Neural correlates of fatigue in granulomatosis with polyangiitis: a functional magnetic resonance imaging study

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Abstract

OBJECTIVE: The aim of this study was to investigate the neurophysiological effects of fatigue among patients with granulomatosis with polyangiitis (GPA).

METHODS: A case-control functional MRI (fMRI) study was conducted. Stable GPA subjects were recruited according to fatigue status, with those reporting fatigue defined as cases and those not defined as controls. In addition, a control group of general population subjects with idiopathic fatigue were studied. During fMRI, all participants performed a fatigue-inducing cognitive task. Functional data were acquired with a 3 T MRI scanner during periods of task activity and rest. Analyses of the differences in blood oxygen level dependent (BOLD) signal were then performed using SPM8 software and comparisons were made between case and control groups.

RESULTS: GPA cases (n = 12) were demographically matched to GPA controls (n = 14) and were clinically similar apart from the higher reporting of fatigue, by design, and depressive symptoms (P = 0.0007). After adjusting for depressive symptoms, comparison of BOLD signals revealed significantly greater activation in the right thalamus, left paracentral lobule, left medial frontal gyrus and right medial globus pallidus among GPA cases. When compared with the similarly fatigued population control group (n = 13), GPA cases shared many overlapping areas of activation. However, in addition, the population control group revealed significantly greater activation elsewhere, principally the left precentral gyrus, right superior frontal gyrus and right cingulate gyrus.

CONCLUSION: fMRI has identified specific differences in the neurophysiology of fatigued GPA subjects. Future application of this promising biomarker may inform the precise mechanisms of this clinically important symptom.

Original languageEnglish
Pages (from-to)2080-2087
Number of pages8
JournalRheumatology
Volume53
Issue number11
Early online date13 Jun 2014
DOIs
Publication statusPublished - Nov 2014

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Granulomatosis with Polyangiitis
Fatigue
Magnetic Resonance Imaging
Control Groups
Population Control
Prefrontal Cortex
Population Groups
Depression
Oxygen
Neurophysiology
Globus Pallidus
Gyrus Cinguli
Frontal Lobe
Thalamus
Software
Biomarkers
Population

Keywords

  • granulomatosis with polyangiitis
  • vasculitis
  • fatigue
  • functional MRI

Cite this

@article{942e88117dfc426e888bf92392e7ce74,
title = "Neural correlates of fatigue in granulomatosis with polyangiitis: a functional magnetic resonance imaging study",
abstract = "OBJECTIVE: The aim of this study was to investigate the neurophysiological effects of fatigue among patients with granulomatosis with polyangiitis (GPA).METHODS: A case-control functional MRI (fMRI) study was conducted. Stable GPA subjects were recruited according to fatigue status, with those reporting fatigue defined as cases and those not defined as controls. In addition, a control group of general population subjects with idiopathic fatigue were studied. During fMRI, all participants performed a fatigue-inducing cognitive task. Functional data were acquired with a 3 T MRI scanner during periods of task activity and rest. Analyses of the differences in blood oxygen level dependent (BOLD) signal were then performed using SPM8 software and comparisons were made between case and control groups.RESULTS: GPA cases (n = 12) were demographically matched to GPA controls (n = 14) and were clinically similar apart from the higher reporting of fatigue, by design, and depressive symptoms (P = 0.0007). After adjusting for depressive symptoms, comparison of BOLD signals revealed significantly greater activation in the right thalamus, left paracentral lobule, left medial frontal gyrus and right medial globus pallidus among GPA cases. When compared with the similarly fatigued population control group (n = 13), GPA cases shared many overlapping areas of activation. However, in addition, the population control group revealed significantly greater activation elsewhere, principally the left precentral gyrus, right superior frontal gyrus and right cingulate gyrus.CONCLUSION: fMRI has identified specific differences in the neurophysiology of fatigued GPA subjects. Future application of this promising biomarker may inform the precise mechanisms of this clinically important symptom.",
keywords = "granulomatosis with polyangiitis, vasculitis, fatigue, functional MRI",
author = "Neil Basu and Murray, {Alison D} and Jones, {Gareth T} and Reid, {David M} and MacFarlane, {Gary J} and Waiter, {Gordon D}",
note = "{\circledC} The Author 2014. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: journals.permissions@oup.com. Funding: This work was supported by NHS Grampian and the Chief Scientist’s Office (ref: CAF/08/08)",
year = "2014",
month = "11",
doi = "10.1093/rheumatology/keu243",
language = "English",
volume = "53",
pages = "2080--2087",
journal = "Rheumatology",
issn = "1462-0324",
publisher = "OXFORD UNIV PRESS INC",
number = "11",

