Lurija Institute for Rehabilitation and Health Sciences, Allensbach, Germany/Neurological Rehabilitation Center Kliniken Schmieder, Allensbach, Germany.
Lurija Institute for Rehabilitation and Health Sciences, Allensbach, Germany/Neurological Rehabilitation Center Kliniken Schmieder, Konstanz, Germany.
Mult Scler. 2019 Feb;25(2):256-266. doi: 10.1177/1352458517743090. Epub 2017 Nov 21.
Among patients with multiple sclerosis (MS), fatigue is the most commonly reported symptom. It can be subdivided into an effort-dependent (fatigability) and an effort-independent component (trait-fatigue).
The objective was to disentangle activity changes associated with effort-independent "trait-fatigue" from those associated with effort-dependent fatigability in MS patients.
This study employed behavioral measures and functional magnetic imaging to investigate neural changes in MS patients associated with fatigue. A total of 40 MS patients and 22 age-matched healthy controls performed in a fatigue-inducing N-back task. Effort-independent fatigue was assessed using the Fatigue Scale of Motor and Cognition (FSMC) questionnaire.
Effort-independent fatigue was observed to be reflected by activity increases in fronto-striatal-subcortical networks primarily involved in the maintenance of homeostatic processes and in motor and cognitive control. Effort-dependent fatigue (fatigability) leads to activity decreases in attention-related cortical and subcortical networks.
These results indicate that effort-independent (fatigue) and effort-dependent fatigue (fatigability) in MS patients have functionally related but fundamentally different neural correlates. Fatigue in MS as a general phenomenon is reflected by complex interactions of activity increases in control networks (effort-independent component) and activity reductions in executive networks (effort-dependent component) of brain areas.
在多发性硬化症（MS）患者中，疲劳是最常见的症状。它可以细分为依赖于努力的（易疲劳性）和独立于努力的成分（特质疲劳）。
本研究旨在区分多发性硬化症患者中与独立于努力的“特质疲劳”相关的活动变化与与依赖于努力的易疲劳性相关的活动变化。
本研究采用行为测量和功能磁共振成像来研究与疲劳相关的多发性硬化症患者的神经变化。共有 40 名多发性硬化症患者和 22 名年龄匹配的健康对照者在疲劳诱导的 N-回任务中进行了测试。使用运动和认知疲劳量表（FSMC）问卷评估独立于努力的疲劳。
独立于努力的疲劳表现为与维持体内平衡过程以及运动和认知控制主要相关的额-纹状体-皮质下网络的活动增加。依赖于努力的疲劳（易疲劳性）导致与注意力相关的皮质和皮质下网络的活动减少。
这些结果表明，多发性硬化症患者的独立于努力的（疲劳）和依赖于努力的疲劳（易疲劳性）具有功能相关但本质上不同的神经相关性。多发性硬化症作为一种普遍现象的疲劳反映了大脑区域控制网络（独立于努力的成分）的活动增加和执行网络（依赖于努力的成分）的活动减少之间的复杂相互作用。
