Hulst Hanneke E, Schoonheim Menno M, Van Geest Quinten, Uitdehaag Bernard M J, Barkhof Frederik, Geurts Jeroen J G
Department of Anatomy and Neurosciences, VU University Medical Center, Amsterdam, The Netherlands
Department of Anatomy and Neurosciences, VU University Medical Center, Amsterdam, The Netherlands.
Mult Scler. 2015 Nov;21(13):1705-12. doi: 10.1177/1352458514567727. Epub 2015 Feb 13.
Memory impairment is frequent in multiple sclerosis (MS), but it is unclear what functional brain changes underlie this cognitive deterioration.
To investigate functional hippocampal activation and connectivity, in relation to memory performance in MS.
Structural and functional magnetic resonance imaging data were acquired for 57 MS patients and 28 healthy controls (HCs), yielding hippocampal measures of volume, lesions, functional activation during a memory task and functional connectivity at rest. Memory function was based on two subtests of a larger neuropsychological test battery and related to hippocampal neuroimaging measures, using linear regression.
Hippocampal volume was lower in MS patients, as compared to HCs. In MS, hippocampal activation during the task was increased in cognitively preserved, but decreased in cognitively impaired, patients. Increased hippocampal connectivity was detected in MS patients, as compared to HCs, between the left hippocampus and the right posterior cingulate. Memory impairment in MS was explained (adjusted R(2) = 0.27) by male gender, decreased hippocampal activation and increased hippocampal connectivity (p = 0.001).
Decreased activation of the hippocampus, increased connectivity and male gender were associated with worse memory performance in MS. These results indicate that increased activation and increased connectivity do not always coincide, and relate differently to cognitive dysfunction in MS.
记忆障碍在多发性硬化症（MS）中很常见，但尚不清楚这种认知衰退背后的大脑功能变化是什么。
研究MS患者海马体的功能激活和连接性与记忆表现的关系。
对57例MS患者和28例健康对照者（HCs）进行了结构和功能磁共振成像数据采集，得出海马体的体积、病变、记忆任务期间的功能激活以及静息状态下的功能连接性测量值。记忆功能基于一个更大的神经心理测试组合中的两个子测试，并使用线性回归与海马体神经成像测量值相关联。
与HCs相比，MS患者的海马体体积较小。在MS患者中，认知功能保留的患者在任务期间海马体激活增加，而认知功能受损的患者海马体激活减少。与HCs相比，MS患者左侧海马体与右侧后扣带回之间的海马体连接性增加。MS患者的记忆障碍可由男性性别、海马体激活减少和海马体连接性增加来解释（调整后的R(2)=0.27）（p=0.001）。
海马体激活减少、连接性增加和男性性别与MS患者较差的记忆表现相关。这些结果表明，激活增加和连接性增加并不总是一致的，并且与MS中的认知功能障碍有不同的关系。
