Fatigue and brain atrophy in Egyptian patients with relapsing remitting multiple sclerosis

Brain connectivity changes underlying depression and fatigue in relapsing-remitting multiple sclerosis: a systematic review

“…Both functional [122, 126, 129] and structural connectivity [117] changes of the thalamus are associated with fatigue in pwRRMS, according to four included studies. Moreover, fatigue in pwRRMS was associated with thalamic atrophy in five studies [106, 109, 127, 144, 147], while a study by Wilting et al found a correlation between thalamic WML volume and fatigue measures in pwRRMS [117]. This is supported by findings from Arm et al reporting similar results for all MS subtypes [57].…”

“…Five studies out of 48 linked fatigue in pwRRMS to thalamic atrophy [106, 109, 127, 144, 147] and one to lesion load in the thalamus [117]. Moreover, 4/48 studies associated fatigue with cerebellar atrophy [109, 135, 144, 147] and 4/48 with decreased volume of caudate nucleus [104, 106, 109, 147].…”

“…Five studies out of 48 linked fatigue in pwRRMS to thalamic atrophy [106, 109, 127, 144, 147] and one to lesion load in the thalamus [117]. Moreover, 4/48 studies associated fatigue with cerebellar atrophy [109, 135, 144, 147] and 4/48 with decreased volume of caudate nucleus [104, 106, 109, 147]. Additionally, fatigue was associated with the atrophy in basal ganglia structures [104, 106, 109], inferior parietal gyrus [104, 106] and corpus callosum [118, 144] (Fig 2 and Table 2).…”

“…The remaining 5/11 studies either controlled for fatigue status [29, 47, 101] or included fatigue as a covariate or a clinical symptom of no interest [98, 99]. Of the 41 publications reporting results of MRI measures in relation to fatigue only , 29/41 included depression assessments [35, 104–107, 109, 110, 114–119, 122–124, 126–131, 146–151], with 14/29 excluding participants with high depression scores [35, 104, 105, 110, 114, 117–119, 122, 124, 126, 127, 129, 131] and 10/29 controlling for depression status [106, 107, 109, 123, 128, 130, 145, 146, 150, 151], or both (5/29) [115, 116, 147–149].…”

“…For conventional MRI, several brain structures suggested to be associated with depression severity were also observed to be involved in fatigue in pwRRMS. Specifically, thalamic [100, 106, 109, 117, 127, 144, 147], cerebellar [109, 135, 144], corpus callosum [118, 137, 144], right superior temporal region [47, 104] and precentral gyrus [47, 144] volumes were negatively correlated with depression and fatigue scores in at least one study per symptom (Fig 2 and Table 2). For structural connectivity, overlap between associations reported for dMRI measures and fatigue or depression was observed in the cingulum (Fig 2 and Table 3).…”