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Longitudinal associations between brain structural changes and fatigue in early MS.

Bardia Nourbakhsh1, Christina Azevedo2, Julia Nunan-Saah3

  • 1Department of Neurology, University of California San Francisco, San Francisco, CA, USA.

Multiple Sclerosis and Related Disorders
|February 10, 2016
PubMed
Summary

Brain atrophy, particularly in the thalamus and cerebellum, may predict worsening fatigue in early multiple sclerosis (MS) patients. Global brain volume loss did not strongly correlate with fatigue severity.

Keywords:
AtrophyFatigueGrey matterMRI scansMultiple sclerosis

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Area of Science:

  • Neurology
  • Neuroimaging
  • Multiple Sclerosis Research

Background:

  • Fatigue is a prevalent and debilitating symptom in multiple sclerosis (MS).
  • Previous studies suggest correlations between brain structural changes and MS fatigue, but findings are inconsistent.

Purpose of the Study:

  • To investigate the relationship between global and regional brain atrophy and fatigue in patients with early relapsing MS.
  • To identify potential imaging biomarkers for predicting fatigue progression.

Main Methods:

  • A cohort of early relapsing MS patients (within 12 months of onset) was studied.
  • MRI metrics included normalized brain parenchymal volume, normalized normal-appearing white and gray matter volume, T2 lesion volume, cortical thickness, thalamic volume, and cerebellar cortical volume.
  • Fatigue was assessed using the Modified Fatigue Impact Scale (MFIS), with statistical analysis using mixed-effects models.

Main Results:

  • Global brain volume measures and T2 lesion volume changes did not correlate with changes in MFIS scores.
  • Lower baseline thalamic volume predicted an increase in the physical subscale of the MFIS.
  • A trend suggested baseline thalamic and cerebellar cortical volumes predict changes in total MFIS scores.

Conclusions:

  • Global brain tissue loss is not a strong predictor of fatigue in early MS.
  • Thalamic and cerebellar cortical atrophy show potential as predictors of future fatigue severity in MS patients.