Barbi Chiara, Pizzini Francesca Benedetta, Tamburin Stefano, Martini Alice, Pedrinolla Anna, Laginestra Fabio Giuseppe, Giuriato Gaia, Martignon Camilla, Schena Federico, Venturelli Massimo
Department of Neurosciences, Biomedicine, and Movement, University of Verona, 37100 Verona, Italy.
Radiology, Department of Diagnostic and Public Health, University of Verona & Department of Diagnostics and Pathology, University Hospital, 37129 Verona, Italy.
Neurol Int. 2022 Jun 8;14(2):506-535. doi: 10.3390/neurolint14020042.
Fatigue is one of the most disabling symptoms of multiple sclerosis (MS); it influences patients' quality of life. The etiology of fatigue is complex, and its pathogenesis is still unclear and debated. The objective of this review was to describe potential brain structural and functional dysfunctions underlying fatigue symptoms in patients with MS. To reach this purpose, a systematic review was conducted of published studies comparing functional brain activation and structural brain in MS patients with and without fatigue. Electronic databases were searched until 24 February 2021. The structural and functional outcomes were extracted from eligible studies and tabulated. Fifty studies were included: 32 reported structural brain differences between patients with and without fatigue; 14 studies described functional alterations in patients with fatigue compared to patients without it; and four studies showed structural and functional brain alterations in patients. The results revealed structural and functional abnormalities that could correlate to the symptom of fatigue in patients with MS. Several studies reported the differences between patients with fatigue and patients without fatigue in terms of conventional magnetic resonance imaging (MRI) outcomes and brain atrophy, specifically in the thalamus. Functional studies showed abnormal activation in the thalamus and in some regions of the sensorimotor network in patients with fatigue compared to patients without it. Patients with fatigue present more structural and functional alterations compared to patients without fatigue. Specifically, abnormal activation and atrophy of the thalamus and some regions of the sensorimotor network seem linked to fatigue.
疲劳是多发性硬化症（MS）最具致残性的症状之一；它会影响患者的生活质量。疲劳的病因复杂，其发病机制仍不明确且存在争议。本综述的目的是描述MS患者疲劳症状背后潜在的脑结构和功能障碍。为实现这一目的，我们对已发表的研究进行了系统综述，比较了有疲劳和无疲劳的MS患者的脑功能激活和脑结构。检索电子数据库直至2021年2月24日。从符合条件的研究中提取结构和功能结果并制成表格。纳入了50项研究：32项报告了有疲劳和无疲劳患者之间的脑结构差异；14项研究描述了有疲劳患者与无疲劳患者相比的功能改变；4项研究显示了患者的脑结构和功能改变。结果揭示了与MS患者疲劳症状可能相关的结构和功能异常。几项研究报告了有疲劳和无疲劳患者在传统磁共振成像（MRI）结果和脑萎缩方面的差异，特别是在丘脑。功能研究表明，与无疲劳患者相比，有疲劳患者的丘脑和感觉运动网络的一些区域存在异常激活。与无疲劳患者相比，有疲劳患者存在更多的结构和功能改变。具体而言，丘脑和感觉运动网络的一些区域的异常激活和萎缩似乎与疲劳有关。
