Changes to the septo-fornical area might play a role in the pathogenesis of anxiety in multiple sclerosis

Miklos Palotai, Andrea Mike, Michele Cavallari, Erzsebet Strammer, Gergely Orsi, Brian C Healy, Katharina Schregel, Zsolt Illes, Charles Rg Guttmann

Research output: Contribution to journalJournal articleResearchpeer-review

Abstract

BACKGROUND: Reports on the relationships between white matter lesion load (WMLL) and fatigue and anxiety in multiple sclerosis (MS) are inconsistent.

OBJECTIVE: To investigate the association of total and tract-specific WMLL with fatigue and anxiety.

METHODS: Total and regional T2 WMLL was assessed for 19 tracts in 48 MS patients (30 females). ICBM-DTI-81 Atlas-based parcellation was combined with WMLL segmentation of T2-weighted magnetic resonance imaging (MRI). Fatigue, anxiety, and depression were assessed using Fatigue Impact Scale, State Trait Anxiety Inventory, and Beck Depression Inventory, respectively.

RESULTS: Fatigue, anxiety, and depression showed significant inter-correlation. We found no association between fatigue and total or regional WMLLs, whereas anxiety was associated with total and regional WMLLs in nine tracts. After adjusting for total WMLL, age, and depression, only the column and body of the fornix (CBF) remained significantly associated with anxiety. Post hoc analyses showed no CBF lesions on T1-weighted MRI and suggested, but could not confirm, that the septum pellucidum might play a role in the pathogenesis of anxiety.

CONCLUSION: Our results suggest that anxiety in MS patients may have a neuropathological substrate in the septo-fornical area, which requires further validation using larger sample size and ultra-high-field MRI in targeted prospective studies.

Original languageEnglish
JournalMultiple Sclerosis Journal
Volume24
Issue number8
Pages (from-to)1105-1114
ISSN1352-4585
DOIs
Publication statusPublished - Jul 2018

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Depression
Septum Pellucidum
Equipment and Supplies
Sample Size
White Matter
Prospective Studies

Keywords

  • Multiple sclerosis
  • anxiety
  • fatigue
  • septo-fornical area
  • white matter lesion load

Cite this

Palotai, M., Mike, A., Cavallari, M., Strammer, E., Orsi, G., Healy, B. C., ... Guttmann, C. R. (2018). Changes to the septo-fornical area might play a role in the pathogenesis of anxiety in multiple sclerosis. Multiple Sclerosis Journal, 24(8), 1105-1114. https://doi.org/10.1177/1352458517711273
Palotai, Miklos ; Mike, Andrea ; Cavallari, Michele ; Strammer, Erzsebet ; Orsi, Gergely ; Healy, Brian C ; Schregel, Katharina ; Illes, Zsolt ; Guttmann, Charles Rg. / Changes to the septo-fornical area might play a role in the pathogenesis of anxiety in multiple sclerosis. In: Multiple Sclerosis Journal. 2018 ; Vol. 24, No. 8. pp. 1105-1114.
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abstract = "BACKGROUND: Reports on the relationships between white matter lesion load (WMLL) and fatigue and anxiety in multiple sclerosis (MS) are inconsistent.OBJECTIVE: To investigate the association of total and tract-specific WMLL with fatigue and anxiety.METHODS: Total and regional T2 WMLL was assessed for 19 tracts in 48 MS patients (30 females). ICBM-DTI-81 Atlas-based parcellation was combined with WMLL segmentation of T2-weighted magnetic resonance imaging (MRI). Fatigue, anxiety, and depression were assessed using Fatigue Impact Scale, State Trait Anxiety Inventory, and Beck Depression Inventory, respectively.RESULTS: Fatigue, anxiety, and depression showed significant inter-correlation. We found no association between fatigue and total or regional WMLLs, whereas anxiety was associated with total and regional WMLLs in nine tracts. After adjusting for total WMLL, age, and depression, only the column and body of the fornix (CBF) remained significantly associated with anxiety. Post hoc analyses showed no CBF lesions on T1-weighted MRI and suggested, but could not confirm, that the septum pellucidum might play a role in the pathogenesis of anxiety.CONCLUSION: Our results suggest that anxiety in MS patients may have a neuropathological substrate in the septo-fornical area, which requires further validation using larger sample size and ultra-high-field MRI in targeted prospective studies.",
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Palotai, M, Mike, A, Cavallari, M, Strammer, E, Orsi, G, Healy, BC, Schregel, K, Illes, Z & Guttmann, CR 2018, 'Changes to the septo-fornical area might play a role in the pathogenesis of anxiety in multiple sclerosis', Multiple Sclerosis Journal, vol. 24, no. 8, pp. 1105-1114. https://doi.org/10.1177/1352458517711273

