Changes in functional network centrality underlie cognitive dysfunction and physical disability in multiple sclerosis

Background:Cognitive dysfunction in multiple sclerosis (MS) has a large impact on the quality of life and is poorly understood.Objective:The aim of this study was to investigate functional network integrity in MS, and relate this to cognitive dysfunction and physical disability.Methods:Resting state fMRI scans were included of 128 MS patients and 50 controls. Eigenvector centrality mapping (ECM) was applied, a graph analysis technique that ranks the importance of brain regions based on their connectivity patterns. Significant ECM changes were related to physical disability and cognitive dysfunction.Results:In MS patients, ECM values were increased in bilateral thalamus and posterior cingulate (PCC) areas, and decreased in sensorimotor and ventral stream areas. Sensorimotor ECM decreases were related to higher EDSS (rho = −0.24, p = 0.007), while ventral stream decreases were related to poorer average cognition (rho = 0.23, p = 0.009). The thalamus displayed increased connectivity to sensorimotor and ventr...