Neural correlates of effort-dependent and effort-independent cognitive fatigue components in patients with multiple sclerosis

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Multiple Sclerosis Journal. 2019, 25(2), pp. 256-266. ISSN 1352-4585. eISSN 1477-0970. Available under: doi: 10.1177/1352458517743090
Zusammenfassung

Background:
Among patients with multiple sclerosis (MS), fatigue is the most commonly reported symptom. It can be subdivided into an effort-dependent (fatigability) and an effort-independent component (trait-fatigue).

Objective:
The objective was to disentangle activity changes associated with effort-independent “trait-fatigue” from those associated with effort-dependent fatigability in MS patients.

Methods:
This study employed behavioral measures and functional magnetic imaging to investigate neural changes in MS patients associated with fatigue. A total of 40 MS patients and 22 age-matched healthy controls performed in a fatigue-inducing N-back task. Effort-independent fatigue was assessed using the Fatigue Scale of Motor and Cognition (FSMC) questionnaire.

Results:
Effort-independent fatigue was observed to be reflected by activity increases in fronto-striatal-subcortical networks primarily involved in the maintenance of homeostatic processes and in motor and cognitive control. Effort-dependent fatigue (fatigability) leads to activity decreases in attention-related cortical and subcortical networks.

Conclusion:
These results indicate that effort-independent (fatigue) and effort-dependent fatigue (fatigability) in MS patients have functionally related but fundamentally different neural correlates. Fatigue in MS as a general phenomenon is reflected by complex interactions of activity increases in control networks (effort-independent component) and activity reductions in executive networks (effort-dependent component) of brain areas.

Zusammenfassung in einer weiteren Sprache
Fachgebiet (DDC)
150 Psychologie
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Multiple sclerosis, fatigue, fatigability, state/trait-fatigue, attention, fMRI
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ISO 690SPITERI, Stefan, Thomas HASSA, Dolores CLAROS-SALINAS, Christian DETTMERS, Mircea Ariel SCHOENFELD, 2019. Neural correlates of effort-dependent and effort-independent cognitive fatigue components in patients with multiple sclerosis. In: Multiple Sclerosis Journal. 2019, 25(2), pp. 256-266. ISSN 1352-4585. eISSN 1477-0970. Available under: doi: 10.1177/1352458517743090
BibTex
@article{Spiteri2019Neura-45206,
  year={2019},
  doi={10.1177/1352458517743090},
  title={Neural correlates of effort-dependent and effort-independent cognitive fatigue components in patients with multiple sclerosis},
  number={2},
  volume={25},
  issn={1352-4585},
  journal={Multiple Sclerosis Journal},
  pages={256--266},
  author={Spiteri, Stefan and Hassa, Thomas and Claros-Salinas, Dolores and Dettmers, Christian and Schoenfeld, Mircea Ariel}
}
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    <dcterms:abstract xml:lang="eng">Background:&lt;br /&gt;Among patients with multiple sclerosis (MS), fatigue is the most commonly reported symptom. It can be subdivided into an effort-dependent (fatigability) and an effort-independent component (trait-fatigue).&lt;br /&gt;&lt;br /&gt;Objective:&lt;br /&gt;The objective was to disentangle activity changes associated with effort-independent “trait-fatigue” from those associated with effort-dependent fatigability in MS patients.&lt;br /&gt;&lt;br /&gt;Methods:&lt;br /&gt;This study employed behavioral measures and functional magnetic imaging to investigate neural changes in MS patients associated with fatigue. A total of 40 MS patients and 22 age-matched healthy controls performed in a fatigue-inducing N-back task. Effort-independent fatigue was assessed using the Fatigue Scale of Motor and Cognition (FSMC) questionnaire.&lt;br /&gt;&lt;br /&gt;Results:&lt;br /&gt;Effort-independent fatigue was observed to be reflected by activity increases in fronto-striatal-subcortical networks primarily involved in the maintenance of homeostatic processes and in motor and cognitive control. Effort-dependent fatigue (fatigability) leads to activity decreases in attention-related cortical and subcortical networks.&lt;br /&gt;&lt;br /&gt;Conclusion:&lt;br /&gt;These results indicate that effort-independent (fatigue) and effort-dependent fatigue (fatigability) in MS patients have functionally related but fundamentally different neural correlates. Fatigue in MS as a general phenomenon is reflected by complex interactions of activity increases in control networks (effort-independent component) and activity reductions in executive networks (effort-dependent component) of brain areas.</dcterms:abstract>
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