Functional connectivity modifications in monoaminergic circuits occur in fatigued MS patients treated with fampridine and amantadine.
J Neurol
; 270(10): 4697-4706, 2023 Oct.
Article
en En
| MEDLINE
| ID: mdl-37462753
ABSTRACT
BACKGROUND:
Monoaminergic network dysfunction may have a role in multiple sclerosis (MS) fatigue pathogenesis.OBJECTIVE:
To investigate modifications of fatigue severity and resting state (RS) functional connectivity (FC) in monoaminergic networks of 45 fatigued MS patients after different symptomatic treatments.METHODS:
Patients were randomly, blindly assigned to fampridine (n = 15), amantadine (n = 15) or placebo (n = 15) treatment and underwent clinical and 3T-MRI evaluations at baseline (t0) and week 4 (w4), i.e. after four weeks of treatment. Fifteen healthy controls (HC) were enrolled. Dopamine-, noradrenaline- and serotonin-related RS FC was assessed by PET-guided constrained independent component analysis.RESULTS:
At t0, MS patients showed widespread monoamine-related RS FC abnormalities. At w4, fatigue scores decreased in all groups (p = range < 0.001-0.002). Concomitantly, fampridine and amantadine patients showed increased insular RS FC in dopamine-related and noradrenaline-related networks (p < 0.001, uncorrected). Amantadine patients also showed increased RS FC of anterior cingulate cortex in dopamine-related and noradrenaline-related networks (p < 0.001, uncorrected). Placebo patients showed increased precuneus/middle cingulate RS FC in the noradrenaline-related network (p < 0.001, uncorrected). In fampridine and placebo patients, just tendencies towards correlations between RS FC and fatigue modifications were found.CONCLUSIONS:
In MS patients, specific RS FC modifications in PET-guided monoaminergic networks were observed, concomitantly with fatigue improvements following treatment. TRIAL REGISTRATION NUMBER EudraCT 2010-023678-38.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Dopamina
/
Esclerosis Múltiple
Tipo de estudio:
Clinical_trials
/
Etiology_studies
Límite:
Humans
Idioma:
En
Revista:
J Neurol
Año:
2023
Tipo del documento:
Article
País de afiliación:
Italia