Neuronal Plasticity and Repair

Stroke is the leading cause of permanent disability in adulthood and frequently has serious consequences, particularly for younger individuals. In Austria, around 20,000 people suffer from stroke every year, with 10-15% of cases affecting young adults between the ages of 18 to 55. As part of a long-term project, we are investigating the frequency and severity of motor and cognitive impairment, as well as relevant MRI markers, in young stroke patients. Additionally, we analyze the impact of these factors on quality of life and professional reintegration. The interdisciplinary approach of this project is a unique international feature.

Regardless of motor recovery, many stroke patients experience cognitive impairments - manifesting as challenges with memory, attention, and planning. The underlying causes and effects of these impairments are still inadequately explored.

Diffusion Tensor Imaging (DTI) and resting-state functional MRI (rfMRI) are promising methods for identifying structural and functional brain changes that may predict cognitive recovery after stroke. This project aims to enhance the understanding of the cerebral mechanisms underlying cognitive impairments and the potential for cognitive improvement after stroke.

Multiple sclerosis (MS) is a chronic, inflammatory, and neurodegenerative disease, representing the most prevalent neurological disorder in young adults. Around 40 to 70% of all people with MS suffer from cognitive impairment, such as difficulties with learning, processing speed, and concentration. Cognitive impairment can occur independently of physical impairment and have detrimental effects on employment and quality of life. This project involves standardized assessments and regular monitoring of cognitive performance, alongside the measurement of MRI markers, to identify individuals at high risk for progressive cognitive decline. Additionally, the study investigates potential neuropsychological factors influencing cognitive performance, including fatigue, depressive mood, and anxiety. Improved understanding of brain changes leading to cognitive impairment in MS can facilitate the development of targeted rehabilitation strategies.

Up to 75 % of individuals with MS experience fatigue. Fatigue is characterized by a perceived lack of physical and/or mental energy that impairs the ability to engage in usual and desired activities. Various multidimensional factors contribute to fatigue, some being immutable (e.g. gender, age), whereas others are modifiable (e.g. resilience, depression) through targeted intervention. Effective strategies for mitigating fatigue in MS often address these modifiable factors using psychoeducation, cognitive behavioral therapy and mindfulness exercises.

Additionally, specific structural and functional brain networks, particularly the cortico-striato-thalamo-cortical network, influence the manifestation of fatigue in MS. Consequently, MRI markers may offer valuable supplementary information for the development and refinement of targeted therapeutic approaches.

Psychological resilience is defined as “the process of managing and adapting to significant sources of stress and adversity (to bend-not-break)”. Resilience contributes to mitigate the physical and emotional distress associated with chronic illness, including MS.

In healthy populations, resilience has been associated with brain regions involved in emotional regulation and reward processing. However, the specific brain networks that support high resilience in individuals with MS remain poorly understood.

This study aims to investigate whether and how alterations in brain structure and function related to MS are associated with psychological resilience.

• Almbauer_Lisa
• Brückl_Kerstin
• Helmlinger Birgit

• University of Graz
• Technical University of Graz
• Medical University of Vienna
• Medical University of Innsbruck
• Amsterdam University Medical Centers
• University hospital Bern
• University of Edinburgh
• University of Helsinki
• University of Oxford
• Radboud University Nijmegen