Resting-State EEG Microstates as Dynamic Biomarkers of Network Dysfunction and Cognitive Impairment in Patients With Multiple Sclerosis

BACKGROUND AND OBJECTIVES: Multiple sclerosis (MS) is characterized by large-scale brain network dysfunctions. EEG microstate analysis may track these dynamics. We investigated whether microstates could distinguish patients with MS from healthy volunteers, and cognitively impaired from cognitively preserved (CP) patients. METHODS: For this cross-sectional observational study, we recruited participants from the Policlinico Umberto I Multiple Sclerosis Center (Rome). We compared microstates of patients with relapsing-remitting MS (Expanded Disability Status Scale [EDSS] score <3, no relapses within 30 days) with those of age-matched and sex-matched healthy volunteers. We also compared cognitively impaired and preserved patients. Group comparisons were performed on microstate temporal parameters and topographies (topographic analysis of variance). Classification used stepwise linear discriminant analysis (LDA). RESULTS: = 0.007). DISCUSSION: EEG microstates reveal behaviorally relevant alterations in patients with MS, supporting their utility as sensitive markers of large-scale functional network reorganization associated with clinical disability.