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Abnormal cervical cord function contributes to fatigue in multiple sclerosis.

M A Rocca1, M Absinta, P Valsasina

  • 1Neuroimaging Research Unit, Institute of Experimental Neurology, Division of Neuroscience San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy.

Multiple Sclerosis (Houndmills, Basingstoke, England)
|March 6, 2012
PubMed
Summary
This summary is machine-generated.

Cervical cord functional abnormalities, not structural damage, are linked to fatigue severity in multiple sclerosis (MS). This study used advanced MRI to explore the connection between cervical cord function and MS-related fatigue.

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Area of Science:

  • Neuroimaging
  • Neurology
  • Medical Research

Background:

  • Multiple sclerosis (MS) is a demyelinating disease affecting the central nervous system.
  • Fatigue is a common and debilitating symptom in MS patients.
  • The underlying mechanisms of MS-related fatigue are not fully understood.

Purpose of the Study:

  • To investigate the association between cervical cord damage and dysfunction and the presence/severity of fatigue in MS.
  • To utilize a multiparametric magnetic resonance (MR) approach for this investigation.
  • To differentiate between structural and functional contributions to MS fatigue.

Main Methods:

  • Acquired cervical cord functional MRI (fMRI) during tactile stimulation and structural MRI of the brain and cord.
  • Included 20 controls, 15 MS patients without fatigue (NF), and 20 MS patients with fatigue (F).
  • Assessed differences in lesions, white matter integrity (fractional anisotropy), cord cross-sectional area, and fMRI activity.

Main Results:

  • Structural MRI measures differed significantly between groups, except for cord lesion number and cross-sectional area.
  • NF-MS patients showed higher cord recruitment compared to controls, and lower brain white matter fractional anisotropy compared to F-MS patients.
  • In MS patients, increased cord recruitment correlated with higher fatigue severity, and F-MS patients exhibited more diffuse cord recruitment patterns.

Conclusions:

  • Functional, rather than structural, abnormalities of the cervical cord are likely implicated in the development of fatigue in MS.
  • Cervical cord functional changes may be a key factor in MS-related fatigue pathogenesis.
  • This research highlights the importance of functional imaging in understanding MS symptoms.