Study Impact/Highlights
- •To our knowledge, this is the first study to show that mildly disabled men with multiple sclerosis have significantly less brain activity in the thalamus and cerebellum during walking compared with women with multiple sclerosis, which may be unique to this patient population.
- •The suggestion that men may possess inherent, preclinical vulnerability to the neuropathologic processes of multiple sclerosis is not supported by the actual results, but it deserves to be tested in a larger sample of healthy subjects.
- •This study provides the feasibility and utility of positron emission tomography with fluorine-18-labeled deoxyglucose aimed at detecting brain region glucose uptake and activity during a physical performance task.
Abstract
Objective
To determine if sex differences in glucose uptake, a marker of brain activity, are
present in brain regions that facilitate walking performance in persons with multiple
sclerosis (MS).
Design
Cross-sectional, observational pilot.
Setting
University laboratory.
Participants
Positron emission tomography with fluorine-18-labeled deoxyglucose (FDG) was performed
on persons with MS and healthy controls (4 men and 4 women per group; N=16) after
a 15-minute walking test.
Interventions
Not applicable.
Main Outcome Measure
Brain activity was quantified as the mean standardized uptake value (SUV).
Results
The mean SUV was significantly lower in the thalamus (P=.029) and cerebellum (P=.029) for men with MS compared with women with MS, but not for the prefrontal (P=.057) or frontal (P=.057) cortices. Similar nonsignificant trends were found for healthy controls. No
mean SUV group × sex interaction effects were found between the MS and healthy control
groups (all P>.05).
Conclusions
To our knowledge, this is the first study of brain activity sex differences based
on FDG uptake in persons with MS during walking. Significantly less FDG uptake in
the thalamus and cerebellum brain regions important for walking performance was found
in men with MS compared with women with MS; however, these comparisons were not significantly
different in the healthy control group. No differences in FDG uptake were found between
the MS and healthy control groups in any of the brain regions examined. Results from
this study provide pilot data for larger studies aimed at identifying underlying mechanisms
responsible for accelerated disability in men with MS.
Keywords
List of abbreviations:
FDG (fluorine-18-labeled deoxyglucose), MS (multiple sclerosis), PET (positron emission tomography), SUV (standardized uptake value)To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Archives of Physical Medicine and RehabilitationAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Relapses in multiple sclerosis are age- and time-dependent.J Neurol Neurosurg Psychiatry. 2008; 79: 1368-1374
- Physical activity in subjects with multiple sclerosis with focus on gender differences: a survey.BMC Neurol. 2014; 14: 47
- Frequency, characteristics, and consequences of falls in multiple sclerosis: findings from a cohort study.Arch Phys Med Rehabil. 2014; 95: 538-545
- Falls in people with MS–an individual data meta-analysis from studies from Australia, Sweden, United Kingdom and the United States.Mult Scler. 2015; 21: 92-100
- Brain activity changes in cognitive networks in relapsing-remitting multiple sclerosis - insights from a longitudinal FMRI study.PLoS One. 2014; 9: e93715
- Cognitive impairment in multiple sclerosis.Lancet Neurol. 2008; 7: 1139-1151
- Cognitive dysfunction in multiple sclerosis. II. Impact on employment and social functioning.Neurology. 1991; 41: 692-696
- Cognitive dysfunction in multiple sclerosis. I. Frequency, patterns, and prediction.Neurology. 1991; 41: 685-691
- Sex differences in resting-state functional connectivity in multiple sclerosis.AJNR Am J Neuroradiol. 2013; 34: 2304-2311
- Sex-specific extent and severity of white matter damage in multiple sclerosis: implications for cognitive decline.Hum Brain Mapp. 2014; 35: 2348-2358
- The relationship between MRI and PET changes and cognitive disturbances in MS.J Neurol Sci. 2006; 245: 99-102
- Reduced thalamic and cerebellar rest metabolism in relapsing-remitting multiple sclerosis, a positron emission tomography study: correlations to lesion load.J Neurol Sci. 2006; 245: 103-109
- A brief overview and assessment of the role and benefits of cognitive rehabilitation.Arch Phys Med Rehabil. 2015; 96: 977-980
