Changes in brain functional connectivity and clinical correlations in neuromyelitis optica spectrum disorder: a longitudinal resting-state fMRI study

NMOSD patients exhibit both compensatory and progressive changes in brain functional connectivity over time. Alterations in the BA23 region are closely associated with clinical outcomes, highlighting its potential as a functional biomarker. Highlights 1. Dynamic alterations in brain functional connectivity were observed in NMOSD patients during follow-up, reflecting both recovery and deterioration. 2. Increased connectivity within the default mode network, especially in the BA23 region, suggests compensatory neural adaptations. 3. Reduced connectivity between BA23 and visual processing regions (fusiform and lingual gyri) was linked to declines in visual acuity and neurological function.