Structural correlates for fatigue in early relapsing remitting multiple sclerosis

Wilting, Janine; Rolfsnes, Hans O.; Zimmermann, Hilga; Behrens, Marion; Fleischer, Vinzenz; Zipp, Frauke; Gröger, Adriane

doi:10.1007/s00330-015-3857-2

Cited by 51 publications

(83 citation statements)

References 44 publications

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“…Furthermore, the magnitude of thalamic, pallidal, and SCP atrophy correlated positively with the FSS score in the total study population, which suggests that these structures are affected proportionately to fatigue severity in RRMS. Our observations support prior findings obtained by using different approaches, such as functional Magnetic Resonance Imaging (fMRI )and voxel based morphometry [ 29 , 32 ]. Nourbakhsh et al [ 33 ], studied a cohort of early relapsing MS patients and reported an association between lower thalamic volume at baseline and increasing physical subscale of MFIS during the study.…”

Section: Discussionsupporting

confidence: 91%

Structural and Neuronal Integrity Measures of Fatigue Severity in Multiple Sclerosis

Bernitsas

Yarraguntla²,

Bao³

et al. 2017

Brain Sciences

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Fatigue is a common and disabling symptom in Multiple Sclerosis (MS). However, consistent neuroimaging correlates of its severity are not fully elucidated. In this article, we study the neuronal correlates of fatigue severity in MS. Forty-three Relapsing Remitting MS (RRMS) patients with MS-related fatigue (Fatigue Severity Scale (FSS) range: 1–7) and Expanded Disability Status Scale (EDSS) ≤ 4, were divided into high fatigue (HF, FSS ≥ 5.1) and low fatigue groups (LF, FSS ≤ 3). We measured T2 lesion load using a semi-automated technique. Cortical thickness, volume of sub-cortical nuclei, and brainstem structures were measured using Freesurfer. Cortical Diffusion Tensor Imaging (DTI) parameters were extracted using a cross modality technique. A correlation analysis was performed between FSS, volumetric, and DTI indices across all patients. HF patients showed significantly lower volume of thalamus, (p = 0.02), pallidum (p = 0.01), and superior cerebellar peduncle ((SCP), p = 0.002). The inverse correlation between the FSS score and the above volumes was significant in the total study population. In the right temporal cortex (RTC), the Radial Diffusivity ((RD), p = 0.01) and Fractional Anisotropy ((FA), p = 0.01) was significantly higher and lower, respectively, in the HF group. After Bonferroni correction, thalamic volume, FA-RTC, and RD-RTC remained statistically significant. Multivariate regression analysis identified FA-RTC as the best predictor of fatigue severity. Our data suggest an association between fatigue severity and volumetric changes of thalamus, pallidum, and SCP. Early neuronal injury in the RTC is implicated in the pathogenesis of MS-related fatigue.

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Section: Discussionsupporting

confidence: 91%

Structural and Neuronal Integrity Measures of Fatigue Severity in Multiple Sclerosis

Bernitsas

Yarraguntla²,

Bao³

et al. 2017

Brain Sciences

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“…The thalamus changes from very early stages of disease, including radiologically isolated syndrome [40] and pediatric populations [41]. Thalamic atrophy has been correlated with neuropsychological function [42][43][44], ambulation [45], and fatigue [46]. The hippocampus shows atrophy in all stages of MS and is associated with deficits in memory encoding and retrieval [47].…”

Section: Gray Matter Atrophymentioning

confidence: 99%

Imaging as an Outcome Measure in Multiple Sclerosis

Ontaneda

Fox

2017

Neurotherapeutics

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Multiple sclerosis (MS) is a chronic demyelinating disease of the central nervous system. Magnetic resonance imaging (MRI) is sensitive to lesion formation both in the brain and spinal cord. Imaging plays a prominent role in the diagnosis and monitoring of MS. Over a dozen anti-inflammatory therapies are approved for MS and the development of many of these medications was made possible through the use of contrast-enhancing lesions on MRI as a phase II outcome. A similar phase II outcome method for the neurodegeneration that underlies progressive courses of the disease is still unavailable. Although magnetic resonance is an invaluable tool for the diagnosis and monitoring of treatment effects in MS, several imaging barriers still exist. In general, MRI is less sensitive to gray matter lesions, lacks pathological specificity, and does not provide quantitative data easily. Several advanced imaging methods including diffusion tensor imaging, magnetization transfer, functional MRI, myelin water fraction imaging, ultra-high field MRI, positron emission tomography, and optical coherence tomography of the retina study promising ways of overcoming the difficulties in MS imaging.

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“…Fatigue is a common symptom in MS, even early in the disease [1]. Two-thirds of patients with MS indicated Fatigue as one of the worst three common symptoms that they experience [2].…”

Section: Introductionmentioning

confidence: 99%

Differentiating Multiple Sclerosis from Myalgic Encephalomyelitis and Chronic Fatigue Syndrome

et al. 2017

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Multiple Sclerosis (MS), Myalgic Encephalomyelitis (ME), and Chronic Fatigue syndrome are debilitating chronic illnesses, with some overlapping symptoms. However, few studies have compared and contrasted symptom and disability profiles for these illnesses for the purpose of further differentiating them. The current study was an online self-report survey that compared symptoms from a sample of individuals with MS (N = 120) with a sample of individuals with ME or CFS (N = 269). Respondents completed the self-report DePaul Symptom Questionnaire. Those individuals with ME or CFS reported significantly more functional limitations and significantly more severe symptoms than those with MS. The implications of these findings are discussed.

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Structural correlates for fatigue in early relapsing remitting multiple sclerosis

Cited by 51 publications

References 44 publications

Structural and Neuronal Integrity Measures of Fatigue Severity in Multiple Sclerosis

Structural and Neuronal Integrity Measures of Fatigue Severity in Multiple Sclerosis

Imaging as an Outcome Measure in Multiple Sclerosis

Differentiating Multiple Sclerosis from Myalgic Encephalomyelitis and Chronic Fatigue Syndrome

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