Evaluation of MS related central fatigue using MR neuroimaging methods: Scoping review

Arm, Jameen; Ribbons, Karen; Lechner‐Scott, Jeannette; Ramadan, Saadallah

doi:10.1016/j.jns.2019.03.007

Cited by 62 publications

(67 citation statements)

References 127 publications

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“…According to existing data resulting from studies investigating the correlation between fatigue and fMRI, the MFIS scale has not been used so widely in similar research. Most published studies evaluate fatigue with the FSS, self-reported cognitive fatigue by a VAS scale, or physical fatigue after induction with a motor task (18). This differentiation between fatigue domains is pragmatic considering some of the recommendations made by researchers in this field (4, 7).…”

Section: Discussionmentioning

confidence: 99%

Functional Magnetic Resonance Imaging Correlations Between Fatigue and Cognitive Performance in Patients With Relapsing Remitting Multiple Sclerosis

et al. 2019

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The correlation between fatigue and cognitive performance in multiple sclerosis (MS) is well reported, but the intimate mechanisms of the fatigue impact on cognition are not fully defined yet. The aim of this study is to investigate blood oxygen level–dependent (BOLD) activations in relapsing remitting MS (RRMS) patients with and without cognitive dysfunction and the impact of fatigue on cortical activations. Forty-two patients with RRMS were enrolled in the study. Cognitive functioning was assessed by the Symbol Digit Modalities Test (SDMT) and Paced Serial Addition Test (PASAT). A cutoff point of a total score of 55 on the SDMT was used to divide the patients into two groups: cognitively impaired (CI), SDMT score equal to or below 55 points, and cognitively preserved (CP), SMDT score above 55 points. Fatigue was assessed by the Modified Fatigue Impact Scale (MFIS). Participants were assessed with the Beck Depression Inventory (BDI) prior to inclusion in order to exclude major depressive episode. Functional Magnetic Resonance Imaging (fMRI) scanning was performed on a 3T MRI. The PVSAT (Paced Visual Serial Addition Test) paradigm was applied as a cognitive task. All functional data were analyzed with SPM12 and statistical analysis with SPSS 19.0. No statistically significant differences between CI and CP patients were found (p=0.953, p=0.322) in the MFIS and BDI score. Performance on the PASAT in CI patients was 34.07±13.721, for CP patients 46.42±11.453, and the SDMT performance in the CI patient group was 42.40±9.179, in the CP group 57.83±2.552. Between-group analysis revealed increased activations in left Brodmann area (BA) 40 in CP patients with several clusters located in the left supramarginal gyrus. Regression analysis showed increased BOLD signal in left BA 40, right BA 40, and left BA 6, associated with a higher score on MFIS. Stronger BOLD signal in left BA 31 was associated with a lower score on MFIS. Significance level was set to p<0.05, FWE (family-wise error) corrected. The differences in BOLD activations suggest the presence of cortical reorganization in our CP patients. The impact of fatigue on cortical activation during a cognitive task is demonstrated by inconformity of activated areas depending on the MFIS score. Our results suggest that activation in BA 40 may represent a mechanism for diminishing fatigue impact on cognitive functioning in CP patients.

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Section: Discussionmentioning

confidence: 99%

Functional Magnetic Resonance Imaging Correlations Between Fatigue and Cognitive Performance in Patients With Relapsing Remitting Multiple Sclerosis

et al. 2019

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“…The majority of studies assessing the link between lesion load and MS-related fatigue 5 reported no association with fatigue considering the brain as a whole. Nevertheless, when specific regions are considered, several studies found an association between fatigue and lesion load in the basal ganglia, frontal and parietal lobes and other cortical areas.…”

Section: Macro- and Microstructural Features Of Ms Fatiguementioning

confidence: 99%

“…A recent review on brain atrophy and fatigue 5 found that only some studies reported no association between fatigue and global atrophy of deep grey matter (GM) structures and cortical GM volumes or thinning of the rolandic region. In contrast, the majority of studies showed an association between global brain atrophy and MS-related cognitive and motor fatigue.…”

Section: Macro- and Microstructural Features Of Ms Fatiguementioning

confidence: 99%

Fatigue in multiple sclerosis: Does the functional or structural damage prevail?

