BACKGROUND The development of tailored recovery-oriented strategies in multiple sclerosis requires early identification of an individual's potential for functional recovery. OBJECTIVE To identify predictors of visuomotor performance improvements, a proxy of functional recovery, using a predictive statistical model that combines demographic, clinical and magnetic resonance imaging (MRI) data. METHODS Right-handed multiple sclerosis patients underwent baseline disability assessment and MRI of the brain structure, function and vascular health. They subsequently undertook 4 weeks of right upper limb visuomotor practice. Changes in performance with practice were our outcome measure. We identified predictors of improvement in a training set of patients using lasso regression; we calculated the best performing model in a validation set and applied this model to a test set. RESULTS Patients improved their visuomotor performance with practice. Younger age, better visuomotor abilities, less severe disease burden and concurrent use of preventive treatments predicted improvements. Neuroimaging localised outcome-relevant sensory motor regions, the microstructure and activity of which correlated with performance improvements. CONCLUSION Initial characteristics, including age, disease duration, visuo-spatial abilities, hand dexterity, self-evaluated disease impact and the presence of disease-modifying treatments, can predict functional recovery in individual patients, potentially improving their clinical management and stratification in clinical trials. MRI is a correlate of outcome, potentially supporting individual prognosis.

中文翻译：

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多发性硬化症患者视觉运动表现训练相关改善的预测因素：行为和 MRI 研究

背景技术在多发性硬化症中制定以恢复为导向的定制策略需要及早识别个体的功能恢复潜力。目的 使用结合人口统计、临床和磁共振成像 (MRI) 数据的预测统计模型来确定视觉运动性能改善的预测因子（功能恢复的指标）。方法 右手多发性硬化症患者接受基线残疾评估和大脑结构、功能和血管健康的 MRI。随后他们进行了为期 4 周的右上肢视觉运动练习。实践中表现的变化是我们的结果衡量标准。我们使用套索回归确定了一组患者训练中改善的预测因子；我们计算了验证集中性能最佳的模型，并将该模型应用于测试集。结果 患者通过练习改善了视觉运动表现。更年轻的年龄、更好的视觉运动能力、更轻的疾病负担以及同时使用预防性治疗预示着病情会有所改善。神经影像学定位与结果相关的感觉运动区域，其微观结构和活动与性能改善相关。结论 初始特征，包括年龄、病程、视觉空间能力、手的灵活性、自我评估的疾病影响以及疾病缓解治疗的存在，可以预测个体患者的功能恢复，从而有可能改善他们的临床管理和临床试验中的分层。MRI 与结果相关，可能支持个体预后。