Audoin Bertrand, Au Duong My Van, Malikova Irina, Confort-Gouny Sylviane, Ibarrola Danielle, Cozzone Patrick J, Pelletier Jean, Ranjeva Jean-Philippe
Centre de Résonance Magnétique Biologique et Médicale, CRMBM-CNRS 6612, Faculté de Médecine, 27 bvd Jean Moulin, 13005 Marseille, France.
J Neurol Sci. 2006 Jun 15;245(1-2):87-91. doi: 10.1016/j.jns.2005.08.026. Epub 2006 Apr 21.
Dysfunction of high controlled information processing is present in patients with multiple sclerosis (MS) right at the beginning of the disease. One hypothesis is that disruption of communication inside large-scale cortical networks, occurring as a consequence of white matter damage, may constitute the anatomical substrate of cognitive impairment at the very early stage of MS. Disturbance of interregional synchronization might be the main pathogenic factor in controlled information processing deficiency in early MS. Preliminary functional MRI studies (fMRI) have provided important clues to corroborate the connectivity hypotheses. First, brain connectivity assessed by fMRI has brought new data about the influence of diffuse white matter damage on connectivity efficiency inside large-scale networks. These studies have suggested that connectivity disturbances occur inside the working memory network in patients at the very early stage of MS and appear related to the extent of structural white matter damage. Also, fMRI studies have suggested that patients may partially compensate for connectivity impairment by a greater cognitive control. Such a compensatory mechanism could limit the determinant functional impact of diffuse white matter damage on high controlled information processing.
多发性硬化症（MS）患者在疾病伊始就存在高度受控信息处理功能障碍。一种假说认为，由于白质损伤导致的大规模皮质网络内部通信中断，可能构成MS极早期认知障碍的解剖学基础。区域间同步紊乱可能是早期MS受控信息处理缺陷的主要致病因素。初步的功能磁共振成像研究（fMRI）为证实连通性假说提供了重要线索。首先，通过fMRI评估的脑连通性带来了关于弥漫性白质损伤对大规模网络内部连通性效率影响的新数据。这些研究表明，在MS极早期患者的工作记忆网络中会出现连通性紊乱，且似乎与结构性白质损伤的程度有关。此外，fMRI研究表明，患者可能通过更强的认知控制来部分补偿连通性损伤。这种补偿机制可能会限制弥漫性白质损伤对高度受控信息处理的决定性功能影响。
