Structural and cognitive correlates of fatigue in progressive multiple sclerosis

Andreasen, Anne Katrine; Marstrand, Lisbet; Siersma, Volkert; Siebner, Hartwig R.; Sellebjerg, Finn

doi:10.1080/01616412.2018.1547813

Cited by 19 publications

(23 citation statements)

References 55 publications

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“…The FSMC allows to quantify cognitive and motor fatigue separately 14 and lately, the scores in FSMC cognitive subscale were related to the performance of neuropsychological tests. 22 Therefore, the results of our study may indirectly confirm previous findings concerning the association between olfactory and cognitive dysfunction in MS. This correlation present only in patients treated with oral DMTs could be explained by the ability of fingolimod 23 and dimethyl fumarate 24 to slow the brain atrophy rate more significantly than injectables.…”

Section: Discussionsupporting

confidence: 89%

Olfactory Dysfunction in Patients With Relapsing-Remitting Multiple Sclerosis Treated With Disease-Modifying Therapies

et al. 2020

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Background: Olfactory dysfunction evaluated with time-consuming tests was more common in patients with multiple sclerosis (MS) than in controls and correlated with neurological deficit. The aim of the present study was to compare olfactory function between patients with relapsing-remitting MS (RRMS) and controls with short and simple screening tool—the Sniffin’ Sticks Identification Test (SSIT)—and search for its association with clinical and radiological features of the disease. Methods: The study included 30 controls and 30 patients with RRMS treated with disease-modifying therapies—injectables (interferon β or glatiramer acetate, N = 18) and oral drugs (dimethyl fumarate or fingolimod, N = 12). Hyposmia was defined as a score of 6 points or fewer in the SSIT olfactory test. The data concerning number of previous relapses, disability in Expanded Disability Status Scale (EDSS), and recent brain magnetic resonance imaging (MRI) scan were collected. Moreover, thalamic volume and third ventricle width were recorded in every patient. Additionally, cognition and fatigue in patients were evaluated 24 months after olfactory assessment with the Symbol Digit Modalities Test (SDMT) and Fatigue Scale for Motor and Cognitive Functions (FSMC), respectively. Results: Patients with RRMS had a higher risk of hyposmia than controls (66.7% vs 36.7%, OR = 1.82, 95% CI, 1.10-3.67, P = .02). Neither inflammatory (number of previous relapses or new brain MRI lesions) nor neurodegenerative (EDSS, SDMT, and FSMC scores; thalamic volume; third ventricle width) MS features did not correlate with SSIT score ( P > .05). In patients treated with oral drugs, olfactory dysfunction correlated with FSMC cognitive subscale ( r = −0.90, P = .006). Conclusions: Olfactory dysfunction is nearly twice as common in RRMS as in controls and correlates with fatigue level in patients treated with dimethyl fumarate or fingolimod.

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Section: Discussionsupporting

confidence: 89%

Olfactory Dysfunction in Patients With Relapsing-Remitting Multiple Sclerosis Treated With Disease-Modifying Therapies

et al. 2020

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“…Although structural neuroimaging based on, for example, cerebral MRI, has been used extensively in the diagnosis and monitoring of MS (Polman et al, 2011), it has failed at explaining the degree and the variety of CIs observed in this disorder (Mollison et al, 2017). Apart from a link with gray matter atrophy, only weak associations have indeed been reproducibly found between structural MRI parameters and CIs/fatigue (Andreasen et al, 2019). Functional neuroimaging therefore offers a unique opportunity to better understand the pathophysiology of cognitive and fatigue symptoms in MS (for a review, see Van Schependom & Nagels, 2017).…”

Section: Introductionmentioning

confidence: 99%

Brain dysconnectivity relates to disability and cognitive impairment in multiple sclerosis

