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Cognitive-motor related brain activity during walking: differences between men and women with multiple sclerosis

Jeffrey R. Hebert, John H. Kindred, Marco Bucci, Jetro J. Tuulari, Lisa A. Brenner, Jeri E. Forster, Phillip J. Koo, Thorsten Rudroff

Archives of Physical Medicine and Rehabilitation, Volume 97, Issue 1, January 2016, Pages 61–66

Study Impact/Highlights

  • To our knowledge, this is the first study to show that mildly disabled men with multiple sclerosis have significantly less brain activity in the thalamus and cerebellum during walking compared with women with multiple sclerosis, which may be unique to this patient population.
  • The suggestion that men may possess inherent, preclinical vulnerability to the neuropathologic processes of multiple sclerosis is not supported by the actual results, but it deserves to be tested in a larger sample of healthy subjects.
  • This study provides the feasibility and utility of positron emission tomography with fluorine-18-labeled deoxyglucose aimed at detecting brain region glucose uptake and activity during a physical performance task.




To determine if sex differences in glucose uptake, a marker of brain activity, are present in brain regions that facilitate walking performance in persons with multiple sclerosis (MS).


Cross-sectional, observational pilot.


University laboratory.


Positron emission tomography with fluorine-18-labeled deoxyglucose (FDG) was performed on persons with MS and healthy controls (4 men and 4 women per group; N=16) after a 15-minute walking test.


Not applicable.

Main Outcome Measure

Brain activity was quantified as the mean standardized uptake value (SUV).


The mean SUV was significantly lower in the thalamus (P=.029) and cerebellum (P=.029) for men with MS compared with women with MS, but not for the prefrontal (P=.057) or frontal (P=.057) cortices. Similar nonsignificant trends were found for healthy controls. No mean SUV group × sex interaction effects were found between the MS and healthy control groups (all P>.05).


To our knowledge, this is the first study of brain activity sex differences based on FDG uptake in persons with MS during walking. Significantly less FDG uptake in the thalamus and cerebellum brain regions important for walking performance was found in men with MS compared with women with MS; however, these comparisons were not significantly different in the healthy control group. No differences in FDG uptake were found between the MS and healthy control groups in any of the brain regions examined. Results from this study provide pilot data for larger studies aimed at identifying underlying mechanisms responsible for accelerated disability in men with MS.

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About the Editors

  • Prof Timothy Vartanian

    Timothy Vartanian, Professor at the Brain and Mind Research Institute and the Department of Neurology, Weill Cornell Medical College, Cornell...
  • Dr Claire S. Riley

    Claire S. Riley, MD is an assistant attending neurologist and assistant professor of neurology in the Neurological Institute, Columbia University,...
  • Dr Rebecca Farber

    Rebecca Farber, MD is an attending neurologist and assistant professor of neurology at the Neurological Institute, Columbia University, in New...

This online Resource Centre has been made possible by a donation from EMD Serono, Inc., a business of Merck KGaA, Darmstadt, Germany.

Note that EMD Serono, Inc., has no editorial control or influence over the content of this Resource Centre. The Resource Centre and all content therein are subject to an independent editorial review.

The Grant for Multiple Sclerosis Innovation
supports promising translational research projects by academic researchers to improve understanding of multiple sclerosis (MS) for the ultimate benefit of patients.  For full information and application details, please click here

Journal Editor's choice

Recommended by Prof. Brenda Banwell

Causes of death among persons with multiple sclerosis

Gary R. Cutter, Jeffrey Zimmerman, Amber R. Salter, et al.

Multiple Sclerosis and Related Disorders, September 2015, Vol 4 Issue 5