scholarly journals Fatigue in multiple sclerosis is associated with multimodal interoceptive abnormalities

2019 ◽  
Vol 26 (14) ◽  
pp. 1845-1853 ◽  
Author(s):  
Cecilia Gonzalez Campo ◽  
Paula C Salamone ◽  
Nicolás Rodríguez-Arriagada ◽  
Fabian Richter ◽  
Eduar Herrera ◽  
...  
Keyword(s):  
Machine Learning ◽  
Multiple Sclerosis ◽  
Functional Connectivity ◽  
Gray Matter Volume ◽  
Area Under The Curve ◽  
Anterior Cingulate ◽  
Impact Scale ◽  
Fatigue Impact Scale ◽  
Magnetic Resonance Imaging Mri ◽  
Interoceptive Accuracy

Background: Fatigue ranks among the most common and disabling symptoms in multiple sclerosis (MS). Recent theoretical works have surmised that this trait might be related to alterations across interoceptive mechanisms. However, this hypothesis has not been empirically evaluated. Objectives: To determine whether fatigue in MS patients is associated with specific behavioral, structural, and functional disruptions of the interoceptive domain. Methods: Fatigue levels were established via the Modified Fatigue Impact Scale. Interoception was evaluated through a robust measure indexed by the heartbeat detection task. Structural and functional connectivity properties of key interoceptive hubs were tested by magnetic resonance imaging (MRI) and resting-state functional MRI. Machine learning analyses were employed to perform pairwise classifications. Results: Only patients with fatigue presented with decreased interoceptive accuracy alongside decreased gray matter volume and increased functional connectivity in core interoceptive regions, the insula, and the anterior cingulate cortex. Each of these alterations was positively associated with fatigue. Finally, machine-learning analysis with a combination of the above interoceptive indices (behavioral, structural, and functional) successfully discriminated (area under the curve > 90%) fatigued patients from both non-fatigued and healthy controls. Conclusion: This study offers unprecedented evidence suggesting that disruptions of neurocognitive markers subserving interoception may constitute a signature of fatigue in MS.

Changes to the septo-fornical area might play a role in the pathogenesis of anxiety in multiple sclerosis

2017 ◽  
Vol 24 (8) ◽  
pp. 1105-1114 ◽  
Author(s):  
Miklos Palotai ◽  
Andrea Mike ◽  
Michele Cavallari ◽  
Erzsebet Strammer ◽  
Gergely Orsi ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Anxiety And Depression ◽  
Ultra High Field ◽  
Lesion Load ◽  
Impact Scale ◽  
Weighted Magnetic Resonance Imaging ◽  
Fatigue Impact Scale ◽  
Magnetic Resonance Imaging Mri ◽  
Post Hoc ◽  
Larger Sample

Background: Reports on the relationships between white matter lesion load (WMLL) and fatigue and anxiety in multiple sclerosis (MS) are inconsistent. Objective: To investigate the association of total and tract-specific WMLL with fatigue and anxiety. Methods: Total and regional T2 WMLL was assessed for 19 tracts in 48 MS patients (30 females). ICBM-DTI-81 Atlas-based parcellation was combined with WMLL segmentation of T2-weighted magnetic resonance imaging (MRI). Fatigue, anxiety, and depression were assessed using Fatigue Impact Scale, State Trait Anxiety Inventory, and Beck Depression Inventory, respectively. Results: Fatigue, anxiety, and depression showed significant inter-correlation. We found no association between fatigue and total or regional WMLLs, whereas anxiety was associated with total and regional WMLLs in nine tracts. After adjusting for total WMLL, age, and depression, only the column and body of the fornix (CBF) remained significantly associated with anxiety. Post hoc analyses showed no CBF lesions on T1-weighted MRI and suggested, but could not confirm, that the septum pellucidum might play a role in the pathogenesis of anxiety. Conclusion: Our results suggest that anxiety in MS patients may have a neuropathological substrate in the septo-fornical area, which requires further validation using larger sample size and ultra-high-field MRI in targeted prospective studies.

