilitation programmes using the different cognitive mechanisms involved in EFT.
authors.affiliation: Cognitive Neuropsychology and Physiopathology of Schizophrenia (INSERM UMR 1114), University of Strasbourg, Strasbourg, France.
authors.forename: Alexandra
authors.initials: A
authors.lastname: Ernst
authors.affiliation: ICube (CNRS UMR 7357), University of Strasbourg, Fédération de Médecine translationnelle de Strasbourg (FMTS), Strasbourg, France.
authors.forename: Marion
authors.initials: M
authors.lastname: Sourty
authors.affiliation: ICube (CNRS UMR 7357), University of Strasbourg, Fédération de Médecine translationnelle de Strasbourg (FMTS), Strasbourg, France.
authors.forename: Daniel
authors.initials: D
authors.lastname: Roquet
authors.affiliation: ICube (CNRS UMR 7357), University of Strasbourg, Fédération de Médecine translationnelle de Strasbourg (FMTS), Strasbourg, France.
authors.forename: Vincent
authors.initials: V
authors.lastname: Noblet
authors.affiliation: ICube (CNRS UMR 7357), University of Strasbourg, Fédération de Médecine translationnelle de Strasbourg (FMTS), Strasbourg, France.
authors.forename: Daniel
authors.initials: D
authors.lastname: Gounot
authors.affiliation: ICube (CNRS UMR 7357), University of Strasbourg, Fédération de Médecine translationnelle de Strasbourg (FMTS), Strasbourg, France; Department of Neurology, University Hospital of Strasbourg, Strasbourg, France.
authors.forename: Frédéric
authors.initials: F
authors.lastname: Blanc
authors.affiliation: Department of Neurology, University Hospital of Strasbourg, Strasbourg, France; Clinical Investigation Centre (CIC INSERM 1434), University Hospital of Strasbourg, Strasbourg, France.
authors.forename: Jérôme
authors.initials: J
authors.lastname: De Seze
authors.affiliation: Cognitive Neuropsychology and Physiopathology of Schizophrenia (INSERM UMR 1114), University of Strasbourg, Strasbourg, France. Electronic address: manning@unistra.fr.
authors.forename: Liliann
authors.initials: L
authors.lastname: Manning
mesh_terms: D000328:Adult; D001931:Brain Mapping; D054022:Cerebrum / Q000000981:diagnostic imaging / Q000503:physiopathology*; D060825:Cognitive Dysfunction / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology* / Q000534:rehabilitation*; D000072466:Cognitive Remediation / Q000379:methods*; D056344:Executive Function / Q000502:physiology; D005260:Female; D006801:Humans; D007092:Imagination / Q000502:physiology; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D020529:Multiple Sclerosis, Relapsing-Remitting / Q000150:complications / Q000000981:diagnostic imaging / Q000503:physiopathology*; D013850:Thinking / Q000502:physiology*; D016896:Treatment Outcome; D014796:Visual Perception / Q000502:physiology
keywords: Cognitive rehabilitation; Episodic future thought; Functional MRI; Multiple sclerosis; Structural MRI