Fatigue in multiple sclerosis is associated with the disruption of frontal and parietal pathways

Sepulcre, Jorge; Masdeu, Joseph C.; Goñi, Joaquín; Arrondo, Gonzalo; Mendizábal, Nieves Vélez de; Bejarano, Bartolomé; Villoslada, Pablo

doi:10.1177/1352458508098373

Cited by 194 publications

(198 citation statements)

References 40 publications

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“…Recently, Sepulcre et al 30 showed an association between atrophy of the superior frontal sulcus and middle frontal sulcus and fatigue severity in a heterogeneous groups of patients with MS, including patients with clinically isolated syndromes suggestive of MS and those with the progressive forms of the disease. These authors suggested that such a regional distribution of atrophy in patients with fatigued MS might be related to retrograde degeneration of axons passing through WM lesions, because these patients had a higher occurrence of lesions in regions of the frontal lobes.…”

Section: Discussionmentioning

confidence: 99%

Voxelwise Assessment of the Regional Distribution of Damage in the Brains of Patients with Multiple Sclerosis and Fatigue

Riccitelli

Rocca

Forn

et al. 2011

AJNR Am J Neuroradiol

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Section: Discussionmentioning

confidence: 99%

Voxelwise Assessment of the Regional Distribution of Damage in the Brains of Patients with Multiple Sclerosis and Fatigue

Riccitelli

Rocca

Forn

et al. 2011

AJNR Am J Neuroradiol

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“…In different clinical populations, fatigue has been linked, albeit inconsistently, with alterations in a host of different brain structures, such as the monoaminergic nuclei, 25 the ascending reticular formation, 26 and the frontostriatal network. 2,27 The heterogeneity of these findings could be related to the different patients population studied, the subjectivity of fatigue perception complaint, or the effect of multiple confounding factors such as mood, disease duration, education, and age.…”

mentioning

confidence: 99%

“…16,27 In our study, the relationship between vmPFC lesions and fatigue was first illustrated by a lesion Figure 1 Overlap map of lesioned areas in fatigued penetrating brain injury subjects…”

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confidence: 99%

Ventromedial prefrontal cortex modulates fatigue after penetrating traumatic brain injury

Pardini¹,

Raymont²,

Grafman³

2010

Neurology

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“…55 In patients with RRMS and SPMS, temporal lobe atrophy is associated with auditory/verbal memory and visual/spatial memory performance, 56 while hippocampal atrophy is related to a poor performance in memory-encoding tasks. 57 Fatigued patients with MS experience GM atrophy in frontal regions, 58 while those with cerebellar dysfunction have a reduced cerebellar GM volume compared with those without. 59 In patients with MS with longstanding disease or severe disability, focal thinning of the primary SMC has been reported.…”

mentioning

confidence: 99%

MR Imaging of Gray Matter Involvement in Multiple Sclerosis: Implications for Understanding Disease Pathophysiology and Monitoring Treatment Efficacy

Filippi

Rocca²

2009

AJNR Am J Neuroradiol

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SUMMARY: Recent pathologic and MR imaging studies have challenged the classic view of MS as a chronic inflammatory-demyelinating condition affecting solely the WM of the central nervous system. Indeed, an involvement of the GM has been shown to occur from the early stages of the disease, to progress with time, and to be only moderately correlated with the extent of WM injury. In this review, we summarize how advances in MR imaging technology and methods of analysis are contributing to ameliorating the detection of focal lesions and to quantifying the extent of "occult" pathology and atrophy, as well as to defining the topographic distribution of such changes in the GM of patients with MS. These advances, combined with the imaging of brain reorganization occurring after tissue injury, should ultimately result in an improved understanding and monitoring of MS clinical manifestations and evolution, either natural or modified by treatment.ABBREVIATIONS: Cereb ϭ cerebellum; Cho ϭ choline; CIS ϭ clinically isolated syndromes; DIR ϭ double inversion recovery; DTI ϭ diffusion tensor imaging; EDSS ϭ Expanded Disability Status Scale; FA ϭ fractional anisotropy; FLAIRϭ fluid-attenuated inversion recovery; fMRI ϭ functional MR imaging; GM ϭ gray matter; L ϭ left; MD ϭ mean diffusivity; MS ϭ multiple sclerosis; MT ϭ magnetization transfer; MTR ϭ magnetization transfer ratio; NAA ϭ N-acetylaspartate; NAWM ϭ normal-appearing white matter; PM ϭ premotor cortex; PPMS ϭ primary-progressive MS; R ϭ right; RRMS ϭ relapsing-remitting MS; RT ϭ relaxation time; SII ϭ secondary sensorimotor cortex; SMA ϭ supplementary motor area; SMC ϭ sensorimotor cortex; SPM ϭ statistical parametric mapping; SPMS ϭ secondary-progressive MS; Thal ϭ thalamus; WM ϭ white matter P athologic and MR imaging studies are challenging the view of MS as a chronic inflammatory-demyelinating condition affecting solely the WM of the central nervous system. Indeed, there is a growing body of evidence showing that a significant portion of MS-related damage affects virtually all the GM structures. Pathologically, cortical lesions have been distinguished in mixed WM-GM lesions (type I) and purely intracortical lesions (types II, III, and IV).1 The latter may represent more than two-thirds of macroscopic cortical pathology in the disease, 1 and the extent of cortical demyelination can exceed that occurring in the WM.1 Demyelination is seen not only in the neocortex (especially in the cingulate cortex) 1,2 but also in the GM of the thalamus, basal ganglia, hypothalamus, hippocampus, cerebellum, and spinal cord. Compared with WM lesions, GM lesions are characterized by a much milder lymphocytic infiltration, less microglial activation, and fewer perivascular cuffs.3 GM lesions also lack complement deposition and have only a modest increase in bloodbrain barrier permeability.2 In MS, GM pathology also includes neuronal injury, with neuritic swelling as well as dendritic and axonal transections.2 In addition to focal lesions, wallerian and trans-synaptic degeneration of fi...

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Fatigue in multiple sclerosis is associated with the disruption of frontal and parietal pathways

Abstract: Our results suggest that the symptom of fatigue is associated with a disruption of brain networks involved in cognitive/attentional processes.

Cited by 194 publications

References 40 publications

Voxelwise Assessment of the Regional Distribution of Damage in the Brains of Patients with Multiple Sclerosis and Fatigue

Voxelwise Assessment of the Regional Distribution of Damage in the Brains of Patients with Multiple Sclerosis and Fatigue

Ventromedial prefrontal cortex modulates fatigue after penetrating traumatic brain injury

MR Imaging of Gray Matter Involvement in Multiple Sclerosis: Implications for Understanding Disease Pathophysiology and Monitoring Treatment Efficacy

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