}

TY - JOUR

T1 - Neural correlates of fatigue in granulomatosis with polyangiitis

T2 - a functional magnetic resonance imaging study

AU - Basu, Neil

AU - Murray, Alison D

AU - Jones, Gareth T

AU - Reid, David M

AU - MacFarlane, Gary J

AU - Waiter, Gordon D

N1 - © The Author 2014. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: journals.permissions@oup.com. Funding: This work was supported by NHS Grampian and the Chief Scientist’s Office (ref: CAF/08/08)

PY - 2014/11

Y1 - 2014/11

N2 - OBJECTIVE: The aim of this study was to investigate the neurophysiological effects of fatigue among patients with granulomatosis with polyangiitis (GPA).METHODS: A case-control functional MRI (fMRI) study was conducted. Stable GPA subjects were recruited according to fatigue status, with those reporting fatigue defined as cases and those not defined as controls. In addition, a control group of general population subjects with idiopathic fatigue were studied. During fMRI, all participants performed a fatigue-inducing cognitive task. Functional data were acquired with a 3 T MRI scanner during periods of task activity and rest. Analyses of the differences in blood oxygen level dependent (BOLD) signal were then performed using SPM8 software and comparisons were made between case and control groups.RESULTS: GPA cases (n = 12) were demographically matched to GPA controls (n = 14) and were clinically similar apart from the higher reporting of fatigue, by design, and depressive symptoms (P = 0.0007). After adjusting for depressive symptoms, comparison of BOLD signals revealed significantly greater activation in the right thalamus, left paracentral lobule, left medial frontal gyrus and right medial globus pallidus among GPA cases. When compared with the similarly fatigued population control group (n = 13), GPA cases shared many overlapping areas of activation. However, in addition, the population control group revealed significantly greater activation elsewhere, principally the left precentral gyrus, right superior frontal gyrus and right cingulate gyrus.CONCLUSION: fMRI has identified specific differences in the neurophysiology of fatigued GPA subjects. Future application of this promising biomarker may inform the precise mechanisms of this clinically important symptom.

AB - OBJECTIVE: The aim of this study was to investigate the neurophysiological effects of fatigue among patients with granulomatosis with polyangiitis (GPA).METHODS: A case-control functional MRI (fMRI) study was conducted. Stable GPA subjects were recruited according to fatigue status, with those reporting fatigue defined as cases and those not defined as controls. In addition, a control group of general population subjects with idiopathic fatigue were studied. During fMRI, all participants performed a fatigue-inducing cognitive task. Functional data were acquired with a 3 T MRI scanner during periods of task activity and rest. Analyses of the differences in blood oxygen level dependent (BOLD) signal were then performed using SPM8 software and comparisons were made between case and control groups.RESULTS: GPA cases (n = 12) were demographically matched to GPA controls (n = 14) and were clinically similar apart from the higher reporting of fatigue, by design, and depressive symptoms (P = 0.0007). After adjusting for depressive symptoms, comparison of BOLD signals revealed significantly greater activation in the right thalamus, left paracentral lobule, left medial frontal gyrus and right medial globus pallidus among GPA cases. When compared with the similarly fatigued population control group (n = 13), GPA cases shared many overlapping areas of activation. However, in addition, the population control group revealed significantly greater activation elsewhere, principally the left precentral gyrus, right superior frontal gyrus and right cingulate gyrus.CONCLUSION: fMRI has identified specific differences in the neurophysiology of fatigued GPA subjects. Future application of this promising biomarker may inform the precise mechanisms of this clinically important symptom.

KW - granulomatosis with polyangiitis

KW - vasculitis

KW - fatigue

KW - functional MRI

U2 - 10.1093/rheumatology/keu243

DO - 10.1093/rheumatology/keu243

M3 - Article

C2 - 24929635

VL - 53

SP - 2080

EP - 2087

JO - Rheumatology

JF - Rheumatology

SN - 1462-0324

IS - 11

ER -