多发性硬化症中对跌倒的担忧的神经关联：杏仁核-海马体和杏仁核-小脑回路的静息态功能连接
Neural correlates of concern about falling in multiple sclerosis: resting-state functional connectivity in amygdala-hippocampal and amygdala-cerebellar circuits.
作者信息
Takla Taylor N, Tamimi Reem, Daugherty Ana M, Landers Merrill R, Marusak Hilary A, Fritz Nora E
机构信息
Neuroimaging and Neurorehabilitation Laboratory, Wayne State University, Detroit, MI, USA.
Translational Neuroscience Program, Wayne State University, Detroit, MI, USA.
出版信息
Exp Brain Res. 2025 May 16;243(6):148. doi: 10.1007/s00221-025-07101-z.
BACKGROUND
Concern about falling (CAF) is common in multiple sclerosis (MS), impacting motor function, cognition, and emotional well-being. However, the underlying neural correlates remain understudied. Given the multifactorial nature of CAF, we hypothesized that neural correlates may involve interactions between brain regions involved in emotional (e.g., amygdala), motor (e.g., cerebellum), and cognitive functions (e.g., hippocampus). This study explored associations between CAF and resting-state functional connectivity (FC) in amygdala-hippocampal and amygdala-cerebellar circuits in MS.
METHODS
Participants with relapsing-remitting MS completed the Falls Efficacy Scale-International to assess CAF, followed by a functional MRI scan. Region of interest (ROI)-to-ROI analyses examined associations between CAF and FC in amygdala-hippocampal and amygdala-cerebellar circuits. Significant connections were identified using false discovery rate (FDR) correction at α = 0.05.
RESULTS
Forty-one individuals participated in our study. CAF was significantly associated with greater amygdala-hippocampal FC (T(39) ≥ 3.76, q ≤ 0.001) and lower amygdala-cerebellar FC (T(39) ≤ -2.52, q ≤ 0.026).
CONCLUSION
These findings highlight distinct neural patterns linked to CAF in MS. Higher CAF was associated with greater amygdala-hippocampal connectivity, suggesting that neural circuits underlying fear-related memories and emotional processing may play a crucial role in perceived fall risk. In contrast, lower amygdala-cerebellar connectivity in individuals with heightened CAF may reflect diminished integration of emotional and motor output, potentially compromising the ability to assess environmental hazards and situations where falls are likely to occur. Further understanding these neural underpinnings may help develop targeted interventions to reduce CAF and its negative impact on people with MS.
背景
对跌倒的担忧（CAF）在多发性硬化症（MS）中很常见，会影响运动功能、认知和情绪健康。然而，其潜在的神经关联仍未得到充分研究。鉴于CAF的多因素性质，我们假设神经关联可能涉及参与情绪（如杏仁核）、运动（如小脑）和认知功能（如海马体）的脑区之间的相互作用。本研究探讨了MS患者中CAF与杏仁核 - 海马体及杏仁核 - 小脑回路静息态功能连接（FC）之间的关联。
方法
复发缓解型MS患者完成国际跌倒效能量表以评估CAF，随后进行功能磁共振成像扫描。感兴趣区域（ROI）到ROI分析检查了CAF与杏仁核 - 海马体及杏仁核 - 小脑回路中FC之间的关联。使用错误发现率（FDR）校正（α = 0.05）确定显著连接。
结果
41名个体参与了我们的研究。CAF与更强的杏仁核 - 海马体FC显著相关（T(39) ≥ 3.76，q ≤ 0.001），与更低的杏仁核 - 小脑FC显著相关（T(39) ≤ -2.52，q ≤ 0.026）。
结论
这些发现突出了MS中与CAF相关的独特神经模式。更高的CAF与更强的杏仁核 - 海马体连接性相关，表明与恐惧相关记忆和情绪处理的神经回路可能在感知到的跌倒风险中起关键作用。相比之下，CAF增强的个体中较低的杏仁核 - 小脑连接性可能反映了情绪和运动输出整合的减少，可能会损害评估环境危害和跌倒可能发生情况的能力。进一步了解这些神经基础可能有助于开发有针对性的干预措施，以减少CAF及其对MS患者的负面影响。
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