Abnormal functional connectivity of thalamic sub-regions contributes to fatigue in multiple sclerosis

2017 ◽  
Vol 24 (9) ◽  
pp. 1183-1195 ◽  
Author(s):  
Milagros Hidalgo de la Cruz ◽  
Alessandro d’Ambrosio ◽  
Paola Valsasina ◽  
Elisabetta Pagani ◽  
Bruno Colombo ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Functional Connectivity ◽  
Resting State ◽  
Structural Connectivity ◽  
Healthy Controls ◽  
Sensorimotor Network ◽  
Cortical Connections ◽  
Impact Scale ◽  
Fatigue Impact Scale ◽  
Cortical Regions

Objective: To investigate sub-regional thalamic resting-state (RS) functional connectivity (FC) abnormalities in multiple sclerosis (MS) and their correlation with fatigue and its subcomponents (physical, cognitive, and psychosocial). Methods: From 122 MS patients and 94 healthy controls, 5 thalamic sub-regions (frontal, motor, postcentral, occipital, temporal) were parcellated based on their cortico-thalamic structural connectivity and used for a seed-based RS FC analysis. Abnormalities of thalamic RS FC in MS patients and their correlation with Modified Fatigue Impact Scale (MFIS) were assessed. Results: Compared to controls and non-fatigued MS ( n = 86), fatigued MS patients ( n = 36) showed thalamic RS FC abnormalities with middle frontal gyrus, sensorimotor network, precuneus, insula, and cerebellum, which correlated with global MFIS. Higher thalamic RS FC with precuneus and lower RS FC with posterior cerebellum correlated with cognitive MFIS. Higher thalamic RS FC with sensorimotor network in frontal-, motor-, and temporal thalamic sub-regions correlated with physical and psychosocial MFIS. Reduced thalamic RS FC with right insula in motor-, postcentral-, and occipital thalamic sub-regions correlated with psychosocial fatigue. Conclusion: Regional thalamic RS FC abnormalities with different cortical regions, including the frontal lobe, sensorimotor network, precuneus, insular cortices, and cerebellum contribute to fatigue in MS. Abnormal RS FC of selected thalamo-cortical connections explains different components of fatigue.

Personalized, bilateral whole-body somatosensory cortex stimulation to relieve fatigue in multiple sclerosis

2017 ◽  
Vol 24 (10) ◽  
pp. 1366-1374 ◽  
Author(s):  
Andrea Cancelli ◽  
Carlo Cottone ◽  
Alessandro Giordani ◽  
Simone Migliore ◽  
Domenico Lupoi ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Somatosensory Cortex ◽  
Conventional Medicine ◽  
Whole Body ◽  
Cortical Folding ◽  
Double Blind ◽  
Impact Scale ◽  
Sample Size Estimate ◽  
Fatigue Impact Scale ◽  
Magnetic Resonance Imaging Mri

Background: The patients suffering from multiple sclerosis (MS) often consider fatigue the most debilitating symptom they experience, but conventional medicine currently offers poorly efficacious therapies. Objective: We executed a replication study of an innovative approach for relieving MS fatigue. Methods: According to the sample size estimate, we recruited 10 fatigued MS patients who received 5-day transcranial direct current stimulation (tDCS) in a randomized, double-blind, Sham-controlled, crossover study, with modified Fatigue Impact Scale (mFIS) score reduction at the end of the treatment as primary outcome. A personalized anodal electrode, shaped on the magnetic resonance imaging (MRI)-derived individual cortical folding, targeted the bilateral whole-body primary somatosensory cortex (S1) with an occipital cathode. Results: The amelioration of fatigue symptoms after Real stimulation (40% of baseline) was significantly larger than after Sham stimulation (14%, p = 0.012). Anodal whole body S1 induced a significant fatigue reduction in mildly disabled MS patients when the fatigue-related symptoms severely hampered their quality of life. Conclusion: This second result in an independent group of patients supports the idea that neuromodulation interventions that properly select a personalized target might be a suitable non-pharmacological treatment for MS fatigue.

