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

Abstract

Motor disorders are a frequent syndrome in multiple sclerosis(MS), leading to severe disability, possibly associated with inefficiencyof adaptive mechanisms, probably because of widespreadstructural changes. Hand palsy with fine motor skillsdamage influences greatly on quality of life, because handfunction plays an important role in everyday activities andworking practices. Thus the aim of the study was to investigatefunctional and structural features of hand palsy in homogenoussample of MS patients during the relapse and in three months.Data were acquired from 25 relapsing-remitting MS patientsduring relapse also characterized by unilateral light hand palsy,and in three months. 12 age-matched healthy controls enteredthe control group. All patients underwent neurologica examination,including nine-hole peg test and dynamometry, andmagnetic resonance imaging of cervical spine and brain,including functional MRI and diffusion tensor imaging (DTI)sequences. All patients had lesions in spinal cord on cervicalspine MRI. fMRI data analysis during relapse showed differentlydirected activation changes and allowed to divide allpatients in two subgroups. These subgroups differed from eachother and control group by deep sensitivity and DTI values. Inthree months patients in the first subgroup had less completefine motor skills recovery, which was accompanied also bypreservation of activation changes and deep sensitivity asymmetryin comparison with the second subgroup. Received dataallow us to assume that clinically similar palsy, caused by spinalcord lesion, could be characterized by greater or lesser sensationimpairment contribution. In three months heterogeneousstructural and functional changes were observed, depending,possibly, on initially different pathologic mechanisms.Revealed differences should be taken into consideration whilerehabilitation planning.

Keywords

• relapsing-remitting multiple sclerosis
• motor disorders
• functional mri
• diffusion-tensor mri