Sjøgård

Wens

Schependom

et al. 2020

Human Brain Mapping

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The pathophysiology of cognitive dysfunction in multiple sclerosis (MS) is still unclear. This magnetoencephalography (MEG) study investigates the impact of MS on brain resting-state functional connectivity (rsFC) and its relationship to disability and cognitive impairment. We investigated rsFC based on power envelope correlation within and between different frequency bands, in a large cohort of participants consisting of 99 MS patients and 47 healthy subjects. Correlations were investigated between rsFC and outcomes on disability, disease duration and 7 neuropsychological scores within each group, while stringently correcting for multiple comparisons and possible confounding factors. Specific dysconnections correlating with MS-induced physical disability and disease duration were found within the sensorimotor and language networks, respectively. Global network-level reductions in within-and cross-network rsFC were observed in the default-mode network. Healthy subjects and patients significantly differed in their scores on cognitive fatigue and verbal fluency. Healthy subjects and patients showed different correlation patterns between rsFC and cognitive fatigue or verbal fluency, both of which involved a shift in patients from the posterior default-mode network to the language network. Introducing electrophysiological rsFC in a regression model of verbal fluency and cognitive fatigue in MS patients significantly increased the explained variance compared to a regression limited to structural MRI markers (relative thalamic volume and lesion load). This MEG study demonstrates that MS induces distinct changes in the resting-state functional brain architecture that relate to disability, disease duration and specific cognitive functioning alterations. It highlights the potential value of electrophysiological intrinsic rsFC for monitoring the cognitive impairment in patients with MS.

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“…A fadiga pode desencadear tanto alterações motoras como cognitivas, o que prejudica ainda mais a qualidade de vida desses indivíduos 11 . Segundo um estudo realizado na Associação de Esclerose Múltipla Goiana, 60% dos indivíduos com EM apresentaram alterações cognitivas, entre as quais se destacam: a memória, concentração, discernimento e raciocínio 22 .…”

Section: Resultsunclassified

“…Pacientes com fadiga têm uma carga mais elevada da lesão e atrofia da matéria cinzenta e branca, quando comparados com aqueles sem fadiga. Além disso, a disfunção axonal está diretamente ligada à fadiga na EM 11 .…”

Section: Introductionunclassified

Fadiga e Disfagia Orofaríngea em Pacientes com Esclerose Múltipla

et al. 2020

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A Esclerose Múltipla é uma doença que afeta o Sistema Nervoso Central, é prevalente em mulheres e tanto sua evolução como a gravidade dos sintomas são variáveis, acometendo de forma diferente cada indivíduo. As manifestações clínicas dependem da localização da lesão e da lesão tecidual e os pacientes podem apresentar uma série de sintomas, dentre eles destacam-se a fadiga e a disfagia. A fadiga na Esclerose Múltipla é de natureza multidimensional e a disfagia é um dos sintomas que pode estar ligado à fadiga. Objetivo: Identificar e correlacionar sintomas de fadiga e risco de disfagia em pacientes com Esclerose Múltipla. Métodos: Estudo do tipo transversal descritivo no qual foram incluídos pacientes com diagnóstico de Esclerose Múltipla atendidos no ambulatório de Neurologia de um Hospital Universitário. Os pacientes foram avaliados por meio da escala MFIS-BR e do questionário DYMUS-BR relacionados à fadiga e deglutição, respectivamente. Resultados: Foram incluídos 74 pacientes. Houve prevalência do sexo feminino (56,8%) e idade maior que 60 anos (95,9%). A forma da esclerose múltipla mais frequente foi a Remitente-recorrente (81,1%), o risco de disfagia foi identificado em 19 pacientes (25,7%) e a presença de sintomas de fadiga em 32 pacientes (43,2%). Houve correlação positiva fraca entre sintomas de fadiga e risco de disfagia (r <0,5) Conclusão: Embora fraca, houve correlação positiva entre sintomas de fadiga e risco de disfagia. Quanto maior o grau da fadiga, tanto maior pode ser o risco de alterações da deglutição.

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Structural and cognitive correlates of fatigue in progressive multiple sclerosis

Cited by 19 publications

References 55 publications

Olfactory Dysfunction in Patients With Relapsing-Remitting Multiple Sclerosis Treated With Disease-Modifying Therapies

Olfactory Dysfunction in Patients With Relapsing-Remitting Multiple Sclerosis Treated With Disease-Modifying Therapies

Brain dysconnectivity relates to disability and cognitive impairment in multiple sclerosis

Fadiga e Disfagia Orofaríngea em Pacientes com Esclerose Múltipla

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