Evaluation of the six-minute walk in multiple sclerosis subjects and healthy controls

2008 ◽  
Vol 14 (3) ◽  
pp. 383-390 ◽  
Author(s):  
Myla D Goldman ◽  
Ruth Ann Marrie ◽  
Jeffrey A Cohen
Keyword(s):  
Multiple Sclerosis ◽  
Short Form ◽  
Intraclass Correlation ◽  
Rest Period ◽  
Practice Effect ◽  
Physical Component Score ◽  
Physical Fatigue ◽  
Subjective Measures ◽  
Impact Scale ◽  
Fatigue Impact Scale

Objective To assess the characteristics of the 6-min walk (6MW) in multiple sclerosis (MS) subjects of varied disability, and controls. To assess the correlation of 6MW to subjective measures of fatigue, health status and ambulation using the modified fatigue impact scale (MFIS), short form-36 Health Questionnaire physical component score and MS walking scale (MSWS). Methods Forty MS expanded disability status scale [(EDSS) 0—6.5] and 20 control subjects were recruited from a MS outpatient clinic. Subjects completed survey material and three 6MWs with 1-h interval rest in a single study visit. Results There was no practice effect or fatigability with repeat 6MW tests with a one-h rest period between test sessions. The 6MW had excellent intra-[intraclass correlation coefficient (ICC) = 0.95] and inter-rater (ICC = 0.91) reliability. MS subjects demonstrated reduced 6MW distance and speed compared with controls ( P < 0.0001). Within the MS population 6MW distance was significantly reduced with increasing disability ( P = 0.05). Compared with the EDSS, the 6MW had a stronger correlation to subjective measures of ambulation and physical fatigue: MSWS ( r = -0.81 versus 0.69) and MFISphy (0.66 versus 0.63). Conclusions The 6MW is a feasible, reproducible, and reliable measure in MS. MS subjects demonstrate motor fatigue in both 6MW distance and speed compared with controls. In MS subjects there is an inverse relationship between motor fatigue and disability. 6MW has a strong correlation to subjective measures of ambulation and physical fatigue. Multiple Sclerosis 2008; 14: 383—390. http://msj.sagepub.com

scholarly journals Assessing fatigue in multiple sclerosis: Psychometric properties of the five-item Modified Fatigue Impact Scale (MFIS-5)

2019 ◽  
Vol 5 (4) ◽  
pp. 205521731988798 ◽  
Author(s):  
Virginia Meca-Lallana ◽  
María Brañas-Pampillón ◽  
Yolanda Higueras ◽  
Antonio Candeliere-Merlicco ◽  
Yolanda Aladro-Benito ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Psychometric Properties ◽  
Impact Scale ◽  
Fatigue Impact Scale

What drives MRI-measured cortical atrophy in multiple sclerosis?

2015 ◽  
Vol 21 (10) ◽  
pp. 1280-1290 ◽  
Author(s):  
V Popescu ◽  
R Klaver ◽  
P Voorn ◽  
Y Galis-de Graaf ◽  
DL Knol ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Inferior Frontal Gyrus ◽  
Superior Temporal Gyrus ◽  
Anterior Cingulate ◽  
Cortical Atrophy ◽  
Post Mortem ◽  
Mri Imaging ◽  
Cortical Volume ◽  
Axonal Pathology ◽  
Magnetic Resonance Imaging Mri

Background: Cortical atrophy, assessed with magnetic resonance imaging (MRI), is an important outcome measure in multiple sclerosis (MS) studies. However, the underlying histopathology of cortical volume measures is unknown. Objective: We investigated the histopathological substrate of MRI-measured cortical volume in MS using combined post-mortem imaging and histopathology. Methods: MS brain donors underwent post-mortem whole-brain in-situ MRI imaging. After MRI, tissue blocks were systematically sampled from the superior and inferior frontal gyrus, anterior cingulate gyrus, inferior parietal lobule, and superior temporal gyrus. Histopathological markers included neuronal, axonal, synapse, astrocyte, dendrite, myelin, and oligodendrocyte densities. Matched cortical volumes from the aforementioned anatomical regions were measured on the MRI, and used as outcomes in a nested prediction model. Results: Forty-five tissue blocks were sampled from 11 MS brain donors. Mean age at death was 68±12 years, post-mortem interval 4±1 hours, and disease duration 35±15 years. MRI-measured regional cortical volumes varied depending on anatomical region. Neuronal density, neuronal size, and axonal density were significant predictors of GM volume. Conclusions: In patients with long-standing disease, neuronal and axonal pathology are the predominant pathological substrates of MRI-measured cortical volume in chronic MS.

