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. 2024 Nov 12;6(6):fcae353. doi: 10.1093/braincomms/fcae353

Figure 5.

Figure 5

Adaptive functional reorganisation in response to white matter changes resulting in cognitive preservation for children with demyelinating disorders. Results from our PLS path modelling for 26 typically developing children, 17 children with MS and 13 children with MOGAD (A) indicates that children with demyelinating disorders had greater myelin and axon compromise of the DMN and ECN networks relative to typically developing children. In turn, increased structural compromise directly predicted longer pro- and anti-saccade reaction times and greater pro- and anti-saccade direction errors. However, in our model both children with demyelinating disorders and increased myelin and axon compromise of the DMN and ECN separately predicted greater pro- and anti-saccade DMN and ECN functional connectivity, which highlights potential adaptive functional reorganisation of these networks in response to structural compromise. In turn, increased DMN and ECN functional connectivity predicted faster saccade reaction times and fewer pro- and anti-saccade direction errors. To examine the influence of disease disability on DMN and ECN structure-function connectivity and saccade performance, separate PLS path models were conducted for children with demyelinating disorders. For both children diagnosed with MS (B) and MOGAD (C), we found that increased disease disability, highlighted by EDSS, age at diagnosis and number of optic neuritis episodes, predicted greater myelin and axon compromise of the DMN and ECN. In turn, increased structural compromise directly predicted longer pro- and anti-saccade reaction times and greater pro- and anti-saccade direction errors. Increased disease disability and increased myelin and axon compromise of the DMN and ECN both directly predicted decreased pro- and anti-saccade DMN and ECN neural synchrony. In turn, decreased DMN and ECN functional connectivity predicted longer pro- and anti-saccade reaction times and greater pro- and anti-saccade direction errors. MOGAD, children diagnosed with myelin oligodendrocyte glycoprotein-associated disorders; MS, children diagnosed with multiple sclerosis; ON, optic neuritis; EDSS, expanded disability status scale; * = P < 0.05.