Fatigue in multiple sclerosis: The contribution of occult white matter damage.
Mult Scler
; 22(13): 1676-1684, 2016 11.
Article
em En
| MEDLINE
| ID: mdl-26846989
ABSTRACT
BACKGROUND:
A functional cortico-subcortical disconnection has been recognized in fatigued multiple sclerosis (MS) patients. Normal appearing white matter (NAWM) damage might contribute to the abovementioned disconnectivity.OBJECTIVES:
To assess the relationship between fatigue and microstructural NAWM damage in relapsing-remitting (RR) MS.METHODS:
Sixty RRMS patients and 29 healthy controls (HC) underwent a magnetic resonance imaging (MRI) protocol including diffusion tensor imaging (DTI). Patients with a mean Fatigue Severity Scale (FSS) score ⩾ 4 were considered fatigued (fatigued MS (F-MS)). Tract-based spatial statistics were applied for voxel-wise analysis of DTI indices. A correlation analysis was performed between FSS score and DTI indices in the entire MS group.RESULTS:
Thirty MS patients were F-MS. Compared to HC, F-MS patients showed a more extensive NAWM damage than not fatigued MS (NF-MS) patients, with additional damage in the following tracts frontal and occipital juxtacortical fibers, external capsule, uncinate fasciculus, forceps minor, superior longitudinal fasciculus, cingulum, and pons. No differences were found between F-MS and NF-MS patients. Fatigue severity correlated to DTI abnormalities of corona radiata, cingulum, corpus callosum, forceps minor, superior longitudinal fasciculus, inferior fronto-occipital fasciculus, thalamus and anterior thalamic radiation, cerebral peduncle, and midbrain.CONCLUSIONS:
Fatigue is associated to a widespread microstructural NAWM damage, particularly in associative tracts connected to frontal lobes.Palavras-chave
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Base de dados:
MEDLINE
Assunto principal:
Imageamento por Ressonância Magnética
/
Esclerose Múltipla Recidivante-Remitente
/
Fadiga
/
Substância Branca
Tipo de estudo:
Etiology_studies
Limite:
Adult
/
Female
/
Humans
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Male
/
Middle aged
Idioma:
En
Ano de publicação:
2016
Tipo de documento:
Article