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Journal Article Ppublish 1 citation

PubMed: 42632522 DOI: 10.1016/j.nbd.2026.107579

The neural correlates of walking fatigability in people with multiple sclerosis: An fNIRS study.

Neurobiol Dis 229:107579

Authors: Felipe Balistieri Santinelli, Cintia Ramari, Kim-Charline Broscheid, Rodrigo Vitorio, Daphne Kos, Bart Van Wijmeersch, Miguel D'Haeseleer, Pieter Meyns, Peter Feys

Affiliations

  • University of Hasselt, REVAL Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Hasselt, 3500, Belgium; University MS Centre (UMSC), Hasselt/Pelt, 3500, Belgium.
  • University of Hasselt, REVAL Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Hasselt, 3500, Belgium; University MS Centre (UMSC), Hasselt/Pelt, 3500, Belgium; Department of Neurology, School of Medicine, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, Brazil.
  • University of Hamburg, Faculty of Psychology and Human Movement Science, Department of Sports and Exercise Medicine, Hamburg, Germany.
  • School of Sport, Exercise and Rehabilitation, Northumbria University, Newcastle upon Tyne, UK.
  • National Multiple Sclerosis Center, Melsbroek, Belgium; KU Leuven, Department of Rehabilitation Sciences, Leuven, Belgium.
  • University of Hasselt, REVAL Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Hasselt, 3500, Belgium; University MS Centre (UMSC), Hasselt/Pelt, 3500, Belgium; Noorderhart Hospital, Rehabilitation and MS, Pelt, Belgium.
  • National Multiple Sclerosis Center, Melsbroek, Belgium; Vrije Universiteit Brussel, Department Neuroprotection & Neuromodulation (NEUR), Center for Neurosciences, Faculty of Medicine and Pharmacy, Brussels, Belgium; University Hospital Brussels, Department of Neurology, Brussels, Belgium.
  • University of Hasselt, REVAL Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Hasselt, 3500, Belgium.
  • University of Hasselt, REVAL Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Hasselt, 3500, Belgium; University MS Centre (UMSC), Hasselt/Pelt, 3500, Belgium.

Abstract

Walking fatigability (WF) is a common and disabling feature of people with multiple sclerosis (pwMS), yet its neural underpinnings are poorly understood. Here, we investigated real-time cortical activity during the 6-min walk test (6MWT) and its relationship with changes in gait speed and quality. PwMS with and without WF (n = 42), and healthy controls (HC, n = 25), completed a 6MWT. Using functional near-infrared spectroscopy, cortical activity was measured in the prefrontal, premotor and motor cortices. Concomitantly, inertial measurement units measured gait speed and quality on a minute-by-minute basis. PwMS with WF (Expanded Disability Status Scale-EDSS = 6 [2.62]) showed marked declines in speed and gait quality, accompanied by altered patterns of cortical activation throughout the 6MWT. While HC and pwMS without WF (EDSS = 3[1.75]) dynamically modulated activity across frontal (p < .004), premotor (p < .043) and motor (p < .032) regions to respond to the task demands, pwMS with WF exhibited sustained reliance on frontal cortical regions and limited engagement of the broader walking network. Across all groups and cortical regions, an overall cortical activity pattern was observed. Specifically, cortical activity peaked during the first minute, stabilised during minutes 2-4, and increased during minutes 5-6. In both HC and pwMS, correlation analyses (rho:324-597) indicate that greater increases in cortical activity were associated with better gait speed/quality. Nevertheless, while these associations suggest that HC can recruit a broader walking control network, pwMS demonstrated an executive-driven pattern of brain-gait control. These findings suggest that walking fatigability can be partly driven by impaired ability to flexibly recruit cortical resources during prolonged walking.

MeSH

Sclerosis, Multiple Sclerosis, Gait, Walking Speed, Walking