Department of Neurology, Aarhus University Hospital, Aarhus, Denmark.
Neuroimage. 2010 Apr 1;50(2):608-15. doi: 10.1016/j.neuroimage.2009.12.118. Epub 2010 Jan 6.
To examine the relationship between fatigue, regional brain atrophy and normal appearing white matter damage in patients with multiple sclerosis.
Primary fatigued (PF) (n, 17) and non-fatigued (NF) (n, 17) patients with relapsing remitting multiple sclerosis and moderate disability were grouped according to their subjective fatigue score. Also, they were examined with respect to processing speed and central motor activation during isometric contraction. Using 3 Tesla MRI quantitative analyses were performed on normal appearing brain tissue and of brain structure volumes with tensor based morphometry.
Between the PF and NF patients there was no significant differences in brain parenchymal fraction (81.5% vs. 82.4%), lesion load (0.53% vs. 0.36%) and NAA/Cr ratio (1.29 vs. 1.32 respectively). Eleven clusters of atrophy in PF versus NF involved gray and nearby white matter, the majority being located in areas functionally related to attentional control. Central motor activation was associated with atrophy in five regions in PF patients, three clusters involving the premotor and primary motor cortex. Normal appearing white matter did not differ between groups.
Primary fatigued patients with multiple sclerosis have extended regional atrophy of supratentorial brain parenchyma, involving the cerebral cortex, nearby white matter and the caudate head, areas which are functionally related to attentional control. We suggest that impaired central motor activation is due to interruption of the cortico-subcortical motor circuits involving the motor cortex.
研究多发性硬化症患者的疲劳、区域性脑萎缩与正常表现的白质损伤之间的关系。
根据主观疲劳评分，将原发性疲劳（PF）（n=17）和非疲劳（NF）（n=17）的复发缓解型多发性硬化症且中度残疾患者进行分组。此外，还对他们进行了等长收缩期间的加工速度和中央运动激活的检查。使用 3 特斯拉 MRI 进行了定量分析，包括正常表现的脑组织和基于张量的形态计量学的脑结构体积。
PF 和 NF 患者之间的脑实质分数（81.5%比 82.4%）、病变负荷（0.53%比 0.36%）和 NAA/Cr 比值（1.29 比 1.32）均无显著差异。PF 与 NF 相比，有 11 个萎缩簇涉及灰质和附近的白质，大多数位于与注意力控制功能相关的区域。中央运动激活与 PF 患者五个区域的萎缩有关，三个簇涉及运动前皮质和初级运动皮质。正常表现的白质在两组之间没有差异。
原发性疲劳多发性硬化症患者存在额上脑实质的广泛区域性萎缩，涉及大脑皮层、附近的白质和尾状核头部，这些区域与注意力控制功能有关。我们认为，中央运动激活受损是由于涉及运动皮质的皮质下运动回路中断所致。
