Deep gray matter and fatigue in MS: a T1 relaxation time study

Area of Science:

• Neuroimaging
• Neurology
• Radiology

Background:

• Fatigue is a common and debilitating symptom in multiple sclerosis (MS), significantly impacting patients' quality of life.
• Subcortical gray matter pathology has been implicated in the development of MS-related fatigue.
• Magnetic resonance imaging (MRI) may offer insights into the structural changes associated with MS fatigue.

Purpose of the Study:

• To investigate the relationship between fatigue severity and MRI-detectable changes in deep gray matter structures in relapsing-remitting MS (RRMS).
• To quantify mean T1 relaxation time (T1) in deep gray matter regions of interest (ROIs) in RRMS patients and healthy controls.
• To assess if T1 values in specific deep gray matter structures correlate with fatigue severity as measured by the Fatigue Severity Scale.

Main Methods:

• Region of interest (ROI) analysis was performed on MRI scans of 52 RRMS patients and 19 healthy volunteers.
• Mean T1 relaxation times were measured in the thalamus, putamen, and caudate nucleus.
• Fatigue severity was assessed using the Fatigue Severity Scale.

Main Results:

• Median T1 values in the thalamus and putamen were significantly higher in RRMS patients compared to healthy controls.
• A significant positive correlation was found between fatigue severity and T1 values in the thalamus (rho = 0.418; p = 0.014).
• The thalamus exhibited significantly higher median T1 values in MS patients with fatigue compared to those without (p = 0.018).

Conclusions:

• Deep gray matter structures, particularly the thalamus, play a role in the pathogenesis of MS-related fatigue.
• T1 relaxation time measurement is a sensitive technique for detecting deep gray matter abnormalities in RRMS.
• These findings support the involvement of gray matter pathology in the manifestation of fatigue in multiple sclerosis.