{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T12:22:11Z","timestamp":1789129331613,"version":"build-2803163510"},"reference-count":44,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"vor","delay-in-days":243,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Fondo Italiano per la Scienza"},{"DOI":"10.13039\/100007366","name":"Fondazione Italiana Sclerosi Multipla","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100007366","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,9,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>The neural mechanisms underlying cognitive dysfunction in aquaporin-4 antibody-positive neuromyelitis optica spectrum disorder (AQP4 + NMOSD) remain unclear. Functional connectivity (FC) studies have revealed network-level alterations, but little is known about the effective interactions that support compensatory reorganization.<\/jats:p>\n                  <jats:p>To address this gap, we investigated how alterations in functional and effective connectivity within large-scale networks relate to cognitive performance in AQP4 + NMOSD.<\/jats:p>\n                  <jats:p>To this end, 20 AQP4 + NMOSD patients and 20 age- and sex-matched healthy controls underwent 3-T structural MRI and resting-state functional MRI. Seed-based and region-of-interest connectivity analyses focused on the default mode network and ventral attention network. Directional interactions were assessed using dynamic causal modelling (DCM). Cognitive performance was evaluated with the Brief International Cognitive Assessment for Multiple Sclerosis and the Controlled Oral Word Association Test (COWAT).<\/jats:p>\n                  <jats:p>Overall, cognition was quite preserved in patients, except for reduced COWAT scores. Functional connectivity analyses revealed increased intra-network functional connectivity but decreased anterior\u2013posterior default mode network integration. Dynamic causal modelling showed asymmetric prefrontal\u2013posterior interactions, with stronger top-down excitatory influences from prefrontal to posterior regions.<\/jats:p>\n                  <jats:p>Taken together, these findings indicate that AQP4 + NMOSD patients exhibit altered functional brain organization despite relatively preserved cognition, suggesting a pattern of large-scale network reorganization that may support cognitive performance.<\/jats:p>","DOI":"10.1093\/braincomms\/fcag334","type":"journal-article","created":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T10:32:34Z","timestamp":1788258754000},"source":"Crossref","is-referenced-by-count":0,"title":["Functional and effective connectivity alterations relate to cognitive performance in aquaporin-4 antibody-positive neuromyelitis optica spectrum disorder"],"prefix":"10.1093","volume":"8","author":[{"given":"Elisa","family":"Leveraro","sequence":"first","affiliation":[{"name":"Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, and Mother\u2013Child Health (DINOGMI), University of Genoa , Genoa 16132 ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0304-0529","authenticated-orcid":false,"given":"Emilio","family":"Cipriano","sequence":"additional","affiliation":[{"name":"Department of Physics (DIFI), University of Genoa , Genoa 16146 ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giada","family":"Lombardi","sequence":"additional","affiliation":[{"name":"Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, and Mother\u2013Child Health (DINOGMI), University of Genoa , Genoa 16132 ,","place":["Italy"]},{"name":"Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King\u2019s College London , London SE5 8AB ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniela","family":"Curr\u00f2","sequence":"additional","affiliation":[{"name":"Department of Neurology, Ospedale San Paolo , Savona 17100 ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3515-3475","authenticated-orcid":false,"given":"Francesco","family":"Tazza","sequence":"additional","affiliation":[{"name":"Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, and Mother\u2013Child Health (DINOGMI), University of Genoa , Genoa 16132 ,","place":["Italy"]},{"name":"IRCCS Azienda Ospedaliera Metropolitana\u2014IRCCS AOM , Genova 16132 ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanni","family":"Novi","sequence":"additional","affiliation":[{"name":"IRCCS Azienda Ospedaliera Metropolitana\u2014IRCCS AOM , Genova 16132 ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alice","family":"Laroni","sequence":"additional","affiliation":[{"name":"Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, and Mother\u2013Child Health (DINOGMI), University of Genoa , Genoa 16132 ,","place":["Italy"]},{"name":"IRCCS Azienda Ospedaliera Metropolitana\u2014IRCCS AOM , Genova 16132 ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paola","family":"Gazzola","sequence":"additional","affiliation":[{"name":"Department of Neurology, PA. Micone Hospital, ASL3 , Genoa 16154 ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Malentacchi","sequence":"additional","affiliation":[{"name":"Department of Neurology and CRESM, San Luigi Gonzaga University Hospital , Orbassano 10043 ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Loredana","family":"Petrucci","sequence":"additional","affiliation":[{"name":"Department of Neurology, Hospital Sant'Andrea , La Spezia 19124 ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3527-6520","authenticated-orcid":false,"given":"Caterina","family":"Lapucci","sequence":"additional","affiliation":[{"name":"IRCCS Azienda Ospedaliera Metropolitana\u2014IRCCS AOM , Genova 16132 ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matilde","family":"Inglese","sequence":"additional","affiliation":[{"name":"Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, and Mother\u2013Child Health (DINOGMI), University of Genoa , Genoa 16132 ,","place":["Italy"]},{"name":"IRCCS Azienda Ospedaliera Metropolitana\u2014IRCCS AOM , Genova 16132 ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,9,1]]},"reference":[{"issue":"7","key":"2026091107171470800_fcag334-B1","doi-asserted-by":"crossref","first-page":"3341","DOI":"10.1007\/s00415-023-11634-0","article-title":"Update on the diagnosis and treatment of neuromyelits optica spectrum disorders (NMOSD) \u2013 revised recommendations of the Neuromyelitis Optica Study Group (NEMOS). 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