Preliminary Study Of The Resting-state Functional Magnetic Resonance Imaging In Relapsing-remitting Multiple Sclerosis

Objective: To investigate, by using resting-state functional magnetic resonance imaging(rs-f MRI), alterations of amplitude of low-frequency fluctuation(ALFF) and thalamic functional connectivity(FC) in patients with RRMS, and to assess the diagnostic value of ALFF and FC analysis in RRMS.Methods: Twenty-three patients with RRMS and 23 sex-, age-, education level- matched healthy controls were recruited during August 2014 and December 2015. All subjects provided written informed consent; the study protocol was approved by the review board for this study. All subjects underwent conventional MRI and resting-state functional MRI(rs-f MRI) and a neuropsychological examination with the Expande Disabiliy Status Scale(EDSS) and assesement of disease duraion. Rs-f MRI data were preprocessed before ALFF and FC analysis. Ono-sample t-test was ultilized to obtain the pattern of thalamic functional connectivity and two-sample t-test was applied to compare differences of ALFF and FC results between the two groups. Receiver operating characteristic(ROC) analysis was applied to compare the diagnostic performance of altered ALFF and thalamic FC regions in RRMS.Results:(1)Relative to healthy controls(HC), patients with RRMS showed higher ALFF in the right fusiform gyrus, lower ALFF in the bilateral anterior cingulate gyrus, bilateral caudate and pons.(2)Compared with HC, 1the RRMS group displayed significantly higher FC of the left thalamus between right posterior cerebellum lobe, bilateral middle frontal gyrus, bilateral supplementary motor area, 2they also exhibited lower FC of the left thalamus in the bilateral anterior cerebellum lobe, bilateral Calcarine fissure and surrounding cortex, left superior parietal lobule.3Patients with RRMS showed increased FC of the right thalamus between the right middle frontal gyrus, left inferior parietal lobule, bilateral supplementary motor area, 4they also demonstrated reduced FC of the right thalamus between the bilateral anterior cerebellum lobe, right lingual gyrus, bilateral superior parietal lobule.(3)ROC analysis:.1Fusiform, anterior cingulate cortex displayed highest AUC value repectively(0.898,0.880) in increased and decreased ALFF regions, the cutoff point was 0.62,1.24 respectively with the corresponding sensitivity and specifity(72.2%,94.4%),(77.8%,83.3%) 2Supplementary motor area exhibited highest AUC(0.864) in the increased left thalamic FC regions. Left anterior cerebellum lobe and superior parietal lobule were two of the decreased left thalamic FC regions demonstrating higher relatively AUC values(0.880), the cutoff point of these left altered thalamic regions was 0.12,-0.06 and 0.03 respectively with the corresponding sensitivity and specifity respectively(83.3%,83.3%),(77.8%,88.9%),(88.9%,72.2%). 3Supplementary motor area and left superior parietal lobule showed highest AUC value repectively(0.843,0.886) in increased and decreased right thalamic FC regions, the cutoff point was 0.11,-0.08 respectively with the correspongding sensitivity and specifity(72.2%,83.3%),(94.4%,77.8%). The differences were statistically significant(P<0.05).Conclusions: Intrinsic brain abnormalities of ALFF and thalamic FC were demonstrated in patients with RRMS, the increased ALFF in fusiform, decreased ALFF in ACC, and increased thalamic FC in the supplementary motor area, decreased thalamic FC in anterior cerebellum lobe and superior parietal lobule may become imaging markers for the diagnosis of RRMS.