title: Forceps minor damage and co-occurrence of depression and fatigue in multiple sclerosis.
abstract: OBJECTIVE
  Using diffusion tensor magnetic resonance imaging (DT MRI), we analyzed the architectural integrity of the brain white matter (WM) from a large cohort of MS patients to identify the structural substrates of the concomitant presence of depression and fatigue.
  
  
  METHODS
  Brain dual-echo, 3D T1-weighted and DT MRI scans were acquired from 147 MS patients and 90 gender- and age-matched healthy controls (HCs). Patients were stratified by the presence of depression (92 depressed (D), 55 not depressed (nD)) and fatigue (81 fatigued (F), 66 not fatigued (nF)). Sixty-five patients had co-occurrence of depression and fatigue (DF). Whole-brain voxel-wise comparisons of WM DT MRI abnormalities were performed using tract-based-spatial-statistics (TBSS). Tract-specific analyses were run in brain WM tracts using standard-space templates.
  
  
  RESULTS
  Whole-brain voxel-wise analysis yielded no significant differences between patient subgroups. At tract-specific analysis, DF patients had reduced fractional anisotropy (FA) of the forceps minor. Reduced FA of the right anterior thalamic radiation and right uncinate fasciculus was found in F-MS vs not F-MS patients after correcting for depression. No significant differences were found between D vs not D-MS patients, after correcting for fatigue.
  
  
  CONCLUSIONS
  This study provides evidence for partially overlapping damage to frontal and fronto-temporal pathways underlying depression and fatigue in MS.
authors.affiliation: Neuroimaging Research Unit, Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Italy/Neurocenter of Southern Switzerland, Civic Hospital, Switzerland.
authors.forename: C
authors.initials: C
authors.lastname: Gobbi
authors.affiliation: Neuroimaging Research Unit, Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Italy/San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Italy.
authors.forename: M A
authors.initials: MA
authors.lastname: Rocca
authors.affiliation: Neuroimaging Research Unit, Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Italy.
authors.forename: E
authors.initials: E
authors.lastname: Pagani
authors.affiliation: Neuroimaging Research Unit, Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Italy/Neurocenter of Southern Switzerland, Civic Hospital, Switzerland.
authors.forename: G C
authors.initials: GC
authors.lastname: Riccitelli
authors.affiliation: Neurocenter of Southern Switzerland, Civic Hospital, Switzerland.
authors.forename: E
authors.initials: E
authors.lastname: Pravatà
authors.affiliation: San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Radaelli
authors.affiliation: San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Martinelli-Boneschi
authors.affiliation: Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Falini
authors.affiliation: Biostatistics Unit, IRCCS-Ospedale Casa Sollievo della Sofferenza, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Copetti
authors.affiliation: San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Comi
authors.affiliation: Neuroimaging Research Unit, Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, 20132, Italy filippi.massimo@hsr.it.
authors.forename: M
authors.initials: M
authors.lastname: Filippi
mesh_terms: D000328:Adult; D000368:Aged; D003863:Depression / Q000150:complications / Q000473:pathology*; D003866:Depressive Disorder / Q000150:complications / Q000473:pathology; D056324:Diffusion Tensor Imaging / Q000379:methods; D005221:Fatigue / Q000150:complications / Q000473:pathology*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000150:complications / Q000473:pathology*; D009413:Nerve Fibers, Myelinated / Q000473:pathology; D009415:Nerve Net / Q000473:pathology
keywords: Multiple sclerosis; depression; diffusion tensor magnetic resonance imaging; fatigue; forceps minor; regional damage