fMRI changes in relapsing-remitting multiple sclerosis patients complaining of fatigue after IFNbeta-1a injection.
If fatigue in multiple sclerosis (MS) is related to an abnormal activation of the sensorimotor brain network, the activity of such a network should vary with varying fatigue. We studied 22 patients treated with interferon beta 1a (IFNbeta-1a; Avonex, Biogen, Cambridge, MA) with no fatigue (10) and with reversible fatigue (12). fMRI examinations were performed: 1) the same day of IFNbeta-1a injection (no fatigue; entry), 2) the day after IFNbeta-1a injection (fatigue; time 1), and 3) 4 days after IFNbeta-1a injection (no fatigue; time 2). Patients performed a simple motor task with the right, clinically unaffected hand. At time 1, compared with entry and time 2, MS patients with reversible fatigue showed an increased activation of the thalamus bilaterally. In MS patients without fatigue thalamus was more activated at entry than at time 1. In both groups at entry the primary SMC and the SMA were more activated than at times 1 and 2. At entry and time 1, when compared to patients with reversible fatigue, those without showed increased activations of the SII. Conversely, patients with reversible fatigue had increased activations of the thalamus and of several regions of the frontal lobes. An abnormal recruitment of the fronto-thalamic circuitry is associated with IFNbeta-1a-induced fatigue in MS patients.
Rocca
Maria A
MA
Neuroimaging Research Unit, Scientific Institute and University Ospedale San Raffaele, Milan, Italy.
Agosta
Federica
F
Colombo
Bruno
B
Mezzapesa
Domenico M
DM
Falini
Andrea
A
Comi
Giancarlo
G
Filippi
Massimo
M
D000276:Adjuvants, Immunologic / Q000009:adverse effects*; D000328:Adult; D001931:Brain Mapping; D002540:Cerebral Cortex / Q000098:blood supply / Q000187:drug effects; D005221:Fatigue / Q000139:chemically induced*; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods; D000068556:Interferon beta-1a; D016899:Interferon-beta / Q000009:adverse effects*; D008279:Magnetic Resonance Imaging; D008297:Male; D020529:Multiple Sclerosis, Relapsing-Remitting / Q000188:drug therapy / Q000503:physiopathology; D009483:Neuropsychological Tests; D010100:Oxygen / Q000097:blood; D011597:Psychomotor Performance / Q000187:drug effects; D013997:Time Factors
D000276:Adjuvants, Immunologic; D016899:Interferon-beta; D010100:Oxygen; D000068556:Interferon beta-1a