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Functional Magnetic Resonance Imaging Correlations Between Fatigue and Cognitive Performance in Patients With
Dessislava Iancheva1, Anastasya Trenova1, Stefka Mantarova1,2
1Department of Neurology, Medical University Plovdiv, Plovdiv, Bulgaria.
Frontiers in Psychiatry
|November 22, 2019
Summary
This study explored how fatigue affects brain activity in multiple sclerosis (MS) patients during cognitive tasks. Findings suggest specific brain regions, like Brodmann area 40, may help preserve cognitive function despite fatigue in MS.
Area of Science:
- Neuroscience
- Cognitive Science
- Medical Imaging
Background:
- Fatigue significantly impacts cognitive performance in multiple sclerosis (MS), but the underlying neural mechanisms remain unclear.
- Understanding these mechanisms is crucial for developing targeted interventions for MS patients experiencing cognitive dysfunction and fatigue.
Purpose of the Study:
- To investigate blood oxygen level-dependent (BOLD) brain activations in relapsing-remitting MS (RRMS) patients with and without cognitive impairment.
- To examine the influence of fatigue severity on cortical activation patterns during a cognitive task in RRMS patients.
Main Methods:
- Functional Magnetic Resonance Imaging (fMRI) was used to measure BOLD activity in 42 RRMS patients during a cognitive task (Paced Visual Serial Addition Test).
- Patients were categorized into cognitively impaired (CI) and cognitively preserved (CP) groups based on Symbol Digit Modalities Test (SDMT) scores.
- Fatigue was assessed using the Modified Fatigue Impact Scale (MFIS), and depression was screened using the Beck Depression Inventory (BDI).
Main Results:
- Cognitively preserved (CP) patients showed increased BOLD activations in the left Brodmann area (BA) 40, including the left supramarginal gyrus, compared to cognitively impaired (CI) patients.
- Regression analyses revealed that higher fatigue scores (MFIS) correlated with increased BOLD signals in left BA 40, right BA 40, and left BA 6.
- Conversely, lower fatigue scores were associated with stronger BOLD signals in left BA 31.
Conclusions:
- The observed differences in BOLD activations suggest cortical reorganization may be occurring in CP MS patients.
- Fatigue demonstrably influences cortical activation patterns during cognitive tasks, with specific areas showing altered activity based on fatigue severity.
- Activation in BA 40 may play a role in mitigating the cognitive effects of fatigue in MS patients with preserved cognitive function.