- Altered functional connectivity and performance variability in relapsing-remitting multiple sclerosis.Mult Scler. 2014; 20: 1453-1463
- Altered likelihood of brain activation in attention and working memory networks in patients with multiple sclerosis: an ALE meta-analysis.Neurosci Biobehav Rev. 2013; 37: 2699-2708
- Thalamic damage and long-term progression of disability in multiple sclerosis.Radiology. 2010; 257: 463-469
- Functional correlates of cognitive dysfunction in multiple sclerosis: a multicenter fMRI study.Hum Brain Mapp. 2014; 35: 5799-5814
- Information processing speed impairment and cerebellar dysfunction in relapsing-remitting multiple sclerosis.J Neurol Sci. 2014; 347: 246-250
- The role of gender and sex hormones in determining the onset and outcome of multiple sclerosis.Mult Scler. 2014; 20: 520-526
- Weight loss after bariatric surgery reverses insulin-induced increases in brain glucose metabolism of the morbidly obese.Diabetes. 2013; 62: 2747-2751
- Automated anatomical labeling of activations in SPM using a macroscopic anatomical parcellation of the MNI MRI single-subject brain.Neuroimage. 2002; 15: 273-289
- Asymmetric glucose uptake in leg muslces of patients with multiple sclerosis during walking detected by [18F]-FDG PET/CT.NeuroRehabilitation. 2014; 35: 813-823
- Walking speed and brain glucose uptake are uncoupled in patients with multiple sclerosis.Front Hum Neurosci. 2014; 9: 84
- Glucose uptake heterogeneity of the leg muscles is similar between patients with multiple sclerosis and healthy controls during walking.Clin Biomech (Bristol, Avon). 2015; 30: 159-165
- Case report: glucose uptake in spinal cord in patients with multiple sclerosis detected by 18F-fluorodeoxyglucose PET/CT after walking.Spinal Cord. 2014; 52: S11-S13
- Nonparametric tests of interaction in experimental design.Rev Educ Res. 1990; 60: 91-126
- Effect size estimates: current use, calculations, and interpretation.J Exp Psychol Gen. 2012; 141: 2-18
- Measuring the cost of cognitive-motor dual tasking during walking in multiple sclerosis.Mult Scler. 2015; 21: 123-131
- Gender differences of brain glucose metabolic networks revealed by FDG-PET: evidence from a large cohort of 400 young adults.PLoS One. 2013; 8: e83821
- Effect of aerobic exercise on cognition, academic achievement, and psychosocial function in children: a systematic review of randomized control trials.Prev Chronic Dis. 2013; 10: E174
- Physical activity and cognitive function in individuals over 60 years of age: a systematic review.Clin Interv Aging. 2014; 9: 661-682
- Motor cognitive dual tasking: Early detection of gait impairment, fall risk and cognitive decline.Z Gerontol Geriatr. 2015; 48: 15-21
- Distracting visuospatial attention while approaching an obstacle reduces the toe-obstacle clearance.Exp Brain Res. 2015; 233: 1137-1144
- Cognitive motor interference during walking in multiple sclerosis using an alternate-letter alphabet task.Arch Phys Med Rehabil. 2014; 95: 1498-1503
- Walking while talking–difficulties incurred during the initial stages of multiple sclerosis disease process.Gait Posture. 2010; 32: 332-335
- Patient-related factors may affect the outcome of neuropysychological rehabilitation in multiple sclerosis.J Neurol Sci. 2013; 334: 106-111
- Cardiorespiratory fitness: a predictor of cortical plasticity in multiple sclerosis.Neuroimage. 2007; 34: 1238-1244
- Aerobic fitness is associated with gray matter volume and white matter integrity in multiple sclerosis.Brain Res. 2010; 1341: 41-51
- Low testosterone is associated with disability in men with multiple sclerosis.Mult Scler. 2014; 20: 1584-1592
- Neuroprotective effects of testosterone treatment in men with multiple sclerosis.Neuroimage Clin. 2014; 4: 454-460
- Testosterone effect on brain metabolism in elderly patients with Alzheimer's disease: comparing two cases at different disease stages.Aging Clin Exp Res. 2013; 25: 343-347
Article Info
Publication History
Published online: October 05, 2015
Footnotes
Supported by the National Multiple Sclerosis Society (grant no. PP1907) and in part by the National Institutes of Health/National Center for Advancing Translational Sciences Colorado Clinical and Translational Sciences Institute (grant no. UL1 TR000154). North American Research Consortium on Multiple Sclerosis is supported in part by the Consortium of Multiple Sclerosis Centers (CMSC) and the CMSC Foundation.
Disclosures: none.
Identification
Copyright
© 2016 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.
