Pathophysiology of the multiple sclerosis associated fatigue
Keywords:
fatigue, multiple sclerosis, pathophysiologyAbstract
One of the most frequent symptoms among the patients with Multiple sclerosis is Multiple sclerosis (MS) associated fatigue.
According to the patients, fatigue is the single most disabling symptom of the disease, affecting 50% to 80% of the patients.
Female patients and patients with progressive MS experience this symptom more frequently. MS associated fatigue is a subjective feeling, which makes their definition even more difficult.
Most of the research is focused on role of proinflammatory cytokines, neuroendocrine mechanisms, autonomic nervous system dysregulation, lesion load, cortical atrophy and neurodegeneration.
The pathophysiology behind the process is yet to be completely understood.
References
Milanov, I., Mnozhestvena skleroza i avtoimunni demielinizirashti zabolyavaniya, Sofiya, Meditsina i fizkultura, 2014, 64.
Natsionalen konsensus za diagnostika i lechenie na Mnozhestvena skleroza, Dvigatelni narusheniya, 2019, 16, dopŭlnenie 1, 60.
Bakshi, R., Miletich, R. S., Henschel, K. et al. Fatigue in multiple sclerosis: cross-sectional correlation with brain MRI findings in 71 patients. Neurology 53, 5, 1999, 1151–1153.
Blamire, A. M., Cader, S., Lee, M., Palace, J., Matthews, P. M. Axonal damage in the spinal cord of multiple sclerosis patients detected by magnetic resonance spectroscopy. Magn Reson Med, 2007, 58, 880-885.
Cohen, B. A. Identification, causation, and prevention of complications (ICAP). Neurology, 2008, 63, 1768 – 1769.
De Stefano, N., Narayanan, S., Francis, G.S., Arnaoutelis R, Tartaglia MC, Antel JP, et al. Evidence of axonal damage in the early stages of multiple sclerosis and its relevance to disability. Arch Neurol, 2001, 58, 65-70.
Egg, R., Hogl, B., Glatzl, S., Beer, R., Berger, T. Autonomic instability, as measured by pupillary unrest, is not associated with multiple sclerosis fatigue severity. Mult. Scler., 2002, 8, 3, 256–260.
Flachenecker, P., Bihler, I., Weber, F., Gottschalk, M., Toyka, K. V., Rieckmann, P. Cytokine mRNA expression in patients with multiple sclerosis and fatigue. Mult Scler 2004,10,165-169.
Flachenecker, P., Rufer, A., Bihler, I. et al. Fatigue in MS is related to sympathetic vasomotor dysfunction. Neurology, 2003, 61, 6, 851–853.
Gallo, P., Grossi, P., Favaretto, A., Calabrese, M. Magnetic resonance evidence of the involvement of the striatal–thalamic–frontal cortex system in determining fatigue in multiple sclerosis. Neurology 2010, 74, Suppl. 2, A508.
Gottschalk, M., Kumpfel, T., Flachenecker, P., Uhr, M., Trenkwalder, C., Holsboer, F. et al. Fatigue and regulation of the hypothalamo–pituitary–adrenal axis in multiple sclerosis. Arch Neurol 2005, 62, 277-280.
Hautecoeur, P., Forzy, G., Gallois, P., Demirbilek, V., Feugas, O. Variations of IL2, IL6, TNF alpha plasmatic levels in relapsing remitting multiple sclerosis. Acta Neurol Belg 1997, 97, 240-243.
Heesen, C., Nawrath, L., Reich, C., Bauer, N., Schulz, K. H., Gold, S. M. Fatigue in multiple sclerosis: an example of cytokine mediated sickness behaviour? J Neurol Neurosurg Psychiatry 2006, 77, 34-39.
Huitinga, I., van der Cammen, M., Salm, L., Erkut, Z., van Dam, A., Tilders, F., et al. IL-1beta immunoreactive neurons in the human hypothalamus: reduced numbers in multiple sclerosis. J Neuroimmunol, 2000, 107, 8–20.
Krupp, L. Fatigue is intrinsic to multiple sclerosis (MS) and is the most commonly reported symptom of the disease. Mult Scler, 2006, 12, 367-368.
Krupp, L. B., Alvarez, L. A., LaRocca, N. G., Scheinberg, L.C. Fatigue in multiple sclerosis. Arch. Neurol. 1988, 45, 4, 435–437.
