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Researchers are finally connecting the dots, and by all accounts aerobic fitness in multiple sclerosis is essential to counteract fatigue. Here's the science behind the discovery. -D
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Mult Scler. 2016 Feb 4. pii: 1352458516628331. [Epub ahead of print]
Fatigue in multiple sclerosis: The contribution of occult white matter damage.
Bisecco A1, Caiazzo G2, d'Ambrosio A3, Sacco R1, Bonavita S1, Docimo R3, Cirillo M4, Pagani E5, Filippi M6, Esposito F7, Tedeschi G1, Gallo A8.
Abstract
BACKGROUND:
A functional cortico-subcortical disconnection has been recognized in fatigued multiple sclerosis (MS) patients. Normal appearing white matter (NAWM) damage might contribute to the abovementioned disconnectivity.
OBJECTIVES:
To assess the relationship between fatigue and microstructural NAWM damage in relapsing-remitting (RR) MS.
METHODS:
Sixty RRMS patients and 29 healthy controls (HC) underwent a magnetic resonance imaging (MRI) protocol including diffusion tensor imaging (DTI). Patients with a mean Fatigue Severity Scale (FSS) score ⩾ 4 were considered fatigued (fatigued MS (F-MS)). Tract-based spatial statistics were applied for voxel-wise analysis of DTI indices. A correlation analysis was performed between FSS score and DTI indices in the entire MS group.
RESULTS:
Thirty MS patients were F-MS. Compared to HC, F-MS patients showed a more extensive NAWM damage than not fatigued MS (NF-MS) patients, with additional damage in the following tracts: frontal and occipital juxtacortical fibers, external capsule, uncinate fasciculus, forceps minor, superior longitudinal fasciculus, cingulum, and pons. No differences were found between F-MS and NF-MS patients. Fatigue severity correlated to DTI abnormalities of corona radiata, cingulum, corpus callosum, forceps minor, superior longitudinal fasciculus, inferior fronto-occipital fasciculus, thalamus and anterior thalamic radiation, cerebral peduncle, and midbrain.
CONCLUSIONS:
Fatigue is associated to a widespread microstructural NAWM damage, particularly in associative tracts connected to frontal lobes.
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Brain Res. 2010 Jun 23;1341:41-51. doi: 10.1016/j.brainres.2009.06.063. Epub 2009 Jun 25.
Aerobic fitness is associated with gray matter volume and white matter integrity in multiple sclerosis.
Prakash RS1, Snook EM, Motl RW, Kramer AF.
Abstract
Alterations in gray and white matter have been well documented in individuals with multiple sclerosis. Severity and extent of such brain tissue damage have been associated with cognitive impairment, disease duration and neurological disability, making quantitative indices of tissue damage important markers of disease progression. In this study, we investigated the association between cardiorespiratory fitness and measures of gray matter atrophy and white matter integrity. Employing voxel-based approaches to analysis of gray matter and white matter, we specifically examined whether higher levels of fitness in multiple sclerosis participants were associated with preserved gray matter volume and integrity of white matter. We found a positive association between cardiorespiratory fitness and regional gray matter volumes and higher focal fractional anisotropy values. Statistical mapping revealed that higher levels of fitness were associated with greater gray matter volume in the midline cortical structures including the medial frontal gyrus, anterior cingulate cortex and the precuneus. Further, we also found that increasing levels of fitness were associated with higher fractional anisotropy in the left thalamic radiation and right anterior corona radiata. Both preserved gray matter volume and white matter tract integrity were associated with better performance on measures of processing speed. Taken together, these results suggest that fitness exerts a prophylactic influence on the structural decline observed early on, preserving neuronal integrity in multiple sclerosis, thereby reducing long-term disability.
FULL ARTICLE (FREE):
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2884046/
-----------------------
Mult Scler. 2016 Feb 4. pii: 1352458516628331. [Epub ahead of print]
Fatigue in multiple sclerosis: The contribution of occult white matter damage.
Bisecco A1, Caiazzo G2, d'Ambrosio A3, Sacco R1, Bonavita S1, Docimo R3, Cirillo M4, Pagani E5, Filippi M6, Esposito F7, Tedeschi G1, Gallo A8.
Abstract
BACKGROUND:
A functional cortico-subcortical disconnection has been recognized in fatigued multiple sclerosis (MS) patients. Normal appearing white matter (NAWM) damage might contribute to the abovementioned disconnectivity.
OBJECTIVES:
To assess the relationship between fatigue and microstructural NAWM damage in relapsing-remitting (RR) MS.
METHODS:
Sixty RRMS patients and 29 healthy controls (HC) underwent a magnetic resonance imaging (MRI) protocol including diffusion tensor imaging (DTI). Patients with a mean Fatigue Severity Scale (FSS) score ⩾ 4 were considered fatigued (fatigued MS (F-MS)). Tract-based spatial statistics were applied for voxel-wise analysis of DTI indices. A correlation analysis was performed between FSS score and DTI indices in the entire MS group.
RESULTS:
Thirty MS patients were F-MS. Compared to HC, F-MS patients showed a more extensive NAWM damage than not fatigued MS (NF-MS) patients, with additional damage in the following tracts: frontal and occipital juxtacortical fibers, external capsule, uncinate fasciculus, forceps minor, superior longitudinal fasciculus, cingulum, and pons. No differences were found between F-MS and NF-MS patients. Fatigue severity correlated to DTI abnormalities of corona radiata, cingulum, corpus callosum, forceps minor, superior longitudinal fasciculus, inferior fronto-occipital fasciculus, thalamus and anterior thalamic radiation, cerebral peduncle, and midbrain.
CONCLUSIONS:
Fatigue is associated to a widespread microstructural NAWM damage, particularly in associative tracts connected to frontal lobes.
-----------------------------
Brain Res. 2010 Jun 23;1341:41-51. doi: 10.1016/j.brainres.2009.06.063. Epub 2009 Jun 25.
Aerobic fitness is associated with gray matter volume and white matter integrity in multiple sclerosis.
Prakash RS1, Snook EM, Motl RW, Kramer AF.
Abstract
Alterations in gray and white matter have been well documented in individuals with multiple sclerosis. Severity and extent of such brain tissue damage have been associated with cognitive impairment, disease duration and neurological disability, making quantitative indices of tissue damage important markers of disease progression. In this study, we investigated the association between cardiorespiratory fitness and measures of gray matter atrophy and white matter integrity. Employing voxel-based approaches to analysis of gray matter and white matter, we specifically examined whether higher levels of fitness in multiple sclerosis participants were associated with preserved gray matter volume and integrity of white matter. We found a positive association between cardiorespiratory fitness and regional gray matter volumes and higher focal fractional anisotropy values. Statistical mapping revealed that higher levels of fitness were associated with greater gray matter volume in the midline cortical structures including the medial frontal gyrus, anterior cingulate cortex and the precuneus. Further, we also found that increasing levels of fitness were associated with higher fractional anisotropy in the left thalamic radiation and right anterior corona radiata. Both preserved gray matter volume and white matter tract integrity were associated with better performance on measures of processing speed. Taken together, these results suggest that fitness exerts a prophylactic influence on the structural decline observed early on, preserving neuronal integrity in multiple sclerosis, thereby reducing long-term disability.
FULL ARTICLE (FREE):
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2884046/