Lower self-report fatigue in multiple sclerosis is associated with localized white matter tract disruption between amygdala, temporal pole, insula, and other connected structures.
Amygdala
/ diagnostic imaging
Brain
/ diagnostic imaging
Cerebral Cortex
/ diagnostic imaging
Depression
/ complications
Fatigue
/ complications
Female
Humans
Magnetic Resonance Imaging
Male
Middle Aged
Multiple Sclerosis
/ complications
Neural Pathways
/ diagnostic imaging
Self Report
Severity of Illness Index
Temporal Lobe
/ diagnostic imaging
White Matter
/ diagnostic imaging
Amygdala
Fatigue
Multiple sclerosis
Structural connectivity
Journal
Multiple sclerosis and related disorders
ISSN: 2211-0356
Titre abrégé: Mult Scler Relat Disord
Pays: Netherlands
ID NLM: 101580247
Informations de publication
Date de publication:
Jan 2019
Jan 2019
Historique:
received:
28
09
2018
revised:
06
11
2018
accepted:
08
11
2018
pubmed:
20
11
2018
medline:
5
4
2019
entrez:
20
11
2018
Statut:
ppublish
Résumé
Fatigue, a frequent and disabling symptom for people with multiple sclerosis (PwMS), inconsistently correlates with white matter (WM) pathology. Network-based analysis, accounting for the manner in which lesions disrupt networks of structurally connected gray matter (GM) regions, may provide additional insight. To identify patterns of WM tract disruption which explain self-reported fatigue severity in PwMS. 137 PwMS and 50 age- and sex-matched healthy controls (HC) underwent fatigue assessment and brain MRI. Lesion maps were applied to determine the severity of WM tract disruption between pairs of GM regions. Then, the Network-Based-Statistics tool was applied to identify structural networks whose disruption explained fatigue severity. To determine whether these networks explain unique variance above conventional MRI measures and depression, regressions were applied controlling for age, sex, brain volume, T2-lesion volume, and depression. Patient-perceived fatigue in PwMS was positively associated with overall lesion burden (β = 0.563, p-value < 0.001). In contrast, localized disruptions in WM tracts between regions including the amygdala, insula, hippocampus, putamen, temporal pole, caudal-middle-frontal gyrus, rostral-middle-frontal gyrus, inferior-parietal gyrus, and banks of the superior temporal sulcus were significantly negatively correlated with fatigue in PwMS (β = -0.586, p-value < 0.001). Average disruption within this specific, localized network explained significant additional variance in fatigue above what was otherwise explained by depression and conventional MRI measures of neuropathology (ΔR Although overall lesion burden correlates positively with fatigue in PwMS, localized WM damage between the amygdala, temporal pole, and other connected structures is associated with lower severity of patient-perceived fatigue.
Sections du résumé
BACKGROUND
BACKGROUND
Fatigue, a frequent and disabling symptom for people with multiple sclerosis (PwMS), inconsistently correlates with white matter (WM) pathology. Network-based analysis, accounting for the manner in which lesions disrupt networks of structurally connected gray matter (GM) regions, may provide additional insight.
OBJECTIVE
OBJECTIVE
To identify patterns of WM tract disruption which explain self-reported fatigue severity in PwMS.
METHODS
METHODS
137 PwMS and 50 age- and sex-matched healthy controls (HC) underwent fatigue assessment and brain MRI. Lesion maps were applied to determine the severity of WM tract disruption between pairs of GM regions. Then, the Network-Based-Statistics tool was applied to identify structural networks whose disruption explained fatigue severity. To determine whether these networks explain unique variance above conventional MRI measures and depression, regressions were applied controlling for age, sex, brain volume, T2-lesion volume, and depression.
RESULTS
RESULTS
Patient-perceived fatigue in PwMS was positively associated with overall lesion burden (β = 0.563, p-value < 0.001). In contrast, localized disruptions in WM tracts between regions including the amygdala, insula, hippocampus, putamen, temporal pole, caudal-middle-frontal gyrus, rostral-middle-frontal gyrus, inferior-parietal gyrus, and banks of the superior temporal sulcus were significantly negatively correlated with fatigue in PwMS (β = -0.586, p-value < 0.001). Average disruption within this specific, localized network explained significant additional variance in fatigue above what was otherwise explained by depression and conventional MRI measures of neuropathology (ΔR
CONCLUSION
CONCLUSIONS
Although overall lesion burden correlates positively with fatigue in PwMS, localized WM damage between the amygdala, temporal pole, and other connected structures is associated with lower severity of patient-perceived fatigue.
Identifiants
pubmed: 30453198
pii: S2211-0348(18)30490-5
doi: 10.1016/j.msard.2018.11.005
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
298-304Informations de copyright
Copyright © 2018. Published by Elsevier B.V.