Compensatory activations in patients with multiple sclerosis during preserved performance on the auditory N-back task.

Recent fMRI studies have suggested that multiple sclerosis (MS) patients show adaptive cortical changes (i.e., compensatory mechanisms) during motor and cognitive tasks to limit the clinical impact of tissue injury. In this study, we investigated the activation pattern during the auditory n-back working memory (WM) paradigm in a group of 17 MS patients and 10 healthy controls with preserved performance in WM tasks. Compared with healthy controls, MS patients showed significantly greater bilateral activation in prefrontal cortex (BA 44), and the insula. These findings were similar to those obtained in previous studies showing that compensatory mechanisms during WM tasks in MS may be based on the use of prefrontal areas adjacent to those involved in the task.