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Fatigue occurs when materials rupture under repeated or fluctuating loads, even at stress levels far below their static breaking strength. It typically results in brittle failure, even for ductile materials. It is a critical consideration in designing machines and structural components subjected to repetitive or varying loads. The nature of these loadings can range from fluctuating loads like unbalanced pump impellers causing vibrations to repeatedly bending a thin steel rod wire back and forth...
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Structural correlates for fatigue in early relapsing remitting multiple sclerosis.

Janine Wilting1, Hans O Rolfsnes1, Hilga Zimmermann1

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Cognitive fatigue in multiple sclerosis (MS) is linked to thalamic microstructural changes, not typical lesions. Compensatory processes may preserve cognition but contribute to the feeling of fatigue.

Keywords:
CognitionDTIFatigueMultiple sclerosisVBM

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Area of Science:

  • Neuroscience
  • Neurology
  • Radiology

Background:

  • Fatigue is a prevalent and poorly understood symptom in multiple sclerosis (MS).
  • Cognitive fatigue significantly impacts daily functioning in early-stage MS patients.
  • Understanding the underlying pathophysiology is crucial for effective management.

Purpose of the Study:

  • To investigate the morphologic and microstructural correlates of cognitive fatigue in early relapsing-remitting MS.
  • To examine neuropsychological parameters associated with cognitive fatigue in this patient group.

Main Methods:

  • Neuropsychological testing and magnetic resonance imaging (MRI) were conducted on 79 early MS patients (38 with fatigue, 41 without) and 40 controls.
  • MRI sequences included anatomical and diffusion tensor imaging.
  • Voxel-based morphometry and tract-based spatial statistics were employed for analysis.

Main Results:

  • Patients with cognitive fatigue showed reduced thalamic fractional anisotropy and increased mean diffusivity.
  • No significant differences in lesion volume or distribution were found between fatigued and non-fatigued MS groups.
  • While subjective cognitive impairment differed, objective cognitive test scores showed no significant group differences.

Conclusions:

  • Morphological and microstructural alterations, particularly in the thalamus, are associated with cognitive fatigue in early MS.
  • These changes are distinct from typical MS lesions.
  • Compensatory mechanisms may initially maintain cognitive performance but contribute to the sensation of fatigue.