A widespread pattern of cortical activations in patients at presentation with clinically isolated symptoms is associated with evolution to definite multiple sclerosis.

BACKGROUND AND PURPOSE Movement-associated cortical changes have been detected at the earlier clinical stage multiple sclerosis. Our purpose was to assess whether different patterns of cortical recruitment are associated with the short-term evolution of definite multiple sclerosis (MS). METHODS We followed for 1 year a group of patients with clinically isolated syndromes (CISs) suggestive of MS and compared the baseline movement-associated patterns of cortical activations between those patients with and those without evolution to definite MS. RESULTS Those patients in whom MS did not evolve had more significant activations of several areas part of the "classic" motor network; those who went on to develop MS had more significant activations of several regions in the frontal, parietal, temporal, and occipital lobes. CONCLUSION In CIS patients, the extent of early cortical reorganization following tissue injury might be a factor associated with a different disease evolution.