Altered basal ganglia functional connectivity in multiple sclerosis patients with fatigue

Finke, Carsten; Schlichting, Jeremias; Papazoglou, Sebastian; Scheel, Michael; Freing, Alina; Soemmer, Carina; Pech, LM; Pajkert, Anna; Pfüller, Caspar; Wuerfel, Jens; Ploner, Christoph J.; Paul, Friedemann; Brandt, AU

doi:10.1177/1352458514555784

Cited by 157 publications

(158 citation statements)

References 40 publications

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“…More interestingly, several MS fatigue networks have been described: the fronto-striatal network [157,179,209], the parieto-striatal network [37], the cortico-cortical network mainly involving fronto-frontal and fronto-parietal regions [13,157,169,202,221] and an interhemispheric network consisting of the corpus callosum and its radiating fibers [13,75,178,244,245]. All of them take part in the socalled ''cortico-striato-thalamo-cortical loop'' of MS fatigue [13,22,47,48,54,57,58,70,169,176,177]. Fig.…”

Section: Anatomical Correlates Of Ms Fatigue: the Cortico-striato-thamentioning

confidence: 98%

Fatigue in multiple sclerosis – Insights into evaluation and management

Ayache

Chalah

2017

Neurophysiologie Clinique/Clinical Neurophysiology

126

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Section: Anatomical Correlates Of Ms Fatigue: the Cortico-striato-thamentioning

confidence: 98%

Fatigue in multiple sclerosis – Insights into evaluation and management

Ayache

Chalah

2017

Neurophysiologie Clinique/Clinical Neurophysiology

126

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“…Inflammation has been shown to affect intrinsic connectivity (134–136) and, for instance, the connectivity between the insula and mid-cingulate cortex seems associated with the inflammation-induced state of malaise and discomfort, in line with the interoceptive role of insula (136). Although this has not yet been studied in relation to fatigue, it is probable that altered connections between structures, in addition to specific structural changes, also contribute to the development of fatigue (97, 137). …”

Section: Potential Neuronal Mechanisms Underlying Dimensions Of Inflamentioning

confidence: 99%

Role of Inflammation in Human Fatigue: Relevance of Multidimensional Assessments and Potential Neuronal Mechanisms

2017

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Fatigue is a highly disabling symptom in various medical conditions. While inflammation has been suggested as a potential contributor to the development of fatigue, underlying mechanisms remain poorly understood. In this review, we propose that a better assessment of central fatigue, taking into account its multidimensional features, could help elucidate the role and mechanisms of inflammation in fatigue development. A description of the features of central fatigue is provided, and the current evidence describing the association between inflammation and fatigue in various medical conditions is reviewed. Additionally, the effect of inflammation on specific neuronal processes that may be involved in distinct fatigue dimensions is described. We suggest that the multidimensional aspects of fatigue should be assessed in future studies of inflammation-induced fatigue and that this would benefit the development of effective therapeutic interventions.

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“…Numerous factors have been described that could be associated with fatigue, for instance, lesions of motor pathways [11, 12], frontal hypometabolism [13], sympathetic dysfunction [14], cytokine dysregulation [15, 16], and basal ganglia dysfunction leading to alterations in dopamine pathways and metabolism [17, 18]. The plethora of proposed mechanisms suggests that MS-associated fatigue may be a syndrome with different origins in individual patients rather than related to a universal factor.…”

Section: Discussionmentioning

confidence: 99%

Neuropsychological Training of Attention Improves MS-Related Fatigue: Results of a Randomized, Placebo-Controlled, Double-Blind Pilot Study

et al. 2017

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Background: Attentional deficits may be pathophysiologically relevant in MS-associated fatigue. Patients and Methods: Thirty MS patients with fatigue and attentional deficits in neuropsychological testing participated in this randomized, placebo-controlled, double-blind trial. The intervention group (IG; n = 14) was treated with 10 h of computerized, specific neuropsychological training performing simple reaction time tasks, whereas the control group (CG; n = 16) also runs through computerized, but unspecific neuropsychological training using tasks without time components. The subjective feeling of fatigue was assessed with the Würzburg Fatigue Inventory for Multiple Sclerosis (WEIMuS) questionnaire, and testing of alertness was used as an objective measure at baseline and after the 2-week study period. Results: Reaction times of alertness were significantly decreased in IG but not CG after 2 weeks. The subjective feeling of fatigue was ameliorated in both groups but more pronounced in IG. Effect sizes were below 0.7 for alertness and WEIMuS scores in CG but large and clinically meaningful in IG for both measures. Conclusions: Our pilot study suggests that neuropsychological training of attention may improve both measures of fatigue. The parallel improvement of attentional deficits and subjective fatigue after specific neuropsychological training support previous findings that fatigue may be at least partially caused by impaired intensity of attention.

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Altered basal ganglia functional connectivity in multiple sclerosis patients with fatigue

Cited by 157 publications

References 40 publications

Fatigue in multiple sclerosis – Insights into evaluation and management

Fatigue in multiple sclerosis – Insights into evaluation and management

Role of Inflammation in Human Fatigue: Relevance of Multidimensional Assessments and Potential Neuronal Mechanisms

Neuropsychological Training of Attention Improves MS-Related Fatigue: Results of a Randomized, Placebo-Controlled, Double-Blind Pilot Study

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