Longitudinal cortex reorganization and white matter tracts structural changes analysis in relapsing-remitting multiple sclerosis patients with hand palsy

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Abstract

Motor disorders are a frequent syndrome in multiple sclerosis (MS), leading to severe disability, possibly associated with inefficiency of adaptive mechanisms, probably because of widespread structural changes. Hand palsy with fine motor skills damage influences greatly on quality of life, because hand function plays an important role in everyday activities and working practices. Thus the aim of the study was to investigate functional and structural features of hand palsy in homogenous sample of MS patients during the relapse and in three months. Data were acquired from 25 relapsing-remitting MS patients during relapse also characterized by unilateral light hand palsy, and in three months. 12 age-matched healthy controls entered the control group. All patients underwent neurologica examination, including nine-hole peg test and dynamometry, and magnetic resonance imaging of cervical spine and brain, including functional MRI and diffusion tensor imaging (DTI) sequences. All patients had lesions in spinal cord on cervical spine MRI. fMRI data analysis during relapse showed differently directed activation changes and allowed to divide all patients in two subgroups. These subgroups differed from each other and control group by deep sensitivity and DTI values. In three months patients in the first subgroup had less complete fine motor skills recovery, which was accompanied also by preservation of activation changes and deep sensitivity asymmetry in comparison with the second subgroup. Received data allow us to assume that clinically similar palsy, caused by spinal cord lesion, could be characterized by greater or lesser sensation impairment contribution. In three months heterogeneous structural and functional changes were observed, depending, possibly, on initially different pathologic mechanisms. Revealed differences should be taken into consideration while rehabilitation planning.

About the authors

S. N. Kulikova

Research Center of Neurology, Russian Academy of Medical Sciences (Moscow)

Author for correspondence.
Email: platonova@neurology.ru
Russian Federation

A. V. Peresedova

Research Center of Neurology, Russian Academy of Medical Sciences (Moscow)

Email: platonova@neurology.ru
Russian Federation

M. V. Krotenkova

Research Center of Neurology, Russian Academy of Medical Sciences (Moscow)

Email: platonova@neurology.ru
Russian Federation

V. V. Bryukhov

Research Center of Neurology, Russian Academy of Medical Sciences (Moscow)

Email: platonova@neurology.ru
Russian Federation

O. V. Trifonova

Research Center of Neurology, Russian Academy of Medical Sciences (Moscow)

Email: platonova@neurology.ru
Russian Federation

I. A. Zavalishin

Research Center of Neurology, Russian Academy of Medical Sciences (Moscow)

Email: platonova@neurology.ru
Russian Federation

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Copyright (c) 2014 Kulikova S.N., Peresedova A.V., Krotenkova M.V., Bryukhov V.V., Trifonova O.V., Zavalishin I.A.

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