Tract-specific white matter correlates of fatigue and cognitive impairment in benign multiple sclerosis

TY - JOUR

T1 - Tract-specific white matter correlates of fatigue and cognitive impairment in benign multiple sclerosis

AU - Bester, Maxim

AU - Lazar, Mariana

AU - Petracca, Maria

AU - Babb, James S

AU - Herbert, Joseph

AU - Grossman, Robert I

AU - Inglese, Matilde

N1 - Copyright © 2013 Elsevier B.V. All rights reserved.

PY - 2013/7/15

Y1 - 2013/7/15

N2 - BACKGROUND: Although benign multiple sclerosis (BMS) is traditionally defined by the presence of mild motor involvement decades after disease onset, symptoms of fatigue and cognitive impairment are very common.OBJECTIVE: To investigate the association between micro-structural damage in the anterior thalamic (AT) tracts and in the corpus callosum (CC), as measured by diffusion tensor imaging (DTI) tractography, and fatigue and cognitive deficits.METHODS: DTI data were acquired from 26 BMS patients and 24 sex- and age-matched healthy controls.RESULTS: General and mental fatigue scores were significantly impaired in patients compared with controls (p≤0.05 for both) and 38% of patients resulted cognitively impaired. Mean diffusivity (MD) of the AT and CC tracts was significantly higher and fractional anisotropy (FA) was lower in patients compared with controls (p<0.001 for all). Fatigue was associated with increased MD (p=0.01) of the AT tracts whereas deficit of executive functions and verbal learning were associated with decreased FA in the body (p=0.004) and genu (p=0.008) of the CC. Deficits in processing speed and attention were associated with the T2 lesion volume of the AT tracts (p<0.01 for all).DISCUSSION: These findings suggest that fatigue and cognitive impairment are quite frequent in BMS patients and are, at least in part, related to micro-structural damage and T2LV of WM tracts connecting the brain cortical and sub-cortical regions of the two hemispheres.

AB - BACKGROUND: Although benign multiple sclerosis (BMS) is traditionally defined by the presence of mild motor involvement decades after disease onset, symptoms of fatigue and cognitive impairment are very common.OBJECTIVE: To investigate the association between micro-structural damage in the anterior thalamic (AT) tracts and in the corpus callosum (CC), as measured by diffusion tensor imaging (DTI) tractography, and fatigue and cognitive deficits.METHODS: DTI data were acquired from 26 BMS patients and 24 sex- and age-matched healthy controls.RESULTS: General and mental fatigue scores were significantly impaired in patients compared with controls (p≤0.05 for both) and 38% of patients resulted cognitively impaired. Mean diffusivity (MD) of the AT and CC tracts was significantly higher and fractional anisotropy (FA) was lower in patients compared with controls (p<0.001 for all). Fatigue was associated with increased MD (p=0.01) of the AT tracts whereas deficit of executive functions and verbal learning were associated with decreased FA in the body (p=0.004) and genu (p=0.008) of the CC. Deficits in processing speed and attention were associated with the T2 lesion volume of the AT tracts (p<0.01 for all).DISCUSSION: These findings suggest that fatigue and cognitive impairment are quite frequent in BMS patients and are, at least in part, related to micro-structural damage and T2LV of WM tracts connecting the brain cortical and sub-cortical regions of the two hemispheres.

KW - Adult

KW - Aged

KW - Anisotropy

KW - Behavior

KW - Brain

KW - Brain Mapping

KW - Cognition Disorders

KW - Corpus Callosum

KW - Diffusion Tensor Imaging

KW - Executive Function

KW - Fatigue

KW - Female

KW - Humans

KW - Male

KW - Middle Aged

KW - Multiple Sclerosis

KW - Neural Pathways

KW - Neuropsychological Tests

KW - Prospective Studies

KW - Spinothalamic Tracts

KW - Verbal Learning

U2 - 10.1016/j.jns.2013.04.005

DO - 10.1016/j.jns.2013.04.005

M3 - SCORING: Journal article

C2 - 23643443

VL - 330

SP - 61

EP - 66

JO - J NEUROL SCI

JF - J NEUROL SCI

SN - 0022-510X

IS - 1-2

ER -