LET'S-ISTC-CNR, Department of Neuroscience, Fatebenefratelli Hospital-Isola Tiberina, Italy.
Mult Scler. 2013 Mar;19(3):334-43. doi: 10.1177/1352458512452921. Epub 2012 Jul 3.
Highly common in multiple sclerosis (MS), fatigue severely impacts patients' daily lives. Previous findings of altered connectivity patterns led to the hypothesis that the distortion of functional connections within the brain-muscle circuit plays a crucial pathogenic role.
The objective of this paper is to identify markers sensitive to fatigue in multiple sclerosis.
Structural (magnetic resonance imaging with assessment of thalamic volume and cortical thickness of the primary sensorimotor areas) and functional (cortico-muscular coherence (CMC) from simultaneous electroencephalo- and surface electromyographic recordings during a weak handgrip task) measures were used on 20 mildly disabled MS patients (relapsing-remitting course, Expanded Disability Status Scale score ≤ 2) who were recruited in two fatigue-dependent groups according to the Modified Fatigue Index Scale (MFIS) score.
The two groups were similar in terms of demographic, clinical and imaging features, as well as task execution accuracy and weariness. In the absence of any fatigue-dependent brain and muscular oscillatory activity alterations, CMC worked at higher frequencies as fatigue increased, explaining 67% of MFIS variance (p=.002).
Brain-muscle functional connectivity emerged as a sensitive marker of phenomena related to the origin of MS fatigue, impacting central-peripheral communication well before the appearance of any impairment in the communicating nodes.
多发性硬化症（MS）中非常常见，疲劳严重影响患者的日常生活。先前关于连接模式改变的发现导致了这样一种假设，即大脑-肌肉回路中功能连接的扭曲起着关键的致病作用。
本文旨在确定多发性硬化症中对疲劳敏感的标志物。
对 20 名轻度残疾的 MS 患者（复发缓解型病程，扩展残疾状态量表评分≤2）进行了结构（磁共振成像，评估丘脑体积和初级感觉运动区的皮质厚度）和功能（皮质-肌肉相干性（CMC），来自在弱手握任务期间同时进行的脑电图和表面肌电图记录）测量，这些患者根据改良疲劳指数量表（MFIS）评分分为两组，即疲劳相关组和非疲劳相关组。
两组在人口统计学、临床和影像学特征、任务执行准确性和疲劳感方面相似。在没有任何与疲劳相关的大脑和肌肉振荡活动改变的情况下，随着疲劳的增加，CMC 工作在更高的频率，解释了 MFIS 方差的 67%（p=.002）。
大脑-肌肉功能连接成为与多发性硬化症疲劳起源相关现象的敏感标志物，在任何通信节点出现任何损伤之前，就对中枢-外周通讯产生影响。
