Abnormal functional connectivity of thalamic sub-regions contributes to fatigue in multiple sclerosis

Cruz, Milagros Hidalgo de la; d’Ambrosio, Alessandro; Valsasina, Paola; Pagani, Elisabetta; Colombo, Bruno; Rodegher, Mariaemma; Falini, Andrea; Comi, Giancarlo; Filippi, Massimo; Rocca, Maria A.

doi:10.1177/1352458517717807

Cited by 55 publications

(64 citation statements)

References 35 publications

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“…Neuroimaging studies (60,81,82) demonstrated that the main pathogenic substrate of MS-related fatigue could be a dysfunction of the circuits between the thalamus, the basal ganglia, and the cortex, and neurophysiological findings support this hypothesis. Indeed single-pulse TMS studies demonstrated that in MS patients the pathogenesis of fatigue is not driven by mechanisms directly related to corticospinal functioning but is due to alterations in structures located upstream to the primary motor cortex (39).…”

Section: Neurophysiology As Investigating Tool For the Pathogenic Mecmentioning

confidence: 91%

The Potential Role of Neurophysiology in the Management of Multiple Sclerosis-Related Fatigue

et al. 2020

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Fatigue is a very common symptom among people with multiple sclerosis (MS), but its management in clinical practice is limited by the lack of clear evidence about the pathogenic mechanisms, objective tools for diagnosis, and effective pharmacological treatments. In this scenario, neurophysiology could play a decisive role, thanks to its ability to provide objective measures and to explore the peripheral and the central structures of the nervous system. We hereby review and discuss current evidence about the potential role of neurophysiology in the management of MS-related fatigue. In the first part, we describe the use of neurophysiological techniques for exploring the pathogenic mechanisms of fatigue. In the second part, we review the potential application of neurophysiology for monitoring the response to pharmacological therapies. Finally, we show data about the therapeutic implications of neurophysiological techniques based on non-invasive brain stimulation.

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Section: Neurophysiology As Investigating Tool For the Pathogenic Mecmentioning

confidence: 91%

The Potential Role of Neurophysiology in the Management of Multiple Sclerosis-Related Fatigue

et al. 2020

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“…The second strategy associates FC values of MS patients with clinical data, such as cognitive ( 50 ) and motor performance ( 67 ), fatigue ( 40 , 68 , 69 ), depression ( 70 ), or sleep disturbance ( 71 ). Here, either the respective symptom severity is used as a regressor of the FC data or the group of MS patients is subdivided into subgroups of preserved vs. impaired function.…”

Section: Overview Of Selected Literaturementioning

confidence: 99%

Functional Connectivity in Multiple Sclerosis: Recent Findings and Future Directions

et al. 2018

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Multiple sclerosis is a debilitating disorder resulting from scattered lesions in the central nervous system. Because of the high variability of the lesion patterns between patients, it is difficult to relate existing biomarkers to symptoms and their progression. The scattered nature of lesions in multiple sclerosis offers itself to be studied through the lens of network analyses. Recent research into multiple sclerosis has taken such a network approach by making use of functional connectivity. In this review, we briefly introduce measures of functional connectivity and how to compute them. We then identify several common observations resulting from this approach: (a) high likelihood of altered connectivity in deep-gray matter regions, (b) decrease of brain modularity, (c) hemispheric asymmetries in connectivity alterations, and (d) correspondence of behavioral symptoms with task-related and task-unrelated networks. We propose incorporating such connectivity analyses into longitudinal studies in order to improve our understanding of the underlying mechanisms affected by multiple sclerosis, which can consequently offer a promising route to individualizing imaging-related biomarkers for multiple sclerosis.

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“…Over the last twenty years, an increasing number of studies have evaluated the pathogenetic bases of MS-related fatigue. Converging evidence from neurophysiology 7,8 and neuroimaging 9,10 demonstrated that, in patients with MS, fatigue has a central origin and a dysfunction of the circuits between thalamus, basal ganglia and cortex could be its main pathogenic substrate. Initially, many authors focused on areas of possible interest for motor fatigue (cortex and basal ganglia), that were easy to investigate with neuroimaging and neurophysiological tools.…”

Section: And Thementioning

confidence: 99%

Fatigue in multiple sclerosis: The role of thalamus

et al. 2019

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Fatigue is very common in multiple sclerosis (MS) and is often considered as its most disabling symptom. Over the last 20 years, an increasing number of studies have evaluated the pathogenetic bases of MS-related fatigue. Converging evidence from neurophysiology and neuroimaging research suggests that a dysfunction in a cortico-subcortical pathway, centered on thalamus, is involved in the pathogenesis of fatigue. However, type and significance of such dysfunction remain unknown, and some studies reported an increase in the activity and connectivity within the thalamic network, whereas others suggested its reduction. Hereby, we review the results of neuroimaging studies supporting the different hypotheses about the role of thalamic network in the pathophysiology of MS-related fatigue and discuss limitations and shortcomings of available data, highlighting the key challenges in the field and the directions for future research.

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Abnormal functional connectivity of thalamic sub-regions contributes to fatigue in multiple sclerosis

Cited by 55 publications

References 35 publications

The Potential Role of Neurophysiology in the Management of Multiple Sclerosis-Related Fatigue

The Potential Role of Neurophysiology in the Management of Multiple Sclerosis-Related Fatigue

Functional Connectivity in Multiple Sclerosis: Recent Findings and Future Directions

Fatigue in multiple sclerosis: The role of thalamus

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