Neural correlates of fatigue in multiple sclerosis: a diffusion tensor imaging and transcranial magnetic stimulation study

Fatigue is a common and specific symptom in neurological diseases described as a ........... In order to investigate the role of connectivity alterations in the development of fatigue and behavioral impairment in multiple sclerosis patients, we examined 19 MS patients combining neurophysiological paradigm by means of Transcranical Magnetic Stimulation (TMS), cognitive assesment and Magnetic Resonance Imaging (MRI) with Diffusion Tensor Imaging (DTI) based tools..........................finding lower Fractional Anysotropy (FA) values in the right hemispheres ......................................a significant atrophy of striatum and thalamus in fatigued patients, correlated to the neurodegenerative process of the striatum-thalamus loop. We assume that fatigue and cognitive impairment could be related to micro-structural impairment of White mattertracts of the cortical-subcortical-cortical loop: