Gender-related differences in functional connectivity in multiple sclerosis

2011 ◽  
Vol 18 (2) ◽  
pp. 164-173 ◽  
Author(s):  
Menno M Schoonheim ◽  
Hanneke E Hulst ◽  
Doriana Landi ◽  
Olga Ciccarelli ◽  
Stefan D Roosendaal ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Functional Connectivity ◽  
Gender Effects ◽  
Control Group ◽  
Visuospatial Memory ◽  
Information Processing Speed ◽  
Network Efficiency ◽  
Functional Changes ◽  
Female Patients ◽  
Male Patients

Background: Gender effects are strong in multiple sclerosis (MS), with male patients showing a worse clinical outcome than female patients. Functional reorganization of neural activity may contribute to limit disability, and possible gender differences in this process may have important clinical implications. Objectives: The aim of this study was to explore gender-related changes in functional connectivity and network efficiency in MS patients. Additionally, we explored the association of functional changes with cognitive function. Methods: Sixty subjects were included in the study, matched for age, education level and intelligence quotient (IQ). Male and female patients were matched for disability, disease duration and white matter lesion load. Two cognitive domains often impaired in MS, i.e. visuospatial memory and information processing speed, were evaluated in all subjects. Functional connectivity between brain regions and network efficiency was explored using resting-state functional magnetic resonance imaging and graph analysis. Differences in cognitive and functional characteristics between groups, and correlations with cognitive performance, were examined. Results: Male patients showed worse performance on cognitive tests than female and male controls, while female patients were cognitively normal. Decreases in functional connectivity and network efficiency, observed in male patients, correlated with reduced visuospatial memory ( r = −0.6 and r = −0.5, respectively). In the control group, no cognitive differences were found between genders, despite differences in functional connectivity between healthy men and women. Conclusions: Functional connectivity differences were found in male patients only and were related to impaired visuospatial memory. These results underline the importance of gender in MS and require further investigation in larger and longitudinal studies.

scholarly journals Vitamin E Level In Friedreich’s Ataxic Phenotype Patients In Four Major Hospitals In Baghdad

2019 ◽  
Vol 13 (1) ◽  
pp. 132-136
Author(s):  
Ahmed Hasan Ahmed
Keyword(s):  
Vitamin E ◽  
Teaching Hospital ◽  
Friedreich Ataxia ◽  
Control Group ◽  
Female Patients ◽  
Radical Trapping ◽  
Male Patients ◽  
The Difference ◽  
Classic Form ◽  
Age Range

Background: Friedreich ataxia (FRDA) is the most common form of inherited ataxia, comprising one-half of all hereditary ataxias with a carrier rate between 1 in 60 to 1 in 90 and with a disease prevalence of 1 per 29,000. It can occur in two forms the classic form or in association with a vitamin E dependent ataxia. The precise role of Vitamin E in the nervous system is unknown; An Oxidative attack is suspected to play a role in Ataxia with Vitamin E deficiency, as well as in Friedreich ataxia. Vitamin E is the major free-radical-trapping antioxidant. Objective: Theobjectives of the study is to asses vitamin E level in patients with Friedreichs ataxia phenotype in Iraqi patients. Type of the study:Cross-sectional study. Method: This study was conducted at the neuroscience hospital and Baghdad teaching hospital during the period from the 1st of November 2013 through November 2014. Forty patients with friedreich's ataxia attended in neuroscience hospital and Baghdad teaching hospital during this period; there was12 male, 20 female patients and their age range between (4-50) years. Results: Regarding the level of vitamin E in patients in the present study, The study revealed that mean level of vitamin E for Friedreich ataxia patients was (10.92 μg/ml) ranging from (8-18 μg/ml),while in the control group the mean was (28.06μg/ml) ranging from (22-36μg/ml), the difference in mean level was found to be statistically significant (p=0.0001.) Thirty percents of (FRDA) patients was (8-9.9μg/ml), while half of patients (50%) were within (10-11.9 μg/ml),and low percentage (15 %)of patients were within (12-13.9 μg/ml ). The rest (5%) were had vitamin E level equal or more than 14 μg/ml. these finding revealed that majority of Friedreich ataxia patients were found with low level of vitamin E (32 patients(80%)), and low percentage with normal level (8 patients(20%.)) Patients with Friedreich ataxia were found to have a comparable level 10.47±1.79(8.4-13.5),11.48±2.61(9.4-18) and 10.66±1.26(9-12.5) for those with less than 10 years, 10-19 years , equal or more than 20 years of age respectively (p=0.382), while it was found to have a significantly decreasing level with advance in the age for the control group, 30.57±4.61(24.5-36), 27.46±3.16(23.7-33.5), 25.50±3.03 (22.9-29) for those less than 10 years, 10-19 years, 20 years or more respectively (p=0.006.) Vitamin E level in relation to Gender showed that Friedriech ataxia male patients had significantly higher vitamin E level compared to females [12.05±2.66 (9.0-18.0) compared to 10.17±1.07 (8.4-12.0)] (p=0.003), while relation to gender in the control group was not of significant value statistically [27.08±2.90 (22.9-30.0) for male compared to 29.04±4.97 (23.7-36) for females] , p=0.136. Conclusion: In the light of the results of the present study, the following conclusions were made:  The level of vitamin E in friedreichs ataxic phenotype patients was subnormal than normal range representing 80% of the sample selected for the test.  The level of vitamin E in male patients of freidriechs ataxic phenotype patients was higher than female patients.  

scholarly journals Long-range connections are more severely damaged and relevant for cognition in multiple sclerosis

Brain ◽  
2019 ◽  
Vol 143 (1) ◽  
pp. 150-160 ◽  
Author(s):  
Kim A Meijer ◽  
Martijn D Steenwijk ◽  
Linda Douw ◽  
Menno M Schoonheim ◽  
Jeroen J G Geurts
Keyword(s):  
Multiple Sclerosis ◽  
Functional Connectivity ◽  
Fractional Anisotropy ◽  
Long Range ◽  
Short Range ◽  
Brain Regions ◽  
Healthy Controls ◽  
Network Efficiency ◽  
Structural Network ◽  
The Impact

Abstract An efficient network such as the human brain features a combination of global integration of information, driven by long-range connections, and local processing involving short-range connections. Whether these connections are equally damaged in multiple sclerosis is unknown, as is their relevance for cognitive impairment and brain function. Therefore, we cross-sectionally investigated the association between damage to short- and long-range connections with structural network efficiency, the functional connectome and cognition. From the Amsterdam multiple sclerosis cohort, 133 patients (age = 54.2 ± 9.6) with long-standing multiple sclerosis and 48 healthy controls (age = 50.8 ± 7.0) with neuropsychological testing and MRI were included. Structural connectivity was estimated from diffusion tensor images using probabilistic tractography (MRtrix 3.0) between pairs of brain regions. Structural connections were divided into short- (length < quartile 1) and long-range (length > quartile 3) connections, based on the mean distribution of tract lengths in healthy controls. To determine the severity of damage within these connections, (i) fractional anisotropy as a measure for integrity; (ii) total number of fibres; and (iii) percentage of tract affected by lesions were computed for each connecting tract and averaged for short- and long-range connections separately. To investigate the impact of damage in these connections for structural network efficiency, global efficiency was computed. Additionally, resting-state functional connectivity was computed between each pair of brain regions, after artefact removal with FMRIB’s ICA-based X-noiseifier. The functional connectivity similarity index was computed by correlating individual functional connectivity matrices with an average healthy control connectivity matrix. Our results showed that the structural network had a reduced efficiency and integrity in multiple sclerosis relative to healthy controls (both P < 0.05). The long-range connections showed the largest reduction in fractional anisotropy (z = −1.03, P < 0.001) and total number of fibres (z = −0.44, P < 0.01), whereas in the short-range connections only fractional anisotropy was affected (z = −0.34, P = 0.03). Long-range connections also demonstrated a higher percentage of tract affected by lesions than short-range connections, independent of tract length (P < 0.001). Damage to long-range connections was more strongly related to structural network efficiency and cognition (fractional anisotropy: r = 0.329 and r = 0.447. number of fibres r = 0.321 and r = 0.278. and percentage of lesions: r = −0.219; r = −0.426, respectively) than damage to short-range connections. Only damage to long-distance connections correlated with a more abnormal functional network (fractional anisotropy: r = 0.226). Our findings indicate that long-range connections are more severely affected by multiple sclerosis-specific damage than short-range connections. Moreover compared to short-range connections, damage to long-range connections better explains network efficiency and cognition.

scholarly journals Frequency of HLA-DRB1 Gene Alleles in Patients With Multiple Sclerosis in a Lithuanian Population

Medicina ◽  
2012 ◽  
Vol 48 (1) ◽  
pp. 2
Author(s):  
Renata Balnytė ◽  
Daiva Rastenytė ◽  
Dalia Mickevičienė ◽  
Antanas Vaitkus ◽  
Erika Skrodenienė ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Case Control Study ◽  
Case Control ◽  
Chain Reaction ◽  
Female Patients ◽  
History Of ◽  
Male Patients ◽  
Polymerase Chain ◽  
The Relationship ◽  
Control Study

The aim of the present study was to investigate the influence of HLA-DRB1 alleles on the genetic susceptibility to multiple sclerosis in the Lithuanian population. Material and Methods. A total of 120 patients with multiple sclerosis and 120 unrelated healthy controls were enrolled in this case-control study. Allelic frequencies were compared between the groups. HLA-DRB1 alleles were genotyped using the polymerase chain reaction. Results. HLA-DRB1*15 was present in 55.8% of the patients with multiple sclerosis and 10.0% of the controls (OR, 5.58; 95% CI, 3.19–9.77; P<0.0001). The protective alleles that were found to be more prevalent among the controls compared with the patients with multiple sclerosis were HLADRB1* 01 (26.7% vs. 7.5%, P<0.0001), *03 (17.5% vs. 8.3%, P=0.034), and *16 (11.7% vs. 3.3%, P=0.014). HLA-DRB1*15 was more common among the female patients with multiple sclerosis than among the male patients (68.4% vs. 34.1%; OR, 4.18; 95%, CI 1.90–9.22; P=0.001). The heterozygous inheritance of HLA-DRB1*15 allele was more common in the patients with a history of maternal multiple sclerosis than in those with a history of paternal multiple sclerosis (29.4% vs. 9.8%; P=0.045). Conclusions. HLA-DRB1*15 was found to be associated with multiple sclerosis in the Lithuanian population. This allele was more prevalent among the female patients with multiple sclerosis. Maternal multiple sclerosis was more common than paternal multiple sclerosis, but the relationship with HLA-DRB1*15 allele was not established. HLA-DRB1*01, *03, and *16 appeared to be the protective alleles in this series.

Gender-related differences in MS: a study of conventional and nonconventional MRI measures

2009 ◽  
Vol 15 (3) ◽  
pp. 345-354 ◽  
Author(s):  
R Antulov ◽  
B Weinstock-Guttman ◽  
JL Cox ◽  
S Hussein ◽  
J Durfee ◽  
...  
Keyword(s):  
Gender Effects ◽  
Mri Findings ◽  
Disease Evolution ◽  
Female Patients ◽  
General Linear Model Analysis ◽  
Relapsing Remitting ◽  
Repair Mechanisms ◽  
Male Patients ◽  
Magnetic Resonance Imaging Mri ◽  
Ventricle Volume

Background Studies showed gender-associated differences in multiple sclerosis (MS) disease evolution and in the evolution of conventional magnetic resonance imaging (MRI) findings. Objective The aim of this study was to investigate gender differences according to a number of conventional and nonconventional MRI measures in patients with MS. Methods We examined 763 consecutive patients with MS [499 (19.2% men) relapsing-remitting (RR), 230 (24.8% men) secondary-progressive, and 34 (44.1% men) primary-progressive], 32 (21.9% men) patients with clinically isolated syndrome (CIS), and 101 (30.7% men) normal controls (NC). Patients were assessed using conventional and nonconventional MRI measures. Gender-related MRI differences were investigated using general linear model analysis, corrected for MS disease type. Results In the total MS group, male patients showed lower normalized peripheral gray matter (GM) ( P < 0.001) and normalized GM ( P = 0.011) volumes than female patients. Female patients presented lower normalized white matter (WM) volumes ( P = 0.011). These gender effects were not observed in NC. Male patients also showed more advanced central atrophy ( P = 0.022). In RRMS male patients, there was also a higher lateral ventricle volume ( P = 0.001). The GM-WM normalized ratio was lower for male patients with MS compared with male NC (0.97 vs. 1.09, P < 0.001) but not in patients with CIS compared with NC. Conclusions There were no significant gender-related differences regarding nonconventional MRI measures. GM and central atrophy are more advanced in male patients, whereas WM atrophy is more advanced in female patients. These gender-related MRI differences may be explained by the effect of sex hormones on brain damage and repair mechanisms.