Lerdal, A., Celius, E. G., Krupp, L., Dahl, A. A. A prospective study of patterns of fatigue in multiple sclerosis. Eur J Neurol 2007, 14, 1338-1343.
Marrie, R. A., Fisher, E., Miller, D. M., Lee, J. C., Rudick, R. A. Association of fatigue and brain atrophy in multiple sclerosis. J. Neurol. Sci. 2005, 228, 2, 161–166.
Merkelbach, S., Dillmann, U., Kolmel, C., Holz, I., Muller, M. Cardiovascular autonomic dysregulation and fatigue in multiple sclerosis. Mult. Scler., 2001, 7, 5, 320–326.
Multiple Sclerosis Council for Clinical Practice Guidelines (Ed.). Fatigue And Multiple Sclerosis: Evidence-Based Management Strategies For Fatigue In Multiple Sclerosis. Paralyzed Veterans Association of America, DC, USA, 1998, 54pp.
Niepel, G., Tench, Ch. R., Morgan, P. S., Evangelou, N., Auer, D. P., Constantinescu. C. Deep gray matter and fatigue in MS: a T1 relaxation time study. J. Neurol. 2006, 253, 7, 896–902.
Pellicano, C., Gallo, A., Li, X., Lkonomidou, V.N., Evangelou, I.E., JM, O. et al. Relationship of cortical atrophy to fatigue in patients with multiple sclerosis. Arch Neurol 2010, 67, 447-453.
Riccitelli, G., Rocca, M. A., Forn, C., Colombo, B., Comi, G., Filippi, M. et al. Voxelwise assessment of the regional distribution of damage in the brains of patients with multiple sclerosis and fatigue. AJNR Am J Neuroradiol 2011, 32, 874-879.
Rocca, M. A., Agosta, F., Colombo, B. et al. f MRI changes in relapsing–remitting multiple sclerosis patients complaining of fatigue after IFNb-1a injection. Hum. Brain Mapp. 2007, 28, 5, 373–382.
Schapiro, R. T. Symptomatic therapies for multiple sclerosis. Multiple Sclerosis: A comprehensive text, Philadelphia, 2008, 383-390.
Sepulcre, J., Masdeu, J. C., Goni, J. et al. Fatigue in multiple sclerosis is associated with the disruption of frontal and parietal pathways. Mult. Scler. 2009, 15, 3, 337–344.
Tartaglia, C., Narayanan, S., Francis, S. J., Santos, A. C., De Stefano, N., Lapierre, Y., et al. The relationship between diffuse axonal damage and fatigue in multiple sclerosis. Arch Neurol 2004, 61,201-207.
Tartaglia, M. C., Narayanan, S., Arnold, D. L. Mental fatigue alters the pattern and increases the volume of cerebral activation required for a motor task in multiple sclerosis patients with fatigue. Eur. J. Neurol. 2008, 15, 4, 413–419.
Tedeschi, G., Dinacci, D., Lavorgna, L, Prinster, A., Savettieri, G., Quattrone, A. et al. Correlation between fatigue and brain atrophy and lesion load in multiple sclerosis patients independent of disability. J Neurol Sci, 2007, 263, 15-19.
Téllez, N., Comabella, M., Julia, E., Río, J., Tintoré, M., Brieva, L. et al. Fatigue in progressive multiple sclerosis is associated with low levels of dehydroepiandrosterone. Mult Scler 2006, 12, 487- 494.
van der Werf, S. P, Jongen, P. J., Lycklama à Nijeholt, G. J, Barkhof, F., Hommes, O. R., Bleijenberg, G. Fatigue in multiple sclerosis: interrelations between fatigue complaints, cerebral MRI abnormalities and neurological disability. J. Neurol. Sci. 1998, 160, 2, 164–170.
White, A. T., Lee, J. N, Light, A. R., Light, K.C. Brain activation in multiple sclerosis: a BOLD fMRI study of the effects of fatiguing hand exercise. Mult. Scler. 2009, 15, 5, 580–586.
Yaldizli, O., Glassl, S., Sturm, D., Papadopoulou, A., Gass, A., Tettenborn, B. et al. Fatigue and progression of corpus callosum atrophy in multiple sclerosis. J Neurol 2011, 258, 2199-2205.
Zellini, F., Niepel, G., Tench, C. R., Constantinescu, C. S. Hypothalamic involvement assessed by T1 relaxation time in patients with relapsingremitting multiple sclerosis. Mult Scler 2009, 15, 1442-1449.
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