• Tom A Fuchs, Stefano Ziccardi, Benedict Ralph H B RHB Jacobs Multiple Sclerosis Center, Department of Neurology, School of Medicine and Biomedical Sciences, University at Buffalo, State University of N, Alexander Bartnik, Amy Kuceyeski, Leigh E Charvet, Devon Oship, Bianca Weinstock-Guttman, Curtis Wojcik, David Hojnacki, Channa Kolb, Jose Escobar, Rebecca Campbell, Hoan Duc Tran, Niels Bergsland, Dejan Jakimovski, Robert Zivadinov, and Michael G Dwyer.
• Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY.
• J Neuroimaging. 2020 Jul 1; 30 (4): 523-530.

Background And PurposeEfficacy of restorative cognitive rehabilitation can be predicted from baseline patient factors. In addition, patient profiles of functional connectivity are associated with cognitive reserve and moderate the structure-cognition relationship in people with multiple sclerosis (PwMS). Such interactions may help predict which PwMS will benefit most from cognitive rehabilitation. Our objective was to determine whether patient response to restorative cognitive rehabilitation is predictable from baseline structural network disruption and whether this relationship is moderated by functional connectivity.MethodsFor this single-arm repeated measures study, we recruited 25 PwMS for a 12-week program. Following magnetic resonance imaging, participants were tested using the Symbol Digit Modalities Test (SDMT) pre- and postrehabilitation. Baseline patterns of structural and functional connectivity were characterized relative to healthy controls.ResultsLower white matter tract disruption in a network of region-pairs centered on the precuneus and posterior cingulate (default-mode network regions) predicted greater postrehabilitation SDMT improvement (P = .048). This relationship was moderated by profiles of functional connectivity within the network (R2 = .385, P = .017, Interaction β = -.415).ConclusionPatient response to restorative cognitive rehabilitation is predictable from the interaction between structural network disruption and functional connectivity in the default-mode network. This effect may be related to cognitive reserve.© 2020 American Society of Neuroimaging.

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