Brain Structural and Functional Alterations in Multiple Sclerosis-Related Fatigue: A Systematic Review

Barbi, Chiara; Pizzini, Francesca; Tamburin, Stefano; Martini, Alice; Pedrinolla, Anna; Laginestra, Fabio Giuseppe; Giuriato, Gaia; Martignon, Camilla; Schena, Federico; Venturelli, Massimo

doi:10.3390/neurolint14020042

Cited by 22 publications

(11 citation statements)

References 129 publications

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“…Motivated by this finding, we evaluated exploratory correlations of this network to clinical and cognitive assessments that covered these domains. Damage to WM tracts innervating and enervating from the thalamus and association cortex have been implicated in symptoms of MS, namely, fatigue, 74 lack of attention 75 and cognitive dysfunction. 75,76 Our post hoc correlations showed a small but significant correlation of average fibre density in this network at BL with attention.…”

Section: Discussionmentioning

confidence: 99%

Improvement of the thalamocortical white matter network in people with stable treated relapsing–remitting multiple sclerosis over time

Alshehri,

Koussis,

Al‐iedani

et al. 2024

NMR in Biomedicine

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Advanced imaging techniques (tractography) enable the mapping of white matter (WM) pathways and the understanding of brain connectivity patterns. We combined tractography with a network‐based approach to examine WM microstructure on a network level in people with relapsing–remitting multiple sclerosis (pw‐RRMS) and healthy controls (HCs) over 2 years. Seventy‐six pw‐RRMS matched with 43 HCs underwent clinical assessments and 3T MRI scans at baseline (BL) and 2‐year follow‐up (2‐YFU). Probabilistic tractography was performed, accounting for the effect of lesions, producing connectomes of 25 million streamlines. Network differences in fibre density across pw‐RRMS and HCs at BL and 2‐YFU were quantified using network‐based statistics (NBS). Longitudinal network differences in fibre density were quantified using NBS in pw‐RRMS, and were tested for correlations with disability, cognition and fatigue scores. Widespread network reductions in fibre density were found in pw‐RRMS compared with HCs at BL in cortical regions, with more reductions detected at 2‐YFU. Pw‐RRMS had reduced fibre density at BL in the thalamocortical network compared to 2‐YFU. This effect appeared after correction for age, was robust across different thresholds, and did not correlate with lesion volume or disease duration. Pw‐RRMS demonstrated a robust and long‐distance improvement in the thalamocortical WM network, regardless of age, disease burden, duration or therapy, suggesting a potential locus of neuroplasticity in MS. This network's role over the disease's lifespan and its potential implications in prognosis and treatment warrants further investigation.

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Section: Discussionmentioning

confidence: 99%

Improvement of the thalamocortical white matter network in people with stable treated relapsing–remitting multiple sclerosis over time

Alshehri,

Koussis,

Al‐iedani

et al. 2024

NMR in Biomedicine

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“…A growing body of evidence suggests that chronic fatigue could be a network disorder ( 56 ), similar to chronic “nociplastic” pain ( 57 ), characterised by abnormal activity and “bad plasticity” in different brain areas ( 58 ), including sensorimotor cortices. For example, electrophysiological and imaging studies showed that fatigue in MS is associated with asymmetries between sensorimotor cortices of the two hemispheres ( 59 ) and increased activation of specific cortical areas of the motor network ( 60 ).…”

Section: Discussionmentioning

confidence: 99%

Fatigue may improve equally after balance and endurance training in multiple sclerosis: a randomised, crossover clinical trial

Perucca,

Scarano,

Russo

et al. 2024

Front. Neurol.

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IntroductionFatigue and poor balance are frequent and severe problems in multiple sclerosis (MS) that may interact. Endurance training is known to be effective on fatigue. This study aims to test if balance training is more effective against MS fatigue.MethodsA randomised crossover trial was run, recruiting 31 MS people (21 women; median age: 46 years, range: 30–64; median EDSS: 4, range: 2.5–5). Participants received balance and endurance training alternately (15 one-to-one sessions, 5 days/week) and were assessed before (T0), after (T1), and 30 days after treatment ended (T2). The Modified Fatigue Impact Scale (MFIS) with scores linearised through Rasch analysis was the primary outcome (the lower the measure, the better the condition, i.e., the lower the fatigue symptoms). The Equiscale balance scale and posturography (EquiTest) were used to assess balance. Linear mixed-effects models with ANOVA were used for significance testing.ResultsThirteen participants had no carryover effect and were included in the primary analysis. Fatigue significantly changed across the three time points (F2,58 = 16.0; p < 0.001), but no difference across treatments was found. Altogether, both treatments significantly improved the MFIS measure at T1 (95%CI: −1.24 logits; mean: −1.67 to −0.81 logits) and T2 (95%CI: −1.04; mean: −1.49 to −0.60) compared to T0 (95%CI: −0.51; mean: −0.95 to −0.08; p ≤ 0.001). Equiscale and posturography highlighted balance improvement after balance training but not after endurance training.ConclusionBalance and endurance training could similarly reduce fatigue in MS patients in the short term. However, only balance training also improved balance in MS.

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“…With this alternation, the best possible score is 28. The quality of induced studies consists of the following score ranges: excellent (26-28), good (20)(21)(22)(23)(24)(25), fair (15)(16)(17)(18)(19), and poor (≤ 14). This modi cation was done in previous reviews related to MS (20,26).…”

Section: Quality Assessmentmentioning

confidence: 99%

The effect of fatigue on postural control in individuals with multiple sclerosis: A systematic review

Sedaghati

Alghosi

Hosseini

2023

Preprint

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Background: Fatigue is the most disabling ‎symptom for individuals with multiple ‎sclerosis which can significantly affect postural control by impairing the ability of the central nervous system to modulate sensory inputs and coordinate motor responses. This systematic review aimed to accumulate the existing evidence. This systematic review aimed to investigate the effect of ‎fatigue on postural control in individuals with multiple ‎sclerosis.‎ Methods: This systematic review was performed in compliance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) statement and registered in PROSPERO with ID CRD42022376262‎. Web of Science, PubMed, Scopus, and Google Scholar was systematically searched until January 2023, and a manual search was performed using the reference lists of included studies. Two authors independently selected the studies, extracted data, and evaluated their ‎methodological quality using the Downs and Black checklist. The process was later discussed ‎with a third author.‎ Results: Five studies were included in this review, of which consistent evidence investigating a direct ‎relationship between fatigue and ‎postural control in individuals with multiple ‎sclerosis. All the studies reported negative effects on postural control. Four ‎studies executed walking tests as fatigue protocols, and one study used a strength testing protocol for both legs, which served as a fatigue-inducing activity‎. Conclusions: The available evidence suggests that individuals with multiple ‎sclerosis may experience postural control deficits due to fatigue. However, the present body of literature exhibits limitations in terms of its quality and methodology. Gender differences, balance, fatigue task, and muscle function are important factors that need to be taken into account when investigating the relationship between fatigue and postural control deficits in MS. Further high-quality research is necessary to comprehend the complex interplay between MS-related fatigue and postural control deficits after physical activity.

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Brain Structural and Functional Alterations in Multiple Sclerosis-Related Fatigue: A Systematic Review

Cited by 22 publications

References 129 publications

Improvement of the thalamocortical white matter network in people with stable treated relapsing–remitting multiple sclerosis over time

Improvement of the thalamocortical white matter network in people with stable treated relapsing–remitting multiple sclerosis over time

Fatigue may improve equally after balance and endurance training in multiple sclerosis: a randomised, crossover clinical trial

The effect of fatigue on postural control in individuals with multiple sclerosis: A systematic review

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