Journal
MULTIPLE SCLEROSIS JOURNAL
Volume 24, Issue 8, Pages 1115-1125Publisher
SAGE PUBLICATIONS LTD
DOI: 10.1177/1352458517712078
Keywords
Multiple sclerosis; demyelinating diseases; fatigue; magnetic resonance imaging; flow cytometry; cerebrospinal fluid
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Funding
- Kommission fur Klinische Forschung
- Medical Faculty of the Technical University of Munich
- German competence network multiple sclerosis (KKNMS) [01GI1307B]
- Deutsche Forschungsgemeinschaft DFG [TR 128]
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Background: Damage of different brain structures has been related to fatigue. Alternatively, functional alterations of central nervous system (CNS) cells by the inflammatory milieu within the CNS may be responsible for the development of fatigue. Aim: To investigate the effect of structural brain damage and inflammatory cerebrospinal fluid (CSF) changes on fatigue in multiple sclerosis (MS). Methods: We determined the association of different clinical, CSF and magnetic resonance imaging (MRI) parameters with prevalence and severity of fatigue, as measured by the Fatigue Scale for Motor and Cognitive Functions in 68 early MS patients (discovery cohort). We validated our findings in two MS cohorts: the MRI validation cohort (N=233) for the clinical and MRI parameters, and the CSF validation cohort (N=81) for the clinical and CSF parameters. Results: Fatigue was associated with clinical disability. Fatigue did not correlate with any CSF parameter but correlated negatively with total and cortical grey matter volume. However, when controlling for Expanded Disability Status Scale (EDSS) in a multivariate model, these associations lost significance. Conclusion: Disability and disease duration best explain fatigue severity but none of the tested MRI or CSF parameter was reliably associated with fatigue.
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