Comparing Individualized Rehabilitation to a Group Wellness Intervention for Persons with Multiple Sclerosis

2009 ◽  
Vol 24 (1) ◽  
pp. 23-26 ◽  
Author(s):  
Matthew A. Plow ◽  
Virgil Mathiowetz ◽  
Dawn A. Lowe
Keyword(s):  
Mental Health ◽  
Multiple Sclerosis ◽  
Physical Health ◽  
Preliminary Evidence ◽  
Effect Sizes ◽  
Future Research ◽  
Impact Scale ◽  
Sf 36 ◽  
Fatigue Impact Scale ◽  
Wellness Intervention

Purpose. Compare the efficacy of two interventions designed to promote health and physical activity (PA). Design. This study was a randomized clinical trial using a time series design. Subjects were randomized into individualized physical rehabilitation (IPR) and group wellness intervention (GWI). Primary questionnaires were administered twice preintervention and twice postintervention. Physical fitness and PA frequency were assessed preintervention and postintervention. Setting. Clinic based in a metropolitan area. Subjects. Fifty volunteers with multiple sclerosis. Interventions. IPR consisted of four physical therapy sessions plus three telephone calls. GWI consisted of seven educational sessions. Measures. Primary: SF-36 Health Survey, Modified Fatigue Impact Scale, Mental Health Inventory. Secondary: physical assessment, PA frequency. Analysis. Stability of primary questionnaires between the two pretests was examined. Efficacy of interventions was evaluated by multivariate analysis of variance (MANOVA) and effect sizes. Results. Primary measures were stable between pretests. MANOVA showed nonsignificant differences between interventions. Eight weeks postintervention, both groups had improved PA, fatigue, resting heart rate, and strength. Effect sizes suggested that IPR had a greater effect on preventing decline of physical health, whereas GWI had a greater effect on improving mental health. Conclusion. Preliminary evidence indicated that health and PA improved in both groups. Effect sizes suggested that participants benefited more physically from IPR and more mentally from GWI. Future research should determine whether combining therapeutic exercise with group education improves both mental and physical health.

Comparison of the influence of different rehabilitation programmes on clinical, spirometric and spiroergometric parameters in patients with multiple sclerosis

2006 ◽  
Vol 12 (2) ◽  
pp. 227-234 ◽  
Author(s):  
K Rasova ◽  
E Havrdova ◽  
P Brandejsky ◽  
M Zálišová ◽  
B Foubikova ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Multiple Sclerosis ◽  
Aerobic Training ◽  
Combined Therapy ◽  
Bicycle Ergometer ◽  
Beck Depression Inventory Score ◽  
Impact Scale ◽  
Fatigue Impact Scale ◽  
Training Programmes

Purpose The aim of this study was to compare the effect of four different programmes on spiroergometric, spirometric and clinical parameters in multiple sclerosis (MS) patients.Methods One hundred and twelve MS patients were divided into four groups. The first group underwent neurophysiologically based physiotherapy, the second aerobic training, the third combined therapy (neurophysiologically based physiotherapy and aerobic training) and the fourth did not change any habits. Seventeen patients did not finish the study. Patients were examined on impairment (Expanded Disability Status Scale), disability (Barthel Index), handicap (Environment Status Scale), quality of life (Multiple Sclerosis Quality of Life), fatigue (Modified Fatigue Impact Scale), depression (Beck Depression Inventory Score), respiratory function (spirometric parameters on spirometry) and physical fitness (spiroergometric parameters on a bicycle ergometer).Results The patients who participated in one of our training programmes showed a significant improvement of the examined parameters in comparison to those who did not change their present habits. Each of the four training programmes had a different impact on the parameters, which means that each of them had a different effect. The neurophysiologically based physiotherapy had the greatest impact on impairment, and the aerobic training on spirometric and spiroergometric parameters. All methods (the neurophysiologically based physiotherapy, the aerobic training and the combined programme) had an impact on fatigue.

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