Bertoli

Tecchio

2020

Mult Scler

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Fatigue in multiple sclerosis (MS) is a highly invalidating symptom, lacking efficacious drugs. This topical review aims at assessing the signs in the literature of functional versus structural damage prevalence at the origin of MS fatigue by focusing on papers that assessed the two counterparts in the same patients, paying attention that the fatigue levels do not correlate with clinical severity. We summarize and discuss evidence of increased levels of fatigue occurring together with the alterations of functional connectivity at multiple levels, in the absence of any relationship with lesion load and local atrophy of the involved structures. Specifically, neuronal communication mainly altered in the corticomuscular synchronizations, between hemispheric homologs and in the resting-state networks involved in emotion (cingulate cortex) and effort-reward balance (striatum and inferior parietal lobule). Finally, given the functional prevalence in neuronal network alterations at the origin of fatigue in MS, we highlight the relevance of developing treatments aiming at compensating the neuronal electric communication dysfunctions.

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“…29 A recent systematic review suggested that the cortico-striato-thalamo-cortical loop has close connections with the development of central fatigue. 30 Disability, as measured by EDSS, was significantly more pronounced in the unemployed patient group at all time points. A higher EDSS, suggestive of greater physical disability, was in our findings to some extent explained by loss of SDGM volume, in particular thalamus, putamen and hippocampus volumes.…”

Section: Discussionmentioning

confidence: 78%

Brain atrophy and employment in multiple sclerosis patients: a 10-year follow-up study

Jacobsen

Zivadinov

Myhr

et al. 2020

Multiple Sclerosis Journal - Experimental, Translational and Cl

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Background Multiple sclerosis is often associated with unemployment. The contribution of grey matter atrophy to unemployment is unclear. Objectives To identify magnetic resonance imaging biomarkers of grey matter and clinical symptoms associated with unemployment in multiple sclerosis patients. Methods Demographic, clinical data and 1.5 T magnetic resonance imaging scans were collected in 81 patients at the time of inclusion and after 5 and 10 years. Global and tissue-specific volumes were calculated at each time point. Statistical analysis was performed using a mixed linear model. Results At baseline 31 (38%) of the patients were unemployed, at 5-year follow-up 44 (59%) and at 10-year follow-up 34 (81%) were unemployed. The unemployed patients had significantly lower subcortical deep grey matter volume ( P < 0.001), specifically thalamus, pallidus, putamen and hippocampal volumes, and cortical volume ( P = 0.011); and significantly greater T1 ( P < 0.001)/T2 ( P < 0.001) lesion volume than the employed patient group at baseline. Subcortical deep grey matter volumes, and to a lesser degree cortical volume, were significantly associated with unemployment throughout the follow-up. Conclusion We found significantly greater atrophy of subcortical deep grey matter and cortical volume at baseline and during follow-up in the unemployed patient group. Atrophy of subcortical deep grey matter showed a stronger association to unemployment than atrophy of cortical volume during the follow-up.

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Evaluation of MS related central fatigue using MR neuroimaging methods: Scoping review

Cited by 62 publications

References 127 publications

Functional Magnetic Resonance Imaging Correlations Between Fatigue and Cognitive Performance in Patients With Relapsing Remitting Multiple Sclerosis

Functional Magnetic Resonance Imaging Correlations Between Fatigue and Cognitive Performance in Patients With Relapsing Remitting Multiple Sclerosis

Fatigue in multiple sclerosis: Does the functional or structural damage prevail?

Brain atrophy and employment in multiple sclerosis patients: a 10-year follow-up study

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