多发性硬化相关疲劳中内感受和皮质-皮质下区域功能连接的改变。
Alterations in functional connectivity of interoceptive and Cortico-Subcortical areas in Multiple Sclerosis-Related fatigue.
作者信息
Silva-Batista Carla, Arpan Ishu, Penteado Nucci Mariana, Horak Fay B
机构信息
Department of Neurology, Oregon Health & Science University, Portland, OR, United States.
Department of Radiology, University of São Paulo, São Paulo, Brazil.
出版信息
Neuroscience. 2025 Mar 5;568:355-363. doi: 10.1016/j.neuroscience.2024.12.036. Epub 2024 Dec 19.
Fatigue in people with Multiple Sclerosis (PwMS) is a poorly understood, complex, and disabling symptom. We hypothesized that the perception of fatigue in PwMS results from increased information processing in cortical areas responsible for the perception of bodily states and decreased information processing in the cortico-basal ganglia network involved in the perception of motor performance. We investigated whether PwMS who perceive excessive fatigue would have increased resting-state functional connectivity (rsFC) between interoceptive brain areas (amygdala, anterior cingulate cortex [ACC], and insula) and decreased rsFC between cortico-basal ganglia premotor network compared to PwMS not reporting fatigue. Twenty-three relapsing-remitting PwMS were divided into fatigued versus non-fatigued groups based on the Modified Fatigue Impact Scale score (≥38 points). Age-matched healthy controls (n = 21) were also analyzed. All the participants underwent resting-state functional magnetic resonance imaging. PwMS who perceived abnormal fatigue, compared to non-fatigued PwMS, showed reduced rsFC between cortico-basal ganglia network and increased rsFC within interoceptive brain areas (amygdala, ACC, and insula) involved in perception of bodily states (P ≤ 0.01). Increased rsFC within interoceptive brain areas was specific for fatigued PwMS as this result did not appear when comparing PwMS (fatigued and non-fatigued) with healthy controls. The Modified Fatigue Impact Scale scores were correlated with the increased rsFC between interoceptive brain areas (amygdala and insula) and decreased rsFC between cortico-basal ganglia (P < 0.01). MS-related perceived fatigue has a central cause, and it may be due to increased interoceptive brain activity (perception of bodily states). Interventions are needed to decrease fatigue and reorganize the brain circuitry.
多发性硬化症患者(PwMS)的疲劳是一种了解不足、复杂且致残的症状。我们假设,PwMS对疲劳的感知源于负责身体状态感知的皮质区域信息处理增加,以及参与运动表现感知的皮质-基底神经节网络信息处理减少。我们研究了与未报告疲劳的PwMS相比,感知到过度疲劳的PwMS在静息态功能连接(rsFC)方面,是否会表现出内感受脑区(杏仁核、前扣带回皮质[ACC]和脑岛)之间的rsFC增加,以及皮质-基底神经节运动前网络之间的rsFC减少。根据改良疲劳影响量表评分(≥38分),将23名复发缓解型PwMS分为疲劳组和非疲劳组。还分析了年龄匹配的健康对照组(n = 21)。所有参与者均接受了静息态功能磁共振成像检查。与非疲劳的PwMS相比,感知到异常疲劳的PwMS在皮质-基底神经节网络之间的rsFC降低,而在参与身体状态感知的内感受脑区(杏仁核、ACC和脑岛)内的rsFC增加(P≤0.01)。内感受脑区内rsFC的增加是疲劳型PwMS所特有的,因为在将PwMS(疲劳型和非疲劳型)与健康对照组进行比较时,并未出现此结果。改良疲劳影响量表评分与内感受脑区(杏仁核和脑岛)之间增加的rsFC以及皮质-基底神经节之间减少的rsFC相关(P < 0.01)。与MS相关的感知疲劳有一个中枢原因,可能是由于内感受脑活动增加(身体状态感知)。需要采取干预措施来减轻疲劳并重新组织脑回路。