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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.

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