Understanding network level changes in multiple sclerosis: relationships with cognitive dysfunction.

Multiple sclerosis (MS) is the most common cause of neurological disability in young adults. Cognitive impairment is common and is strongly associated with adverse outcomes including unemployment. Recent studies across a number of neurodegenerative conditions demonstrate that pathology typically occurs along networks of connected brain regions. These regions may be selectively vulnerable due to specific metabolic and cytoarchitectural characteristics. MS, long considered a multi-focal condition characterised by random pathology in the central nervous system, has recently been re-evaluated, in light of similar, network-based pathology.
The present study will examine how changes in core cortical hub regions relate to cognitive impairment in people with MS using a number of complementary approaches. First, we will examine whether patterns of cognitive impairment reflect changes within these core regions. Second, we will examine whether these regions demonstrate changes in levels of sodium accumulation and cortical connectivity at early stages in MS. Third, we will examine whether similar changes occur in the specific pathways linking these hub regions. These findings will offer substantial new insight into the mechanisms of pathology in MS and the factors that affect employment, social function and quality of life.