Unit of Neurology, Neurophysiology, Neurobiology, Department of Medicine, Università Campus Bio-Medico di Roma, Rome, Italy/NeXT: Neurophysiology and Neuroengineering of Human-Technology Interaction Research Unit, Campus Bio-Medico University, Rome, Italy.
NMR Research Unit, Queen Square MS Centre, Department of Neuroinflammation, UCL Queen Square Institute of Neurology, Faculty of Brain Sciences, University College London, London, UK.
Mult Scler. 2020 Jan;26(1):6-16. doi: 10.1177/1352458519851247. Epub 2019 May 29.
Fatigue is very common in multiple sclerosis (MS) and is often considered as its most disabling symptom. Over the last 20 years, an increasing number of studies have evaluated the pathogenetic bases of MS-related fatigue. Converging evidence from neurophysiology and neuroimaging research suggests that a dysfunction in a cortico-subcortical pathway, centered on thalamus, is involved in the pathogenesis of fatigue. However, type and significance of such dysfunction remain unknown, and some studies reported an increase in the activity and connectivity within the thalamic network, whereas others suggested its reduction. Hereby, we review the results of neuroimaging studies supporting the different hypotheses about the role of thalamic network in the pathophysiology of MS-related fatigue and discuss limitations and shortcomings of available data, highlighting the key challenges in the field and the directions for future research.
疲劳在多发性硬化症（MS）中非常常见，通常被认为是其最具致残性的症状。在过去的 20 年中，越来越多的研究评估了 MS 相关疲劳的发病基础。神经生理学和神经影像学研究的一致证据表明，以丘脑为中心的皮质下通路功能障碍与疲劳的发病机制有关。然而，这种功能障碍的类型和意义尚不清楚，一些研究报告称丘脑网络的活动和连通性增加，而另一些研究则表明其减少。在此，我们回顾了支持关于丘脑网络在 MS 相关疲劳的病理生理学中的作用的不同假说的神经影像学研究结果，并讨论了现有数据的局限性和不足，突出了该领域的关键挑战和未来研究方向。
