Patients with myelitis due to neuromyelitis optica spectrum disorder (NMOSD) may experience functional alternations in several brain regions. Some of these changes may be associated with better clinical performance and could play a role in NMOSD rehabilitation, according to a recently published study in Multiple Sclerosis and Related Disorders.

Several studies have shown a correlation between spinal injury and functional activity alterations in the brain. Changes in functional connectivity due to myelitis have already been proven in several studies involving patients with multiple sclerosis and have been associated with complications such as fatigue and cognitive abnormalities. However, there is a lack of information regarding functional connectivity changes in NMOSD patients with myelitis.

Transverse myelitis is considered to be an important cause of disability in patients with NMOSD. And some authors believe that a better understanding of the neuronal plasticity involved in these functional connectivity changes could improve rehabilitation techniques for patients with NMOSD. 


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In this study, the authors aimed to assess functional connectivity alterations in 20 patients with NMOSD and a history of myelitis using resting state network analysis and region-of-interest-based whole-brain voxels analysis from resting state magnetic resonance imaging (rs-fMRI). Findings were compared with a healthy control group.

Patients with NMOSD exhibited significantly higher functional connectivity strengths in the basal ganglia network nuclei than the control group. Conversely, functional connectivity strengths in the sensorimotor network (BGN) are represented by the primary sensorimotor cortices, and the supplementary motor was higher in the healthy control group.

Results from rs-fMRI were correlated with the Expanded Disability Status Scale to assess the clinical implications of functional connection changes. Changes in the BGN were associated with better clinical features, including better gait function.

“Our study demonstrated wide resting-state functional connectivity alterations in patients with NMOSD after myelitis, suggesting that the brain functional network is a complex interconnected network with both the process of damage and that of compensation,” the authors concluded. 

Reference

Yang L, Qin Y, Chen K, et al. The role of basal ganglia network in neural plasticity in neuromyelitis optica spectrum disorder with myelitis. Mult Scler Relat Disord. 2022;68:104170. doi:10.1016/j.msard.2022.104170