TY - JOUR
T1 - MRI and motor evoked potential findings in nondisabled multiple sclerosis patients with and without symptoms of fatigue
AU - Colombo, Bruno
AU - Boneschi, Filippo Martinelli
AU - Rossi, Paolo
AU - Rovaris, Marco
AU - Maderna, Luca
AU - Filippi, Massimo
AU - Comi, Giancarlo
PY - 2000
Y1 - 2000
N2 - Fatigue is a common symptom of multiple sclerosis (MS) even in the early phases of the disease, when neurological disability is usually still not present. To investigate the pathophysiology of fatigue we compared neurophysiological (motor evoked potentials of the four limbs, MEPs) and brain magnetic resonance imaging (MRI) findings in two groups of nondisabled MS patients, those with (n = 15) and those without (n = 15) fatigue. Fatigue was assessed by an interview and scored by the Fatigue Severity Scale. The two groups were matched for sex, age, disease duration, Expanded Disability Status Scale score, pyramidal Functional System (FS) score, and depression score. MEPs were abnormal in five patients with fatigue and in one patient without fatigue. A significant association was found between the patient scores on the Fatigue Severity Scale, and the burden of MRI lesions (r = 0.5; P <0.005). Significantly higher parietal lobe (P <0.05), internal capsule (P <0.05), and periventricular trigone (P<0.05) lesion loads were found in patients with fatigue than in those without. Our results agree with a central nervous system origin of fatigue in MS patients. This symptom might be a consequence either of a functional deafferentation of the cortex due to cortico- subcortical interconnection damage or of a demyelination in critical sites of the CNS, such as the cortico-spinal tract.
AB - Fatigue is a common symptom of multiple sclerosis (MS) even in the early phases of the disease, when neurological disability is usually still not present. To investigate the pathophysiology of fatigue we compared neurophysiological (motor evoked potentials of the four limbs, MEPs) and brain magnetic resonance imaging (MRI) findings in two groups of nondisabled MS patients, those with (n = 15) and those without (n = 15) fatigue. Fatigue was assessed by an interview and scored by the Fatigue Severity Scale. The two groups were matched for sex, age, disease duration, Expanded Disability Status Scale score, pyramidal Functional System (FS) score, and depression score. MEPs were abnormal in five patients with fatigue and in one patient without fatigue. A significant association was found between the patient scores on the Fatigue Severity Scale, and the burden of MRI lesions (r = 0.5; P <0.005). Significantly higher parietal lobe (P <0.05), internal capsule (P <0.05), and periventricular trigone (P<0.05) lesion loads were found in patients with fatigue than in those without. Our results agree with a central nervous system origin of fatigue in MS patients. This symptom might be a consequence either of a functional deafferentation of the cortex due to cortico- subcortical interconnection damage or of a demyelination in critical sites of the CNS, such as the cortico-spinal tract.
KW - Fatigue
KW - Magnetic resonance imaging
KW - Motor evoked potentials
KW - Multiple sclerosis
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M3 - Article
C2 - 10993490
AN - SCOPUS:0033884981
VL - 247
SP - 506
EP - 509
JO - Journal of Neurology
JF - Journal of Neurology
SN - 0340-5354
IS - 7
ER -