Altered functional connectivity and performance variability in relapsing–remitting multiple sclerosis

2014 ◽  
Vol 20 (11) ◽  
pp. 1453-1463 ◽  
Author(s):  
Magdalena Wojtowicz ◽  
Erin L Mazerolle ◽  
Virender Bhan ◽  
John D Fisk
Keyword(s):  
Multiple Sclerosis ◽  
Information Processing ◽  
Functional Connectivity ◽  
Processing Speed ◽  
Resting State ◽  
Healthy Controls ◽  
Information Processing Speed ◽  
Frontal Pole ◽  
Performance Variability ◽  
Relapsing Remitting

Background: Patients with multiple sclerosis (MS) demonstrate slower and more variable performance on attention and information processing speed tasks. Greater variability in cognitive task performance has been shown to be an important predictor of neurologic status and provides a unique measure of cognitive performance in MS patients. Objectives: This study investigated alterations in resting-state functional connectivity associated with within-person performance variability in MS patients. Methods: Relapsing–remitting MS patients and matched healthy controls completed structural MRI and resting-state fMRI (rsfMRI) scans, as well as tests of information processing speed. Performance variability was calculated from reaction time tests of processing speed. rsfMRI connectivity was investigated within regions associated with the default mode network (DMN). Relations between performance variability and functional connectivity in the DMN within MS patients were evaluated. Results: MS patients demonstrated greater reaction time performance variability compared to healthy controls ( p<0.05). For MS patients, more stable performance on a complex processing speed task was associated with greater resting-state connectivity between the ventral medial prefrontal cortex and the frontal pole. Conclusions: Among MS patients, greater functional connectivity between medial prefrontal and frontal pole regions appears to facilitate performance stability on complex speed-dependent information processing tasks.

scholarly journals PARATHYROID HORMONE AND BIOCHEMICAL METABOLIC BONE MARKERS IN PATIENTS WITH β-THALASSEMIA MAJOR IN MISAN PROVINCE / IRAQ

2020 ◽  
Vol 17 (35) ◽  
pp. 65-72
Author(s):  
Noor AL-Huda Salah AL-ZUHAIRY ◽  
Zainab Abdul Jabbar Ridha AL-ALI
Keyword(s):  
Vitamin D ◽  
Alkaline Phosphatase ◽  
Thalassemia Major ◽  
Control Group ◽  
Female Patients ◽  
Metabolic Bone ◽  
Significant Difference ◽  
Calcium Phosphorus ◽  
Male Patients ◽  
Serum Pth

Beta-thalassemia is a heterogeneous group of hereditary blood disorders characterized by defects in the synthesis of the β- chains of hemoglobin, resulting in variable phenotypes ranging from severe anemia to clinically asymptomatic individuals. This study aims to assess the serum PTH, vitamin D, calcium, phosphorus, alkaline phosphatase, and magnesium levels in β-thalassemia major patients. A total of 50 (30 male and 20 female) patients with β- thalassemia major with ages range 11- 16 years and an equal number of sex-matched healthy adolescents as a control group were included in this study. A total of 52% of patients were lived in an urban area, and there was no significant difference between patients and the control group regarding residency. Male patients showed low statistically significant (P 0.05) mean serum PTH, vitamin D, and calcium levels, but mean serum phosphorus and alkaline phosphatase levels were significantly higher (P 0.05) as compared to the male control group. However, female patients had low, but without statistical significant (P>0.05) mean serum PTH level, whereas vitamin D and calcium levels were highly significant (P 0.05) reduced. The phosphorus and ALP levels were highly significantly (P 0.05) increased as compared to female controls. Regarding β- thalassemia major group, the current study showed male patients had non-significant (P 0.05) higher levels of PTH, calcium, phosphorus, and ALP. In contrast, vitamin D level was non-significantly (P 0.05) low in male patients as compared to female patients. Mean serum level of PTH had a negative correlation with phosphorus, but it had a positive association with vitamin D, calcium, ALP, and magnesium. In conclusion, this study demonstrated that β-thalassemia major patients have a markedly deranged biochemical metabolic bone profile. Regular monitoring of PTH and biochemical mineral profile is also recommended.

