Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

White Matter Tract Disruption, Fatigue Examined

Mult Scler Relat Disord; ePub 2018 Nov 9; Fuchs, et al

Although overall lesion burden correlates positively with fatigue in people with multiple sclerosis (PwMS), localized white matter (WM) damage between the amygdala, temporal pole, and other connected structures is associated with lower severity of patient-perceived fatigue. This according to a recent study that aimed to identify patterns of WM tract disruption that explain self-reported fatigue severity in PwMS. 137 PwMS and 50 age- and sex-matched healthy controls (HC) underwent fatigue assessment and brain MRI. Lesion maps were applied to determine the severity of WM tract disruption between pairs of gray matter (GM) regions. Researchers found:

  • Patient-perceived fatigue in PwMS was positively associated with overall lesion burden (β = 0.563).
  • In contrast, localized disruptions in WM tracts between regions including the amygdala, insula, hippocampus, putamen, temporal pole, caudal-middle-frontal gyrus, rostral-middle-frontal gyrus, inferior-parietal gyrus, and banks of the superior temporal sulcus were significantly negatively correlated with fatigue in PwMS (β = −0.586).
  • Average disruption within this specific, localized network explained significant additional variance in fatigue above what was otherwise explained by depression and conventional MRI measures of neuropathology (ΔR2 = 0.078).


Fuchs TA, Vaughn CB, Benedict RHB, et al. Lower self-report fatigue in multiple sclerosis is associated with localized white matter tract disruption between amygdala, temporal pole, insula, and other connected structures. [Published online ahead of print November 9, 2018]. Mult Scler Relat Disord. doi:10.1016/j.msard.2018.11.005.

This Week's Must Reads

Stroke Care Comparison of Asian Americans and Whites, JAMA Neurology; ePub 2019 Jan 22; Song, Liang, et al

Aerobic Exercise Can Improve Executive Functioning , Neurology; 2019 Jan 15; Blumenthal, et al

Episodic Memory Decline is Neurodegenerative Marker, Neurology; ePub 2019 Jan 23; Wilson, Yang, et al

Serum Troponin Level Marker for Visceral Infarcts , J Stroke Cerebrovasc Dis; ePub 2019 Jan 18; Azher, et al

Urine Sodium-to-Potassium Ratio Predicts Stroke, Stroke; ePub 2019 Jan 21; Averill, Young, et al

Must Reads in Multiple Sclerosis

Prevalence of Asthma in Persons with MS, Mult Scler Relat Disord; ePub 2018 Dec 11; Hill, et al

Normal-Appearing White Matter in MS Examined, Neuroradiology; ePub 2018 Dec 12; Yu, et al

MS Disease Burden: Which Symptoms Matter Most?, Mult Scler Relat Disord; 2018 Oct; Barin, et al

Retinal Layer Thickness and MS Conversion Risk, Mult Scler; ePub 2018 Dec 3; Filippatou, et al

Importance of Coping and QOL in People with MS, Int J MS Care; ePub 2018 Dec 6; Grech, et al