title: Relationship of cortical atrophy to fatigue in patients with multiple sclerosis.
abstract: BACKGROUND
  Fatigue is a common and disabling symptom of multiple sclerosis (MS). Previous studies reported that damage of the corticostriatothalamocortical circuit is critical in its occurrence.
  
  
  OBJECTIVE
  To investigate the relationship between fatigue in MS and regional cortical and subcortical gray matter atrophy.
  
  
  METHODS
  Case-control study.
  
  
  METHODS
  National Institutes of Health.
  
  
  METHODS
  Twenty-four patients with MS and 24 matched healthy volunteers who underwent 3.0-T magnetic resonance imaging and evaluations of fatigue (Modified Fatigue Impact Scale) and depression (Center for Epidemiologic Studies Depression Scale).
  
  
  METHODS
  Relationship between thalamic and basal ganglia volume, cortical thickness of frontal and parietal lobes, and, in patients, T2 lesion volume and normal-appearing white matter volume and the extent of fatigue.
  
  
  RESULTS
  Patients were more fatigued than healthy volunteers (P = .04), while controlling for the effect of depression. Modified Fatigue Impact Scale score correlated with cortical thickness of the parietal lobe (r = -0.50, P = .01), explaining 25% of its variance. The posterior parietal cortex was the only parietal area significantly associated with the Modified Fatigue Impact Scale scores.
  
  
  CONCLUSIONS
  Cortical atrophy of the parietal lobe had the strongest relationship with fatigue. Given the implications of the posterior parietal cortex in motor planning and integration of information from different sources, our preliminary results suggest that dysfunctions in higher-order aspects of motor control may have a role in determining fatigue in MS.
authors.affiliation: Neuroimmunology Branch, National Institute of Neurological Disorders and Stroke, National Institutes of Health, 10 Center Dr, Bethesda, MD 20892-1400, USA.
authors.forename: Clelia
authors.initials: C
authors.lastname: Pellicano
authors.forename: Antonio
authors.initials: A
authors.lastname: Gallo
authors.forename: Xiaobai
authors.initials: X
authors.lastname: Li
authors.forename: Vasiliki N
authors.initials: VN
authors.lastname: Ikonomidou
authors.forename: Iordanis E
authors.initials: IE
authors.lastname: Evangelou
authors.forename: Joan M
authors.initials: JM
authors.lastname: Ohayon
authors.forename: Susan K
authors.initials: SK
authors.lastname: Stern
authors.forename: Mary
authors.initials: M
authors.lastname: Ehrmantraut
authors.forename: Fredric
authors.initials: F
authors.lastname: Cantor
authors.forename: Henry F
authors.initials: HF
authors.lastname: McFarland
authors.forename: Francesca
authors.initials: F
authors.lastname: Bagnato
mesh_terms: D000328:Adult; D001284:Atrophy / Q000473:pathology* / Q000503:physiopathology; D001931:Brain Mapping; D016022:Case-Control Studies; D002540:Cerebral Cortex / Q000473:pathology* / Q000503:physiopathology; D015331:Cohort Studies; D003866:Depressive Disorder / Q000150:complications / Q000473:pathology / Q000503:physiopathology; D004185:Disability Evaluation; D018450:Disease Progression; D015673:Fatigue Syndrome, Chronic / Q000209:etiology* / Q000473:pathology* / Q000503:physiopathology; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000150:complications* / Q000473:pathology* / Q000503:physiopathology; D010296:Parietal Lobe / Q000473:pathology / Q000503:physiopathology; D012720:Severity of Illness Index; D055815:Young Adult