scholarly journals EEG Alpha and Beta Band Functional Connectivity and Network Structure Mark Hub Overload in Mild Cognitive Impairment During Memory Maintenance

2021 ◽  
Vol 13 ◽  
Author(s):  
Zsuzsanna Fodor ◽  
András Horváth ◽  
Zoltán Hidasi ◽  
Alida A. Gouw ◽  
Cornelis J. Stam ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Functional Connectivity ◽  
Network Analysis ◽  
Network Topology ◽  
Medial Temporal Lobe ◽  
Memory Load ◽  
Control Group ◽  
Visuospatial Memory ◽  
Beta Band

Background: While decreased alpha and beta-band functional connectivity (FC) and changes in network topology have been reported in Alzheimer’s disease, it is not yet entirely known whether these differences can mark cognitive decline in the early stages of the disease. Our study aimed to analyze electroencephalography (EEG) FC and network differences in the alpha and beta frequency band during visuospatial memory maintenance between Mild Cognitive Impairment (MCI) patients and healthy elderly with subjective memory complaints.Methods: Functional connectivity and network structure of 17 MCI patients and 20 control participants were studied with 128-channel EEG during a visuospatial memory task with varying memory load. FC between EEG channels was measured by amplitude envelope correlation with leakage correction (AEC-c), while network analysis was performed by applying the Minimum Spanning Tree (MST) approach, which reconstructs the critical backbone of the original network.Results: Memory load (increasing number of to-be-learned items) enhanced the mean AEC-c in the control group in both frequency bands. In contrast to that, after an initial increase, the MCI group showed significantly (p &lt; 0.05) diminished FC in the alpha band in the highest memory load condition, while in the beta band this modulation was absent. Moreover, mean alpha and beta AEC-c correlated significantly with the size of medial temporal lobe structures in the entire sample. The network analysis revealed increased maximum degree, betweenness centrality, and degree divergence, and decreased diameter and eccentricity in the MCI group compared to the control group in both frequency bands independently of the memory load. This suggests a rerouted network in the MCI group with a more centralized topology and a more unequal traffic load distribution.Conclusion: Alpha- and beta-band FC measured by AEC-c correlates with cognitive load-related modulation, with subtle medial temporal lobe atrophy, and with the disruption of hippocampal fiber integrity in the earliest stages of cognitive decline. The more integrated network topology of the MCI group is in line with the “hub overload and failure” framework and might be part of a compensatory mechanism or a consequence of neural disinhibition.

scholarly journals Sex Differences of Uncinate Fasciculus Structural Connectivity in Individuals with Conduct Disorder

2014 ◽  
Vol 2014 ◽  
pp. 1-9 ◽  
Author(s):  
Jibiao Zhang ◽  
Junling Gao ◽  
Huqing Shi ◽  
Bingsheng Huang ◽  
Xiang Wang ◽  
...  
Keyword(s):  
Conduct Disorder ◽  
Diffusion Tensor ◽  
Structural Connectivity ◽  
Gender Effects ◽  
Control Group ◽  
Healthy Controls ◽  
Uncinate Fasciculus ◽  
Female Patients ◽  
Healthy Control ◽  
Microstructural Integrity

Conduct disorder (CD) is one of the most common behavior disorders in adolescents, such as impulsivity, aggression, and running from school. Males are more likely to develop CD than females, and two previous diffusion tensor imaging (DTI) studies have demonstrated abnormal microstructural integrity in the uncinate fasciculus (UF) in boys with CD compared to a healthy control group. However, little is known about changes in the UF in females with CD. In this study, the UF was illustrated by tractography; then, the fractional anisotropy (FA), axial diffusivity, mean diffusion, radial diffusivity (RD), and the length and number of the UF fiber bundles were compared between male and female patients with CD and between female patients with CD and female healthy controls, as well as between males with CD and healthy males. We found that males with CD showed significantly higher FA of the bilateral UF and significantly lower RD of the left UF when comparing with females with CD. Meanwhile, significantly higher FA and lower RD of the bilateral UF were also found in boys with CD relative to the male healthy controls. Our results replicated previous reports that the microstructural integrity of the UF was abnormal in boys with CD. Additionally, our results demonstrated significant gender effects on the UF of patients with CD, which may indicate why boys have higher rates of conduct problems than girls.

