Cerebellar Contributions to Motor and Cognitive Control in Multiple Sclerosis✰✰✰

Nora E Fritz; Erin M Edwards; Chuyang Ye; Jerry Prince; Zhen Yang; Timothy Gressett; Jennifer Keller; Emily Myers; Peter A Calabresi; Kathleen M Zackowski

doi:10.1016/j.apmr.2021.12.010

Cerebellar Contributions to Motor and Cognitive Control in Multiple Sclerosis^✰✰✰

Arch Phys Med Rehabil. 2022 Aug;103(8):1592-1599. doi: 10.1016/j.apmr.2021.12.010. Epub 2022 Jan 6.

Authors

Affiliations

¹ Center for Movement Studies, Kennedy Krieger Institute, Baltimore, MD; Physical Medicine and Rehabilitation, Johns Hopkins School of Medicine, Baltimore, MD; Department of Health Care Sciences, Wayne State University, Detroit, MI; Department of Neurology, Wayne State University, Detroit, MI; Translational Neuroscience Program, Wayne State University, Detroit, MI. Electronic address: Nora.fritz@wayne.edu.
² Department of Health Care Sciences, Wayne State University, Detroit, MI; Translational Neuroscience Program, Wayne State University, Detroit, MI.
³ School of Information and Electronics, Beijing Institute of Technology, Beijing, China.
⁴ Electrical and Computer Engineering, Johns Hopkins University, Baltimore, MD.
⁵ School of Medicine, Tulane University, New Orleans, LA.
⁶ Center for Movement Studies, Kennedy Krieger Institute, Baltimore, MD.
⁷ Department of Health Care Sciences, Wayne State University, Detroit, MI.
⁸ Department of Neurology, Johns Hopkins University, Baltimore, MD; Department of Neuroscience, Johns Hopkins University, Baltimore, MD.
⁹ Center for Movement Studies, Kennedy Krieger Institute, Baltimore, MD; Physical Medicine and Rehabilitation, Johns Hopkins School of Medicine, Baltimore, MD; Department of Neurology, Johns Hopkins University, Baltimore, MD.

PMID: 34998712
DOI: 10.1016/j.apmr.2021.12.010

Abstract

Objective: To evaluate relationships between specific cerebellar regions and common clinical measures of motor and cognitive function in persons with multiple sclerosis (PwMS).

Design: Cross-sectional.

Setting: Laboratory.

Participants: Twenty-nine PwMS and 28 age- and sex-matched controls without multiple sclerosis (MS) (N=57).

Interventions: Not applicable.

Main outcome measures: Both diffusion and lobule magnetic resonance imaging analyses and common clinical measures of motor and cognitive function were used to examine structure-function relationships in the cerebellum.

Results: PwMS demonstrate significantly worse motor and cognitive function than controls, including weaker strength, slower walking, and poorer performance on the Symbol Digit Modalities Test, but demonstrate no differences in cerebellar volume. However, PwMS demonstrate significantly worse diffusivity (mean diffusivity: P=.0003; axial diffusivity: P=.0015; radial diffusivity: P=.0005; fractional anisotropy: P=.016) of the superior cerebellar peduncle, the primary output of the cerebellum. Increased volume of the motor lobules (I-V, VIII) was significantly related to better motor (P<.022) and cognitive (P=.046) performance, and increased volume of the cognitive lobules (VI-VII) was also related to better motor (P<.032) and cognitive (P=.008) performance, supporting the role of the cerebellum in both motor and cognitive functioning.

Conclusions: These data highlight the contributions of the cerebellum to both motor and cognitive function in PwMS. Using novel neuroimaging techniques to examine structure-function relationships in PwMS improves our understanding of individualized differences in this heterogeneous group and may provide an avenue for targeted, individualized rehabilitation aimed at improving cerebellar dysfunction in MS.

Keywords: Cerebellum; Cognition; Diffusion tensor imaging; Magnetic resonance imaging; Multiple sclerosis; Rehabilitation.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Cerebellum / diagnostic imaging
Cognition
Cross-Sectional Studies
Humans
Magnetic Resonance Imaging
Multiple Sclerosis* / diagnostic imaging