Elsevier

NeuroImage

Volume 15, Issue 3, March 2002, Pages 559-567
NeuroImage

Regular Article
Functional Magnetic Resonance Imaging Correlates of Fatigue in Multiple Sclerosis

https://doi.org/10.1006/nimg.2001.1011Get rights and content

Abstract

Although fatigue is a common and troublesome symptom of multiple sclerosis (MS), its pathogenesis is poorly understood. In this study, we used functional magnetic resonance imaging (fMRI) to test whether a different pattern of movement-associated cortical and subcortical activations might contribute to the development of fatigue in patients with MS. We obtained fMRI during the execution of a simple motor task with completely normally functioning hands from 15 MS patients with fatigue (F), 14 MS patients without fatigue (NF), and 15 sex- and age-matched healthy volunteers. F and NF MS patients were also matched for major clinical and MRI variables. FMRI data were analyzed using statistical parametric mapping. In all patients, severity of fatigue was rated using the Fatigue Severity Scale (FSS). Compared to healthy subjects, MS patients showed more significant activations of the contralateral primary somatomotor cortex, the contralateral ascending limb of the Sylvian fissure, the contralateral intraparietal sulcus (IPS), the contralateral supplementary motor area, and the ipsilateral and contralateral cingulate motor area (CMA). Compared to F MS patients, NF patients showed more significant activations of the ipsilateral cerebellar hemisphere, the ipsilateral rolandic operculum, the ipsilateral precuneus, the contralateral thalamus, and the contralateral middle frontal gyrus. In contrast, F MS patients had a more significant activation of the contralateral CMA. Significant inverse correlations were found between FSS scores and relative activations of the contralateral IPS (r = −0.63), ipsilateral rolandic operculum (r = −0.61), and thalamus (r = −0.62). This study provides additional evidence that fatigue in MS is related to impaired interactions between functionally related cortical and subcortical areas. It also suggests that fMRI might be a valuable tool to monitor the efficacy of treatment aimed at reducing MS-related fatigue.

References (40)

  • A.L. Brody et al.

    Prefrontal–subcortical and limbic circuit mediation of major depressive disorder

    Semin. Clin. Neuropsychiatry

    (2001)
  • B. Colombo et al.

    MRI and motor evoked potential findings in non-disabled multiple sclerosis patients with and without symptoms of fatigue

    J. Neurol.

    (2000)
  • E. Disbrow et al.

    Somatotopic organization of cortical fields in the lateral sulcus of Homo sapiens: Evidence for SII and PV

    J. Comp. Neurol.

    (2000)
  • M. Filippi

    Linking structural, metabolic and functional changes in multiple sclerosis

    Eur. J. Neurol.

    (2001)
  • G.R. Fink et al.

    Multiple nonprimary motor areas in the human cortex

    J. Neurophysiol.

    (1997)
  • S.T. Grafton et al.

    Human functional anatomy of visually guided finger movements

    Brain

    (1992)
  • R.M. Herndon

    Handbook of Neurologic Rating Scales

    (1997)
  • I.H. Jenkins et al.

    Motor sequence learning: A study with positron emission tomography

    J. Neurosci.

    (1994)
  • L.B. Krupp et al.

    Fatigue in multiple sclerosis

    Arch. Neurol.

    (1988)
  • Cited by (0)

    View full text