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

2009 ◽  
Vol 15 (3) ◽  
pp. 337-344 ◽  
Author(s):  
J Sepulcre ◽  
JC Masdeu ◽  
J Goñi ◽  
G Arrondo ◽  
N Vélez de Mendizábal ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
White Matter ◽  
Gray Matter ◽  
Parietal Lobe ◽  
White Matter Lesion ◽  
Lesion Load ◽  
Attentional Processes ◽  
Fatigue Score ◽  
Gray Matter Atrophy ◽  
The Right

Background Fatigue is one of the most frequent and disturbing symptoms in multiple sclerosis (MS), directly affecting the patient’s quality of life. However, many questions remain unclear regarding the anatomic brain correlate of MS-related fatigue. Objective To assess the relationship between fatigue and white matter lesion location and gray matter atrophy. Methods In this study, 60 patients with MS were evaluated with the Modified Fatigue Impact Scale and magnetic resonance imaging. Location of white matter lesion was analyzed using a voxel-by-voxel lesion probability mapping approach and gray matter atrophy degree and location using an optimized voxel-based morphometry method. Results We found a correlation between lesion load and fatigue score (T2 lesion load: r = 0.415, P = 0.001; T1 lesion load r = 0.328, P = 0.011). Moreover, fatigue correlated with lesions in the right parietotemporal (periatrial area, juxtaventricular white matter deep in the parietal lobe and callosal forceps) and left frontal (middle-anterior corpus callosum, anterior cingulum and centrum semiovale of the superior and middle frontal gyri) white matter regions ( P < 0.001 in all cases). Finally, fatigue score significantly correlated with gray matter atrophy in frontal regions, specifically, the left superior frontal gyrus and bilateral middle frontal gyri ( P < 0.001 in all cases). Conclusion Our results suggest that the symptom of fatigue is associated with a disruption of brain networks involved in cognitive/attentional processes.

Brain atrophy evolution and lesion load accrual in multiple sclerosis: a 2-year follow-up study

2008 ◽  
Vol 15 (2) ◽  
pp. 204-211 ◽  
Author(s):  
G Tedeschi ◽  
D Dinacci ◽  
M Comerci ◽  
L Lavorgna ◽  
G Savettieri ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
White Matter ◽  
Disease Progression ◽  
Gray Matter ◽  
Brain Atrophy ◽  
Disease Duration ◽  
Lesion Load ◽  
Whole Brain ◽  
Gray Matter Atrophy

Background To investigate in a large cohort of patients with multiple sclerosis (MS), lesion load and atrophy evolution, and the relationship between clinical and magnetic resonance imaging (MRI) correlates of disease progression. Methods Two hundred and sixty-seven patients with MS were studied at baseline and two years later using the same MRI protocol. Abnormal white matter fraction, normal appearing white matter fraction, global white matter fraction, gray matter fraction and whole brain fraction, T2-hyperintense, and T1-hypointense lesions were measured at both time points. Results The majority of patients were clinically stable, whereas MRI-derived brain tissue fractions were significantly different after 2 years. The correlation between MRI data at baseline and their variation during the follow-up showed that lower basal gray matter atrophy was significantly related with higher progression of gray matter atrophy during follow-up. The correlation between MRI parameters and disease duration showed that gray matter atrophy rate decreased with increasing disease duration, whereas the rate of white matter atrophy had a constant pattern. Lower basal gray matter atrophy was associated with increased probability of developing gray matter atrophy at follow-up, whereas gray matter atrophy progression over 2 years and new T2 lesion load were risk factors for whole brain atrophy progression. Conclusions In MS, brain atrophy occurs even after a relatively short period of time and in patients with limited progression of disability. Short-term brain atrophy progression rates differ across tissue compartments, as gray matter atrophy results more pronounced than white matter atrophy and appears to be a early phenomenon in the MS-related disease progression.

