MS is a complex disease that can have many symptoms. Fatigue is one of the most common symptoms, affecting up to 80% of people with MS and significantly affecting their quality of life.

Finding a way to treat fatigue is important but current approaches, both pharmacological and non-pharmacological, often have unsatisfactory results. This is partly due to a lack of understanding of exactly what causes fatigue in MS.

Researchers from Brazil studied brain atrophy (shrinking) in a group of people with MS who had mild disabilities, to assess the relationship between brain atrophy and MS fatigue.

They studied MRI scans from 49 people with relapsing-remitting MS and found that fatigue was common even in people who had mild disabilities or relatively short disease duration.

The severity of fatigue was strongly associated with depressive symptoms and lowered quality of life, but not with disease duration or age.

People with fatigue had global gray-matter atrophy (shrinking of a type of neural tissue found in the brain and spinal cord) which seems to be related to higher levels of physical disability. However, certain brain structures involved in effort-reward functions had more gray-matter atrophy in people with fatigue, regardless of physical disability and depressive symptoms.

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