Fatigue in Multiple Sclerosis: General and Perceived Fatigue Does Not Depend on Corticospinal Tract Dysfunction

Conclusions: in MS patients the pathogenesis of fatigue seems not driven by the mechanisms directly related to corticospinal function (that characterize fatigue in controls) but seems probably due to other “central abnormalities” upstream to primary motor cortex. Introduction Multiple sclerosis (MS) is an immuno-mediated disorder of the central nervous system (CNS) in which inflammation, demyelination, and axonal damage coexist (1). MS prevalence and incidence have increased progressively over time (2). Importantly, MS is commonly diagnosed between 20 and 40 years of age, affecting the early stages of working lives and leading to a further increase in social costs (3, 4). MS is characterized by sensory and motor symptoms, bladder and bowel problems, cognitive impairment and fatigue. Fatigue trait in MS was defined, by the Multiple sclerosis council for clinical practice guidelines, as “a subjective lack of physical and/or mental energy that is perceived by the individual or caregiver to interfere with usual and desired activities”(5). It occurs frequently and is considered one of the most disabling symptom since it interferes with the performance of daily activities (6). However, the pathophysiology of fatigue and the mechanisms involved are still poorly understood (7–13). On the other hand, fatigue state, can be defined as the decline in peak force (torque) after performing an exercise intervention (14). Generally, fatigue trigg...
Source: Frontiers in Neurology - Category: Neurology Source Type: research