Functional magnetic resonance imaging correlates of fatigue in multiple sclerosis
Functional magnetic resonance imaging correlates of fatigue in multiple sclerosis
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DOI：
10.1006/nimg.2001.1011
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发表时间：
2002-03-01
期刊：
影响因子：
5.7
通讯作者：
Comi, G
中科院分区：
文献类型：
--
作者：
Filippi, M;Rocca, MA;Comi, G
虽然疲劳是多发性硬化症(MS)的一种常见且令人困扰的症状，但其发病机制尚不清楚。在这项研究中，我们使用功能磁共振成像(FMRI)来测试不同的运动相关皮质和皮质下激活模式是否有助于MS患者疲劳的发展。我们在15名MS疲劳患者(F)、14名无疲劳MS患者(NF)和15名性别和年龄匹配的健康志愿者执行一项简单的运动任务时获得了fMRI。F和NFMS患者的主要临床和MRI变量也是匹配的。使用统计参数图对fMRI数据进行分析。在所有患者中，使用疲劳严重程度量表(FSS)对疲劳严重程度进行分级。与健康对照组相比，MS患者对侧初级躯体运动皮质、侧裂升支、对侧顶内沟(EPS)、对侧等部位的激活更为显著。辅助运动区，同侧和对侧扣带运动区(CMA)。与F MS患者相比，NF患者的同侧小脑半球、同侧丘脑盖、同侧楔前叶、对侧丘脑和对侧丘脑的激活更为显著。额叶中回。相比之下，F MS患者对侧颈总动脉的激活更为显著。FSS评分与对侧IPS(r=-0.63)、同侧丘脑(r=-0.61)和丘脑(r=-0.62)的相对激活呈显著负相关。这项研究提供了额外的证据，证明多发性硬化症患者的疲劳与功能相关的皮质和皮质下区域之间的相互作用受损有关。这也表明，功能磁共振成像可能是一个有价值的工具，以监测旨在减少多发性硬化症相关疲劳的治疗效果。(C)2002年埃尔塞维尔科学公司(美国)。
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 (EPS), 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. (C) 2002 Elsevier Science (USA).