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Microstructural Changes in the Left Mesocorticolimbic Pathway are Associated with the Comorbid Development of Fatigue and Depression in Multiple Sclerosis
Author(s) -
Palotai Miklos,
Small Catherine,
Makris Nikolaos,
Somes Nathaniel G.,
Pinzon Alfredo Morales,
Rathi Yogesh,
Marzullo Aldo,
Levitt James J.,
Bakshi Rohit,
Chitnis Tanuja,
Guttmann Charles R. G.
Publication year - 2021
Publication title -
journal of neuroimaging
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.822
H-Index - 64
eISSN - 1552-6569
pISSN - 1051-2284
DOI - 10.1111/jon.12832
Subject(s) - medicine , fractional anisotropy , depression (economics) , medial forebrain bundle , cardiology , multiple sclerosis , psychiatry , diffusion mri , magnetic resonance imaging , dopamine , dopaminergic , radiology , economics , macroeconomics
BACKGROUND AND PURPOSE Lower reward responsiveness has been associated with fatigue in multiple sclerosis (MS). However, association of MS‐related fatigue with damage to the mesocorticolimbic reward pathway (superolateral medial forebrain bundle [slMFB]) has not been assessed. We investigated the association of fatigue and depression with slMFB damage in MS patients stratified based on longitudinal fatigue patterns. METHODS Patient stratification: 1. Sustained Fatigue (SF): latest two Modified Fatigue Impact Scale (MFIS) ≥ 38 ( n = 26); 2. Reversible Fatigue (RF): latest MFIS < 38, and at least one previous MFIS ≥ 38 ( n = 25); 3. Never Fatigued (NF): ≥ 5 consecutive MFIS < 38 ( n = 42); 4. Healthy Controls ( n = 6). Diffusion MRI‐derived measures of fractional anisotropy (FA), axial (AD), mean (MD), and radial diffusivity (RD) of the slMFB were compared between the groups. Depression was assessed using the Center for Epidemiologic Studies‐Depression Scale (CES‐D). RESULTS Depressed (CES‐D ≥ 16) SF patients showed significantly higher MD and RD than nondepressed SF and RF, and depressed RF patients, and significantly lower FA than nondepressed SF and depressed RF patients in their left slMFB. Depressed SF patients showed significantly higher left slMFB MD and AD than healthy controls. CONCLUSION Microstructural changes to the left slMFB may play a role in the comorbid development of fatigue and depression in MS.