scholarly journals Evaluation of Cardiac Repolarization Indices in Epilepsy Patients Treated with Carbamazepine and Valproic Acid

Medicina ◽  
2020 ◽  
Vol 56 (1) ◽  
pp. 20
Author(s):  
Ramazan Asoğlu ◽  
Mahmut Özdemir ◽  
Nesim Aladağ ◽  
Emin Asoğlu
Keyword(s):  
Valproic Acid ◽  
Qt Interval ◽  
Qt Dispersion ◽  
Clonic Seizure ◽  
Control Group ◽  
Cardiac Repolarization ◽  
Healthy Controls ◽  
Male Population ◽  
Female Patients ◽  
Male Patients

Background and Objectives: Epilepsy patients have a higher risk of sudden unexplained death compared to the rest of the population. Cardiac repolarization abnormalities might be seen in epilepsy during interictal periods. We aimed to evaluate the changes in electrocardiography (ECG) parameters in generalized tonic-clonic seizure patients treated with carbamazepine or valproic acid (VPA) drug. Materials and Methods: A totally of 129 subjects (66 epilepsy patients, 63 healthy subjects) were enrolled in the study. Of the patients, 36 were on carbamazepine and 30 were on VPA. There were 12-lead ECGs obtained from all participants. RR interval (time between consecutive R peaks), QT interval (defines the period of ventricular repolarization), corrected QT (QT interval corrected for heart rate; QTc), QTc-maximum (QTc-max), QTc-minimum (QTc-min), QTc dispersion (QTcd), P (atrial depolarization )-maximum (P-max), P-minimum (P-min) and P dispersion (Pd) were measured. Results: QTd (QT dispersion), QTcd, and Pd values were significantly higher in the patients compared to the controls (p < 0.01). QTcd, Pd, and P-max values were statistically higher in male patients compared to healthy male controls. QTcd values were significantly higher in female patients using carbamazepine compared to the female patients on VPA and healthy controls (p = 0.01). Male patients using VPA had significantly higher QTcd values against the male population in carbamazepine and control groups. Conclusions: This study demonstrated that QTd, QTcd, and Pd values were significantly higher in epilepsy patients than in healthy controls. In addition, female patients using carbamazepine and male patients using VPA were prone to ventricular arrhythmia compared to the control group.

scholarly journals Increased functional sensorimotor network efficiency relates to disability in multiple sclerosis

2020 ◽  
pp. 135245852096629
Author(s):  
Myrte Strik ◽  
Declan T Chard ◽  
Iris Dekker ◽  
Kim A Meijer ◽  
Anand JC Eijlers ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Logistic Regression ◽  
Functional Connectivity ◽  
Structural Damage ◽  
Premotor Cortex ◽  
Functional Network ◽  
Grey Matter Volume ◽  
Network Efficiency ◽  
Brain Volumes ◽  
Disability Status

Background: Network abnormalities could help explain physical disability in multiple sclerosis (MS), which remains poorly understood. Objective: This study investigates functional network efficiency changes in the sensorimotor system. Methods: We included 222 MS patients, divided into low disability (LD, Expanded Disability Status Scale (EDSS) ⩽3.5, n = 185) and high disability (HD, EDSS ⩾6, n = 37), and 82 healthy controls (HC). Functional connectivity was assessed between 23 sensorimotor regions. Measures of efficiency were computed and compared between groups using general linear models corrected for age and sex. Binary logistic regression models related disability status to local functional network efficiency (LE), brain volumes and demographics. Functional connectivity patterns of regions important for disability were explored. Results: HD patients demonstrated significantly higher LE of the left primary somatosensory cortex (S1) and right pallidum compared to LD and HC, and left premotor cortex compared to HC only. The logistic regression model for disability ( R2 = 0.38) included age, deep grey matter volume and left S1 LE. S1 functional connectivity was increased with prefrontal and secondary sensory areas in HD patients, compared to LD and HC. Conclusion: Clinical disability in MS associates with functional sensorimotor increases in efficiency and connectivity, centred around S1, independent of structural damage.

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