Abstract：
BACKGROUND:Fatigue is a common and debilitating symptom in multiple sclerosis (MS). Over the past decade, a growing body of research has focussed on the pathophysiological mechanisms underlying central (cognitive and physical) fatigue in MS. The precise mechanisms causing fatigue in MS patients are complex and poorly understood, and may differ between patients. Advanced quantitative magnetic resonance imaging (MRI) techniques allow for objective assessment of disease pathology and have been used to characterise the pathophysiology of central fatigue in MS. OBJECTIVE:To systematically review the existing literature of MRI-based studies assessing the pathophysiological mechanisms of MS-related central fatigue. METHODS:A systematic literature search of four major databases (PubMed, Medline, Embase, Scopus and Google Scholar) was conducted to identify MRI-based studies of MS-related fatigue published in the past 20 years. Studies using the following MRI-based methods were included: structural (lesion load/atrophy), T1 relaxation time/magnetisation transfer ratio (MTR), diffusion tensor imaging (DTI), functional MRI (fMRI) and magnetic resonance spectroscopy (MRS). RESULTS:A total of 92 studies were identified as meeting the search criteria and included for review. Structurally, regional gray/white matter atrophy, cortical thinning, decreased T1 relaxation times and reduced fractional anisotropy were associated with central fatigue in MS. Functionally, hyperactivity and reduced functional connectivity in several regional areas of frontal, parietal, occipital, temporal and cerebellum were suggested as causes of central fatigue. Biochemically, a reduction in N-acetyl aspartate/creatine and increased (glutamine+glutamate)/creatine ratios were correlated with fatigue severity in MS. CONCLUSION:Several advanced quantitative MRI methods have been employed in the study of central fatigue in MS. Central fatigue in MS is associated with macro/microstructural and functional changes within specific brain regions (frontal, parietal, temporal and deep gray matter) and specific pathways/networks (cortico-cortical and cortico-subcortical). Alternations in the cortico-striatal-thalamocortical (CSTC) loop are correlated with the development of fatigue in MS patients.
journal_name
J Neurol Scijournal_title
Journal of the neurological sciencesauthors
Arm J,Ribbons K,Lechner-Scott J,Ramadan Sdoi
10.1016/j.jns.2019.03.007subject
Has Abstractpub_date
2019-05-15 00:00:00pages
52-71eissn
0022-510Xissn
1878-5883pii
S0022-510X(19)30120-0journal_volume
400pub_type
杂志文章,评审abstract：:Administration of retinoic acid (RA) prevented the development of experimental allergic encephalomyelitis (EAE) in Lewis rats. RA suspended in corn oil was given for 3 days before the expected onset of the disease to rats immunized with myelin and to controls. The drug suppressed the neurological symptoms as well as t...
journal_title：Journal of the neurological sciences
pub_type： 杂志文章
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abstract：:We studied the effects of 0.2 Hz repetitive transcranial magnetic stimulation (rTMS) successively performed 6 times for 2 weeks in 12 patients with idiopathic Parkinson's disease (PD). Ten patients received rTMS to the bilateral frontal cortex (frontal rTMS) and six patients received rTMS to the bilateral occipital co...
journal_title：Journal of the neurological sciences
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abstract：BACKGROUND:Restless legs syndrome (RLS) is characterized by the urge to move the legs accompanied by movement-responsive, abnormal sensations, which worsen at rest and night. We investigated the distribution of sensory symptoms and clinical correlations in patients with RLS and its variants. METHODS:Eighty-nine patien...
journal_title：Journal of the neurological sciences
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journal_title：Journal of the neurological sciences
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journal_title：Journal of the neurological sciences
pub_type： 杂志文章
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journal_title：Journal of the neurological sciences
pub_type： 临床试验,杂志文章,多中心研究,随机对照试验
doi：10.1016/0022-510x(95)00010-y
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journal_title：Journal of the neurological sciences
pub_type： 杂志文章
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journal_title：Journal of the neurological sciences
pub_type： 杂志文章
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journal_title：Journal of the neurological sciences
pub_type： 杂志文章
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journal_title：Journal of the neurological sciences
pub_type： 杂志文章
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journal_title：Journal of the neurological sciences
pub_type： 杂志文章
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journal_title：Journal of the neurological sciences
pub_type： 杂志文章,评审
doi：10.1016/j.jns.2012.08.005
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journal_title：Journal of the neurological sciences
pub_type： 杂志文章
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journal_title：Journal of the neurological sciences
pub_type： 杂志文章
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pub_type： 杂志文章,meta分析
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journal_title：Journal of the neurological sciences
pub_type： 杂志文章
doi：10.1016/0022-510x(83)90063-1
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journal_title：Journal of the neurological sciences
pub_type： 杂志文章,评审
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journal_title：Journal of the neurological sciences
pub_type： 杂志文章
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journal_title：Journal of the neurological sciences
pub_type： 杂志文章
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pub_type： 杂志文章
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pub_type： 杂志文章
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journal_title：Journal of the neurological sciences
pub_type： 杂志文章
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journal_title：Journal of the neurological sciences
pub_type： 杂志文章
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更新日期：2010-01-15 00:00:00
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journal_title：Journal of the neurological sciences
pub_type： 杂志文章,评审
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journal_title：Journal of the neurological sciences
pub_type： 杂志文章
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journal_title：Journal of the neurological sciences
pub_type： 杂志文章
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journal_title：Journal of the neurological sciences
pub_type： 杂志文章
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更新日期：2014-05-15 00:00:00
