Arizona State University, Tempe, AZ, USA; Veterans Affairs Phoenix Medical Center Phoenix, AZ, USA.
Colorado State University, Fort Collins, CO, USA.
Neuroimage Clin. 2017 Sep 28;17:153-162. doi: 10.1016/j.nicl.2017.09.019. eCollection 2018.
People with multiple sclerosis (MS) exhibit pronounced changes in brain structure, activity, and connectivity. While considerable work has begun to elucidate how these neural changes contribute to behavior, the heterogeneity of symptoms and diagnoses makes interpretation of findings and application to clinical practice challenging. In particular, whether MS related changes in brain activity or brain connectivity protect against or contribute to worsening motor symptoms is unclear. With the recent emergence of neuromodulatory techniques that can alter neural activity in specific brain regions, it is critical to establish whether localized brain activation patterns are contributing to (i.e. maladaptive) or protecting against (i.e. adaptive) progression of motor symptoms. In this manuscript, we consolidate recent findings regarding changes in supraspinal structure and activity in people with MS and how these changes may contribute to motor performance. Furthermore, we discuss a hypothesis suggesting that increased neural activity during movement may be either adaptive or maladaptive depending on where in the brain this increase is observed. Specifically, we outline preliminary evidence suggesting sensorimotor cortex activity in the ipsilateral cortices may be maladaptive in people with MS. We also discuss future work that could supply data to support or refute this hypothesis, thus improving our understanding of this important topic.
多发性硬化症（MS）患者的大脑结构、活动和连通性会发生明显变化。尽管已经开展了大量工作来阐明这些神经变化如何导致行为改变，但症状和诊断的异质性使得解释研究结果和将其应用于临床实践具有挑战性。特别是，MS 相关的大脑活动或大脑连通性变化是有助于还是加剧运动症状的恶化尚不清楚。随着可改变特定脑区神经活动的神经调节技术的最新出现，确定局部大脑激活模式是否有助于（即适应性不良）或对抗（即适应性）运动症状的进展至关重要。在本文中，我们整合了最近关于多发性硬化症患者的脊髓上结构和活动变化的研究结果，以及这些变化如何影响运动表现。此外，我们讨论了一个假设，即运动过程中增加的神经活动可能是适应性的，也可能是适应性不良的，这取决于这种增加发生在大脑的哪个部位。具体来说，我们概述了初步证据，表明对侧皮质的感觉运动皮层活动可能在多发性硬化症患者中适应性不良。我们还讨论了未来的工作，这些工作可以提供支持或反驳这一假设的数据，从而提高我们对这一重要主题的理解。
