Román Cristina A F, Wylie Glenn R, DeLuca John, Yao Bing
Rocco Ortenzio Neuroimaging Center, Kessler Foundation, West Orange, NJ, United States.
Department of Physical Medicine and Rehabilitation, Rutgers New Jersey Medical School, New Jersey, NJ, United States.
Front Neurol. 2022 Jul 4;13:911012. doi: 10.3389/fneur.2022.911012. eCollection 2022.
Fatigue, including cognitive fatigue, is one of the most debilitating symptoms reported by persons with multiple sclerosis (pwMS). Cognitive fatigue has been associated with disruptions in striato-thalamo-cortical and frontal networks, but what remains unknown is how the at which pwMS become fatigued over time relates to microstructural properties within the brain. The current study aims to fill this gap in knowledge by investigating how cognitive fatigue rate relates to white matter and basal ganglia microstructure in a sample of 62 persons with relapsing-remitting MS. Participants rated their level of cognitive fatigue at baseline and after each block (x7) of a within-scanner cognitive fatigue inducing task. The slope of the regression line of all eight fatigue ratings was designated as "cognitive fatigue rate." Diffusional kurtosis imaging maps were processed using tract-based spatial statistics and regional analyses (i.e., basal ganglia) and associated with cognitive fatigue rate. Results showed cognitive fatigue rate to be related to several white matter tracts, with many having been associated with basal ganglia connectivity or the previously proposed "fatigue network." In addition, cognitive fatigue rate was associated with the microstructure within the putamen, though this did not survive multiple comparisons correction. Our approach of using cognitive fatigue rate, rather than trait fatigue, brings us closer to understanding how brain pathology may be impacting the experience of fatigue in the moment, which is crucial for developing interventions. These results hold promise for continuing to unpack the complex construct that is cognitive fatigue.
疲劳，包括认知疲劳，是多发性硬化症患者（pwMS）报告的最使人衰弱的症状之一。认知疲劳与纹状体 - 丘脑 - 皮质和额叶网络的破坏有关，但pwMS随时间产生疲劳的方式与大脑内微观结构特性之间的关系仍不清楚。当前的研究旨在通过调查62例复发缓解型多发性硬化症患者样本中认知疲劳率与白质和基底神经节微观结构之间的关系来填补这一知识空白。参与者在基线时以及在扫描仪内认知疲劳诱发任务的每个模块（共7个模块）之后对他们的认知疲劳水平进行评分。所有八个疲劳评分的回归线斜率被指定为“认知疲劳率”。使用基于束的空间统计学和区域分析（即基底神经节）处理扩散峰度成像图，并将其与认知疲劳率相关联。结果表明，认知疲劳率与几条白质束有关，其中许多白质束与基底神经节连接或先前提出的“疲劳网络”有关。此外，认知疲劳率与壳核内的微观结构有关，尽管在多重比较校正后该结果并不显著。我们使用认知疲劳率而非特质疲劳的方法，使我们更接近于理解脑病理学如何在当下影响疲劳体验，这对于开发干预措施至关重要。这些结果有望继续解开认知疲劳这一复杂的概念。
