The following is a summary of “Psychological factors and brain magnetic resonance imaging metrics associated with fatigue in persons with multiple sclerosis,” published in the October 2023 issue of Neurology by Hechenberger et al.
Psychological factors and brain changes may predict fatigue in persons with multiple sclerosis (pwMS). Researchers performed a retrospective study to identify the factors most accurately predict fatigue.
About 136 pwMS patients and 49 normal controls (NC) underwent clinical, neuropsychological, and magnetic resonance imaging evaluations. The study assessed Fatigue using the “Fatigue Scale for Motor and Cognitive Functions,” resulting in total, motor, and cognitive fatigue scores. They also examined global and subcortical brain volumes, white matter lesions, and microstructural changes (examining fractional anisotropy; FA) along the cortico-striatal-thalamo-cortical (CSTC) loop. Using multifactorial linear regression models, they explored potential total, motor, and cognitive fatigue predictors.
The result demonstrated that fatigue was observed in 53% of pwMS and 20% of NC. Predictors of total fatigue in pwMS included higher depression levels and reduced microstructural tissue integrity in the cortico-striatal-thalamo-cortical (CSTC) loop (adjusted R2 = 0.52, P< 0.001). Motor fatigue was predicted by lower education, female gender, higher physical disability, increased depression levels, and self-efficacy (adjusted R2 = 0.54, P< 0.001). Cognitive fatigue was associated with higher depression levels, lower self-efficacy, and reduced fractional anisotropy (FA) in the CSTC loop (adjusted R2 = 0.45, P< 0.001).
The study found psychological factors and brain changes can predict how severe fatigue will be in people with MS.