Microstructural fronto-striatal and temporo-insular alterations are associated with fatigue in patients with multiple sclerosis independent of white matter lesion load and depression

2019 ◽  
Vol 26 (13) ◽  
pp. 1708-1718 ◽  
Author(s):  
Miklos Palotai ◽  
Michele Cavallari ◽  
Ismail Koubiyr ◽  
Alfredo Morales Pinzon ◽  
Aria Nazeri ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
White Matter ◽  
Physical Disability ◽  
Disease Duration ◽  
White Matter Lesion ◽  
Brain Magnetic Resonance Imaging ◽  
Brain Regions ◽  
Specific Substrate ◽  
Patient Stratification ◽  
Lesion Load

Background: Fatigue in multiple sclerosis (MS) has been inconsistently associated with disruption of specific brain circuitries. Temporal fluctuations of fatigue have not been considered. Objective: The aim of this study was to investigate the association of fatigue with brain diffusion abnormalities, using robust criteria for patient stratification based on longitudinal patterns of fatigue. Methods: Patient stratification: (1) sustained fatigue (SF, n = 26): latest two Modified Fatigue Impact Scale (MFIS) ⩾ 38; (2) reversible fatigue (RF, n = 25): latest MFIS < 38 and minimum one previous MFIS ⩾ 38; and (3) never fatigued (NF, n = 42): MFIS always < 38 (five assessments minimum). 3T brain magnetic resonance imaging (MRI) was used to perform voxel-wise comparison of fractional anisotropy (FA) between the groups controlling for age, sex, disease duration, physical disability, white matter lesion load (T2LV), and depression. Results: SF and, to a lesser extent, RF patients showed lower FA in multiple brain regions compared to NF patients, independent of age, sex, disease duration, and physical disability. In cingulo-postcommissural-striato-thalamic regions, the differences in FA between SF and NF (but not between RF and NF or SF) patients were independent of T2LV, and in ventromedial prefronto-precommissuro-striatal and temporo-insular areas, independent of T2LV and depression. Conclusion: Damage to ventromedial prefronto-precommissuro-striatal and temporo-insular pathways appears to be a specific substrate of SF in MS.

scholarly journals Influences of lobar gray matter and white matter lesion load on cognition and mood

2010 ◽  
Vol 181 (2) ◽  
pp. 90-96 ◽  
Author(s):  
Susanne G. Mueller ◽  
Wendy J. Mack ◽  
Dan Mungas ◽  
Joel H. Kramer ◽  
Valerie Cardenas-Nicolson ◽  
...  
Keyword(s):  
White Matter ◽  
Gray Matter ◽  
White Matter Lesion ◽  
Lesion Load

scholarly journals Evolution of Cortical and White Matter Lesion Load in Early-Stage Multiple Sclerosis: Correlation With Neuroaxonal Damage and Clinical Changes

2020 ◽  
Vol 11 ◽  
Author(s):  
Ramona-Alexandra Todea ◽  
Po-Jui Lu ◽  
Mario Joao Fartaria ◽  
Guillaume Bonnier ◽  
Renaud Du Pasquier ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
White Matter ◽  
White Matter Lesion ◽  
Early Stage ◽  
Lesion Load ◽  
Clinical Changes

scholarly journals Brain atrophy in multiple sclerosis: therapeutic, cognitive and clinical impact

2016 ◽  
Vol 74 (3) ◽  
pp. 235-243 ◽  
Author(s):  
Juan Ignacio Rojas ◽  
Liliana Patrucco ◽  
Jimena Miguez ◽  
Edgardo Cristiano
Keyword(s):  
Multiple Sclerosis ◽  
White Matter ◽  
Gray Matter ◽  
Inflammatory Disease ◽  
Brain Atrophy ◽  
Clinical Impact ◽  
Cognitive Disability ◽  
Permanent Damage ◽  
Gray Matter Atrophy

ABSTRACT Multiple sclerosis (MS) was always considered as a white matter inflammatory disease. Today, there is an important body of evidence that supports the hypothesis that gray matter involvement and the neurodegenerative mechanism are at least partially independent from inflammation. Gray matter atrophy develops faster than white matter atrophy, and predominates in the initial stages of the disease. The neurodegenerative mechanism creates permanent damage and correlates with physical and cognitive disability. In this review we describe the current available evidence regarding brain atrophy and its consequence in MS patients.

scholarly journals Unraveling the relationship between regional gray matter atrophy and pathology in connected white matter tracts in long-standing multiple sclerosis

2015 ◽  
Vol 36 (5) ◽  
pp. 1796-1807 ◽  
Author(s):  
Martijn D. Steenwijk ◽  
Marita Daams ◽  
Petra J.W. Pouwels ◽  
Lisanne J. Balk ◽  
Prejaas K. Tewarie ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
White Matter ◽  
Gray Matter ◽  
White Matter Tracts ◽  
Gray Matter Atrophy ◽  
The Relationship
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