Save
Microstructural damage to associative cortico-thalamic tracts play a role in the pathophysiology of fatigue in multiple sclerosis
Author(s): ,
M. Palotai
Affiliations:
Department of Radiology, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, United States
,
I. Koubiyr
Affiliations:
INSERM U1215, Neurocentre Magendie, Bordeaux, France
,
A. Morales Pinzon
Affiliations:
Department of Radiology, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, United States
,
N. Makris
Affiliations:
Department of Psychiatry, Brigham and Women’s Hospital, Harvard Medical School
,
B.C. Healy
Affiliations:
Department of Neurology, Brigham and Women`s Hospital, Harvard Medical School; Biostatistics Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States
,
B. Glanz
Affiliations:
Department of Neurology, Brigham and Women`s Hospital, Harvard Medical School
,
H.L. Weiner
Affiliations:
Department of Neurology, Brigham and Women`s Hospital, Harvard Medical School
,
C. Tanuja
Affiliations:
Department of Neurology, Brigham and Women`s Hospital, Harvard Medical School
C.R.G. Guttmann
Affiliations:
Department of Radiology, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, United States
ECTRIMS Online Library. Palotai M. Oct 12, 2018; 228982
Miklos Palotai
Miklos Palotai
Login now to access Regular content available to all registered users.

You may also access this content "anytime, anywhere" with the Free MULTILEARNING App for iOS and Android
Abstract
Discussion Forum (0)
Rate & Comment (0)

Abstract: P1142

Type: Poster Sessions

Abstract Category: Pathology and pathogenesis of MS - MRI and PET

Background: Damage to the cortico-striato-thalamic loop has been associated with fatigue in multiple sclerosis (MS), albeit inconsistently, possibly due to single time-point assessment of fatigue employed in most studies. Since fatigue may fluctuate over time, definition of fatigue based on longitudinal patterns may provide more robust findings. Functional anatomical subdivisions of the cortico-striato-thalamic loop have not been investigated in MS patients with fatigue.
Objectives: To investigate the association of fatigue with brain diffusion abnormalities in associative, limbic and sensorimotor subdivisions of the cortico-striato-thalamic loop, using robust criteria for patient stratification based on longitudinal patterns of fatigue.
Methods: Patient stratification: 1. Sustained Fatigue (SF): latest two Modified Fatigue Impact Scale (MFIS)≥38; 2. Reversible Fatigue (RF): latest MFIS< 38, and at least one previous MFIS≥38; 3. Never Fatigued (NF): MFIS always< 38 (5 assessments minimum). Accordingly, we selected from the CLIMB Study cohort 93 MS patients with relapsing-remitting (82) or secondary-progressive (9) disease type (26SF/25RF/42NF). Disability and depression were assessed using Expanded Disability Status Scale (EDSS) and Center for Epidemiologic Studies Depression Scale (CES-D), respectively. 3T diffusion tensor (DT) brain MRI was used to compare fractional anisotropy (FA), axial (AD), mean (MD) and radial diffusivity (RD) of associative, limbic and sensorimotor subdivisions of cortico-striatal and cortico-thalamic tracts between the groups controlling for age+sex+disease duration+EDSS±CES-D.
Results: AD was higher in the right associative cortico-thalamic tract in SF versus NF, but not in RF versus NF or SF versus RF patients, controlling for age+sex+disease duration+EDSS (p=0.042). When controlling also for CES-D, AD of this tract became more significantly associated with SF (p=0.018). No difference was found in the other components of the cortico-striato-thalamic loop between the groups.
Conclusion: Our results suggest that sustained reporting of fatigue over years is associated with microstructural damage to the right associative cortico-thalamic tract, independent of depression. Under the assumption that damage to select circuitries may lead to specific resistance to anti-fatigue drugs, our study might be of particular relevance to the understanding of differential anti-fatigue treatment responses.
Disclosure: Dr. Palotai reports no disclosures.
Mr. Koubiyr reports no disclosures.
Dr. Morales Pinzon reports no disclosures.
Dr. Makris reports no disclosures.
Dr. Healy was on the Biogen Worldwide Medical Biostatistics Multiple Sclerosis Advisory Board and received grant support from Genzyme, Merck Serono, Novartis, and Verily Life Sciences.
Dr. Glanz received research support from Merck Serono and Verily Life Sciences.
Dr. Weiner reports grants from National Institutes of Health, National Multiple Sclerosis Society, Verily Life Sciences, Genentech, Inc., Google Life Sciences, EMD Serono, Inc., Biogen, Teva Pharmaceuticals, and Novartis; grants and consulting from Sanofi US Services, Inc.; consulting and advising from Tilos Therapeutics; consulting and advising from Tiziana Life Sciences; consulting and advising from IM Therapeutics; personal fees, consulting and advising from vTv Therapeutics; personal fees, consulting and advising from MedDay Pharmaceuticals.
Dr. Chitnis has served on the advisory boards for clinical trials sponsored by Novartis and Sanofi-Genzyme, and has received consulting/advisory fees from Bayer, Biogen, Celgene, Genentech-Roche, Novartis and Sanofi-Genzyme. She has received research grant support from Biogen, Octave, Serono and Verily.
Dr. Guttmann has nothing to disclose that could constitute a conflict of interest for this work. Dr. Guttmann has received research funding from Sanofi, the National Multiple Sclerosis Society, and the International Progressive Multiple Sclerosis Alliance.

Code of conduct/disclaimer available in General Terms & Conditions
Anonymous User Privacy Preferences

Strictly Necessary Cookies (Always Active)

MULTILEARNING platforms and tools hereinafter referred as “MLG SOFTWARE” are provided to you as pure educational platforms/services requiring cookies to operate. In the case of the MLG SOFTWARE, cookies are essential for the Platform to function properly for the provision of education. If these cookies are disabled, a large subset of the functionality provided by the Platform will either be unavailable or cease to work as expected. The MLG SOFTWARE do not capture non-essential activities such as menu items and listings you click on or pages viewed.


Performance Cookies

Performance cookies are used to analyse how visitors use a website in order to provide a better user experience.



Google Analytics is used for user behavior tracking/reporting. Google Analytics works in parallel and independently from MLG’s features. Google Analytics relies on cookies and these cookies can be used by Google to track users across different platforms/services.


Save Settings