Changes to the septo-fornical area might play a role in the pathogenesis of anxiety in multiple sclerosis. / Palotai, Miklos; Mike, Andrea; Cavallari, Michele; Strammer, Erzsebet; Orsi, Gergely; Healy, Brian C; Schregel, Katharina; Illes, Zsolt; Guttmann, Charles Rg.

In: Multiple Sclerosis Journal, Vol. 24, No. 8, 07.2018, p. 1105-1114.

Research output: Contribution to journalJournal articleResearchpeer-review

TY - JOUR

T1 - Changes to the septo-fornical area might play a role in the pathogenesis of anxiety in multiple sclerosis

AU - Palotai, Miklos

AU - Mike, Andrea

AU - Cavallari, Michele

AU - Strammer, Erzsebet

AU - Orsi, Gergely

AU - Healy, Brian C

AU - Schregel, Katharina

AU - Illes, Zsolt

AU - Guttmann, Charles Rg

PY - 2018/7

Y1 - 2018/7

N2 - BACKGROUND: Reports on the relationships between white matter lesion load (WMLL) and fatigue and anxiety in multiple sclerosis (MS) are inconsistent.OBJECTIVE: To investigate the association of total and tract-specific WMLL with fatigue and anxiety.METHODS: Total and regional T2 WMLL was assessed for 19 tracts in 48 MS patients (30 females). ICBM-DTI-81 Atlas-based parcellation was combined with WMLL segmentation of T2-weighted magnetic resonance imaging (MRI). Fatigue, anxiety, and depression were assessed using Fatigue Impact Scale, State Trait Anxiety Inventory, and Beck Depression Inventory, respectively.RESULTS: Fatigue, anxiety, and depression showed significant inter-correlation. We found no association between fatigue and total or regional WMLLs, whereas anxiety was associated with total and regional WMLLs in nine tracts. After adjusting for total WMLL, age, and depression, only the column and body of the fornix (CBF) remained significantly associated with anxiety. Post hoc analyses showed no CBF lesions on T1-weighted MRI and suggested, but could not confirm, that the septum pellucidum might play a role in the pathogenesis of anxiety.CONCLUSION: Our results suggest that anxiety in MS patients may have a neuropathological substrate in the septo-fornical area, which requires further validation using larger sample size and ultra-high-field MRI in targeted prospective studies.

AB - BACKGROUND: Reports on the relationships between white matter lesion load (WMLL) and fatigue and anxiety in multiple sclerosis (MS) are inconsistent.OBJECTIVE: To investigate the association of total and tract-specific WMLL with fatigue and anxiety.METHODS: Total and regional T2 WMLL was assessed for 19 tracts in 48 MS patients (30 females). ICBM-DTI-81 Atlas-based parcellation was combined with WMLL segmentation of T2-weighted magnetic resonance imaging (MRI). Fatigue, anxiety, and depression were assessed using Fatigue Impact Scale, State Trait Anxiety Inventory, and Beck Depression Inventory, respectively.RESULTS: Fatigue, anxiety, and depression showed significant inter-correlation. We found no association between fatigue and total or regional WMLLs, whereas anxiety was associated with total and regional WMLLs in nine tracts. After adjusting for total WMLL, age, and depression, only the column and body of the fornix (CBF) remained significantly associated with anxiety. Post hoc analyses showed no CBF lesions on T1-weighted MRI and suggested, but could not confirm, that the septum pellucidum might play a role in the pathogenesis of anxiety.CONCLUSION: Our results suggest that anxiety in MS patients may have a neuropathological substrate in the septo-fornical area, which requires further validation using larger sample size and ultra-high-field MRI in targeted prospective studies.

KW - Multiple sclerosis

KW - anxiety

KW - fatigue

KW - septo-fornical area

KW - white matter lesion load

U2 - 10.1177/1352458517711273

DO - 10.1177/1352458517711273

M3 - Journal article

C2 - 28548605

VL - 24

SP - 1105

EP - 1114

JO - Multiple Sclerosis Journal

JF - Multiple Sclerosis Journal

SN - 1352-4585

IS - 8

ER -