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GIUSEPPE SALEMI

Correlation between fatigue and brain atrophy and lesion load in multiple sclerosis patients independent of disability.

  • Autori: TEDESCHI G; DINACCI D; LAVORGNA L; PRINSTER A; SAVETTIERI G; QUATTRONE A; LIVREA P; MESSINA C; REGGIO A; SERVILLO G; BRESCIAMORRA V; OREFICE G; PACIELLO M; BRUNETTI A; PAOLILLO A; CONIGLIO G; BONAVITA S; DI COSTANZO A; BELLACOSA A; VALENTINO P; QUARANTELLI M; PATTI F; SALEMI G; CAMMARATA E; SIMONE I; SALVATORE M; BONAVITA V; ALFANO B
  • Anno di pubblicazione: 2007
  • Tipologia: Articolo in rivista (Articolo in rivista)
  • OA Link: http://hdl.handle.net/10447/19978

Abstract

Background: Fatigue is a major problem in multiple sclerosis (MS), and its association with MRI features is debated. Objective: To study the correlation between fatigue and lesion load, white matter (WM), and grey matter (GM), in MS patients independent of disability. Methods: We studied 222 relapsing remitting MS patients with low disability (scores ≤ 2 at the Kurtzke Expanded Disability Status Scale). Lesion load, WM and GM were measured by fully automated, operator-independent, multi-parametric segmentation method. T1 and T2 lesion volume were also measured by a semi-automated method. Fatigue was assessed by the Fatigue Severity Scale (FSS), and patients divided in high-fatigue (FSS ≥ 5; n = 197) and low-fatigue groups (FSS ≤ 4; n = 25). Results: High-fatigue patients showed significantly higher abnormal white matter fraction (AWM-f), T1 and T2 lesion loads, and significant lower WM-f, and GM-f. Multivariate analysis showed that high FSS was significantly associated with lower WM-f, and GM-f. Females and highly educated patients were significantly less fatigued. Conclusion: These results suggest that among MS patients with low disability those with high-fatigue show higher WM and GM atrophy and higher lesion load, and that female sex and higher levels of education may play a protective role towards fatigue. Furthermore, they suggest that in MS, independent of disability, WM and GM atrophy is a risk factor to have fatigue.