Imaging cognitive fatigability in multiple sclerosis: objective quantification of cerebral blood flow during a task of s
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ORIGINAL RESEARCH
Imaging cognitive fatigability in multiple sclerosis: objective quantification of cerebral blood flow during a task of sustained attention using ASL perfusion fMRI Jason A. Berard 1,2 & Zhuo Fang 3 & Lisa A. S. Walker 1,2,3,4 & Alyssa Lindsay-Brown 2 & Leila Osman 2 & Ian Cameron 2,3 & Roxana Cruce 2 & Greg O. Cron 2,5,6 & Mark S. Freedman 2,3 & Andra M. Smith 1,2,3
# Springer Science+Business Media, LLC, part of Springer Nature 2019
Abstract Cognitive fatigability (CF) can be defined as an inability to maintain performance throughout a sustained cognitive task. Individuals with multiple sclerosis (MS) are more susceptible to CF than healthy controls (HCs); however, the neural correlates underlying CF are still under investigation. Arterial spin labeling (ASL) perfusion imaging provides a non-invasive method of objectively quantifying cerebral blood flow (CBF) during sustained attention tasks. To date, no study has yet evaluated CF in MS using this methodology. 10 MS and 10 HCs completed a 20-min psychomotor vigilance task (PVT). CF was evaluated by dividing the PVT into quintiles and examining performance from the 1st to the last. Mean reaction times (RTs) and number of lapses were recorded. Global and regional CBF changes were evaluated throughout the PVT as well as during pre- and post-task rest. Increased susceptibility to CF was noted in the MS group. Distinct patterns of CBF activation were observed in areas comprising frontoparietal, cortico-striatal, cerebellar, and basal ganglia regions; however, when and how these regions were engaged differed between the MS and HC groups. In particular, dysfunction in CBF to the middle frontal gyrus may underlie the CF effects observed. In addition, individuals with MS appear to struggle with “switching off” regions of the attentional network at rest following sustained cognitive effort. Findings support the use of ASL as an appropriate methodology for evaluating CF in MS with an overall pattern of attentional network dysfunction being observed. Objectively quantifying CF in this manner can help validate patients’ subjective complaints. Keywords Cognitive fatigability . Multiple sclerosis . Arterial spin labeling . fMRI, neuroimaging
Introduction During tasks involving sustained cognitive effort, individuals with multiple sclerosis (MS) often experience increased * Jason A. Berard [email protected] 1
School of Psychology, University of Ottawa, Ottawa, Canada
2
The Ottawa Hospital Research Institute, 501 Smyth Road, Suite 7300, Ottawa, Ontario K1H 8L6, Canada
3
University of Ottawa Brain and Mind Research Institute, Ottawa, Canada
4
School of Psychology and Institute of Cognitive Science, Carleton University, Ottawa, Canada
5
The Ottawa Hospital, Ottawa, Canada
6
Department of Radiology, University of Ottawa, Ottawa, Canada
feelings of fatigue accompanied by steady declines in performance over the period of task engagement. This phenomenon has been referred to by multiple names including “cognitive fatigue” (Walker et al. 2012), “time-on ta
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