White Matter Damage in Multiple Sclerosis Disproportionately Targets Default Mode, Executive Control, and Salience Networks
- Teresa D. Figley1,2,3,4,
- Jennifer Kornelsen1,2,3,4,
- Md Nasir Uddin1,2,3,*,
- Kaihim Wong1,2,3,4,
- Salina Pirzada1,2,3,
- Sean Carter1,2,3,
- Carl A. Helmick5,
- Christopher B. O’Grady6,
- Erin L. Mazerolle7,
- Ronak Patel4,8,
- Charles N. Bernstein9,
- John D. Fisk5,10,
- Ruth Ann Marrie4,9,10,11,
- Chase R. Figley1,2,3,4,
- for the Comorbidity and Cognition in Multiple Sclerosis (CCOMS) Study Group†
- 1Department of Radiology, University of Manitoba, Winnipeg, Manitoba R3A 1R9, Canada
- 2Division of Diagnostic Imaging, Health Sciences Centre, Winnipeg, Manitoba R3A 1R9, Canada
- 3PrairieNeuro Research Centre, Kleysen Institute for Advanced Medicine, Winnipeg, Manitoba R3E 0Z3, Canada
- 4Manitoba Multiple Sclerosis Research Centre, University of Manitoba, Winnipeg, Manitoba R3E 3P5, Canada
- 5Departments of Psychiatry, Medicine, Psychology & Neuroscience, Dalhousie University, Halifax, Nova Scotia B3H 2E2, Canada
- 6Department of Anesthesia and Biomedical Translational Imaging Centre, Dalhousie University, Halifax, Nova Scotia B3H 3A7, Canada
- 7Departments of Psychology and Computer Science, St. Francis Xavier University, Antigonish, Nova Scotia B2G 2W5, Canada
- 8Department of Clinical Health Psychology, University of Manitoba, Winnipeg, Manitoba R3E 3N4, Canada
- 9Department of Internal Medicine, University of Manitoba, Winnipeg, Manitoba R3E 3N4, Canada
- 10Nova Scotia Health, Halifax, Nova Scotia B3H 2Y9, Canada
- 11Departments of Medicine and Community Health and Epidemiology, Dalhousie University, Halifax, Nova Scotia B3H 2Y9, Canada
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Author contributions: T.D.F., J.K., M.N.U., K.W., S.P., S.C., C.A.H., C.B.O’G., E.L.M., R.P., C.N.B., J.D.F., R.A.M., and C.R.F. designed research; T.D.F. and C.R.F. performed research; T.D.F., M.N.U., K.W., S.P., C.A.H., C.B.O’G., and C.R.F. analyzed data.
Abstract
Multiple sclerosis (MS) and several other neurodegenerative disorders affect structurally and functionally connected brain networks. However, the extent of structural damage within specific networks relative to global white matter has not been systematically explored in MS. The aims of this study were therefore to investigate white matter within six brain networks—i.e., dorsal/ventral default mode, left/right executive control, and anterior/posterior salience networks—to (1) determine whether MS white matter lesions are disproportionately prevalent in these regions compared with global white matter; (2) quantify microstructural degradation in these regions among persons with MS (pwMS) compared with healthy controls (HCs); and (3) ascertain whether network degradation is larger than expected compared with global white matter differences between pwMS and HCs. White matter lesion maps, global white matter masks, and whole-brain diffusion MRI maps of mean diffusivity from 104 pwMS (48 ± 12 years; 85 female) and 100 HCs (39 ± 16; 65 female) were analyzed using the UManitoba-JHU Functionally-Defined Human White Matter Atlases. Statistical analyses included parametric t tests and post hoc nonparametric Wilcoxon tests. Among pwMS, 4/6 white matter networks contained disproportionately high lesion volumes (p < 0.008). All six networks exhibited lower microstructure among pwMS compared with HCs (p < 0.008); and even after controlling for subject-specific global white matter values, 5/6 white matter networks exhibited disproportionately reduced tissue microstructure among pwMS compared with HCs (p < 0.008). These findings suggest that MS disproportionately affects white matter structural connections underlying specific intrinsic brain networks, including the default mode, executive control, and salience networks.
- diffusion MRI
- lesion network mapping
- multiple sclerosis
- network collapse
- network degeneration
- structural connectivity
- white matter
- Received February 9, 2025.
- Revision received February 26, 2026.
- Accepted March 25, 2026.
- Copyright © 2026 the authors





