Structural correlates for fatigue in early relapsing remitting multiple sclerosis.

OBJECTIVES: Fatigue is a common symptom in multiple sclerosis (MS) patients, even early in the disease, but the pathophysiology remains unclear. We aimed to determine morphologic and microstructural correlates and neuropsychological parameters of cognitive fatigue in early relapsing-remitting MS patients. METHODS: Seventy-nine early relapsing-remitting MS patients (38 with fatigue and 41 without), none of whom suffered from depression, underwent neuropsychological testing. Magnetic resonance imaging was performed using anatomical and diffusion tensor imaging sequences on all patients and 40 controls. Voxel-based morphologic analysis and tract-based spatial statistics were performed. RESULTS: Only patients with cognitive fatigue, but not those without, exhibited alterations in the thalamic region, showing reduced thalamic fractional anisotropy and increased mean diffusivity values. No differences in lesion volume and lesion distribution were observed between patient groups. In cognitive tests, no significant differences were found between the two groups in the number of patients with pathologic scores; however, subjective cognitive impairment differed. CONCLUSION: Morphological alterations and distinct microstructural changes (mainly in the thalamus) but not typical MS lesions were found to be related to cognitive fatigue in early MS. We suggest that compensatory processes adapting to these changes could initially facilitate normal cognitive performance, but also result in a feeling of fatigue. KEY POINTS: • Morphological alterations and microstructural changes are related to fatigue in multiple sclerosis • Thalamic alterations in particular were related to fatigue in early MS • Fatigued patients exhibited subjective but not measurable cognitive impairment • Compensatory processes help preserve or maintain cognitive performance but also contribute to fatigue.

Putaminal alteration in multiple sclerosis patients with spinal cord lesions.

Typical multiple sclerosis (MS) lesions occur in the brain as well as in the spinal cord. However, two extreme magnetic resonance imaging phenotypes appear occasionally: those with predominantly spinal cord lesions (MS + SL) and those with cerebral lesions and no detectable spinal lesions (MS + CL). We assessed whether morphological differences can be found between these two extreme phenotypes. We examined 19 patients with MS + SL, 18 with MS + CL and 20 controls. All subjects were examined using magnetic resonance imaging, including anatomical and diffusion tensor imaging sequences. Voxel-based morphologic and regions of interest-based analyses and tract-based spatial statistics were performed. Patients also underwent neuropsychological testing. Demographic, clinical and neuropsychological characteristics did not differ between MS + SL and MS + CL patients. Patients with MS + SL showed significantly larger putamen volumes than those with MS + CL which correlated negatively with disability. Compared to controls, only MS + CL revealed clear cortical and deep gray matter atrophy, which correlated with cerebral lesion volume. Additionally, extensive white matter microstructural damage was found only in MS + CL compared to MS + SL and controls in the tract-based spatial statistics. Higher putamen volumes in MS + SL could suggest compensatory mechanisms in this area responsible for motor control. Widely reduced fractional anisotropy values in MS + CL were caused by higher cerebral lesion volume and thus presumably stronger demyelination, which subsequently leads to higher global gray matter atrophy.

On the accuracy of framing-rate measurements in ultra-high speed rotating mirror cameras.

Rotating mirror systems based on the Miller Principle are a mainstay modality for ultra-high speed imaging within the range 1-25 million frames per second. Importantly, the true temporal accuracy of observations recorded in such cameras is sensitive to the framing rate that the system directly associates with each individual data acquisition. The purpose for the present investigation was to examine the validity of such system-reported frame rates in a widely used commercial system (a Cordin 550-62 model) by independently measuring the framing rate at the instant of triggering. Here, we found a small but significant difference between such measurements: the average discrepancy (over the entire spectrum of frame rates used) was found to be 0.66 ± 0.48%, with a maximum difference of 2.33%. The principal reason for this discrepancy was traced to non-optimized sampling of the mirror rotation rate within the system protocol. This paper thus serves three purposes: (i) we highlight a straightforward diagnostic approach to facilitate scrutiny of rotating-mirror system integrity; (ii) we raise awareness of the intrinsic errors associated with data previously acquired with this particular system and model; and (iii), we recommend that future control routines address the sampling issue by implementing real-time measurement at the instant of triggering.

Chip Protein U-Box Domain Truncation Affects Purkinje Neuron Morphology and Leads to Behavioral Changes in Zebrafish.

The ubiquitin ligase CHIP (C-terminus of Hsc70-interacting protein) is encoded by STUB1 and promotes ubiquitination of misfolded and damaged proteins. CHIP deficiency has been linked to several diseases, and mutations in the human STUB1 gene are associated with recessive and dominant forms of spinocerebellar ataxias (SCAR16/SCA48). Here, we examine the effects of impaired CHIP ubiquitin ligase activity in zebrafish (Danio rerio). We characterized the zebrafish stub1 gene and Chip protein, and generated and characterized a zebrafish mutant causing truncation of the Chip functional U-box domain. Zebrafish stub1 has a high degree of conservation with mammalian orthologs and was detected in a wide range of tissues in adult stages, with highest expression in brain, eggs, and testes. In the brain, stub1 mRNA was predominantly detected in the cerebellum, including the Purkinje cell layer and granular layer. Recombinant wild-type zebrafish Chip showed ubiquitin ligase activity highly comparable to human CHIP, while the mutant Chip protein showed impaired ubiquitination of the Hsc70 substrate and Chip itself. In contrast to SCAR16/SCA48 patients, no gross cerebellar atrophy was evident in mutant fish, however, these fish displayed reduced numbers and sizes of Purkinje cell bodies and abnormal organization of Purkinje cell dendrites. Mutant fish also had decreased total 26S proteasome activity in the brain and showed behavioral changes. In conclusion, truncation of the Chip U-box domain leads to impaired ubiquitin ligase activity and behavioral and anatomical changes in zebrafish, illustrating the potential of zebrafish to study STUB1-mediated diseases.