The Dynamic Brain in Multiple Sclerosis: Excitation–Inhibition Balance, Network States and Cognitive Impairment
Prof. Jeroen van Schependom
Senior Research Fellow (Hoofddocent)
Faculty Of Engineering, Faculty Of Medicine and Pharmacy
Vrije Universiteit Brussel, Belgie/Belgium
Cognitive impairment in multiple sclerosis is often approached as a consequence of structural damage, yet the symptoms experienced by patients emerge from ongoing neural activity that unfolds over milliseconds to seconds. In this keynote, I will argue that understanding cognitive impairment in MS requires a dynamic view of brain function. I will present recent work combining electrophysiological markers of excitation–inhibition balance with analyses of transient brain network states during rest and cognitive tasks. These studies suggest that MS is associated with altered aperiodic activity, reduced modulation of neural excitability during cognitive demands, and less reliable activation of task-relevant network states. Rather than reflecting a single impaired region or network, cognitive dysfunction in MS may therefore arise from a reduced capacity of the brain to flexibly regulate and coordinate activity over time. This dynamic perspective may help explain deficits in information processing speed and provides a framework for developing sensitive biomarkers and targeted neuromodulation strategies.