Atrophy in the right thalamus is strongly correlated with the severity of fatigue in patients with neuromyelitis optica spectrum disorder (NMOSD), a new study published in Scientific Reports found. The authors discovered that the local shape volume of the right thalamus could, therefore, serve as a biomarker of fatigue in these patients.

Fatigue is a major symptom of NMOSD but the underlying mechanism causing fatigue is not well understood. Here, a team of researchers from South Korea led by Ju‑Hong Min, MD, PhD, analyzed the relationship between subcortical structures and the severity of fatigue in patients with NMOSD to identify neural substrates of fatigue.

The team evaluated the clinical characteristics of 40 patients with NMOSD using brain magnetic resonance imaging (MRI). They assessed fatigue severity using the Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-fatigue) questionnaire.

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The results showed that 72.5% of patients analyzed experienced fatigue. The FACIT-fatigue score was negatively correlated with the Expanded Disability Status Scale and Beck Depression Inventory scores.

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The researchers also reported that they observed the right thalamus as being the only extracted region for various threshold experiments. Moreover, patients with more fatigue had decreased local shape volume in the right thalamus.

“Fatigue is common in patients with NMOSD, and atrophy in the right thalamus is strongly correlated with fatigue severity,” the researchers concluded. More longitudinal studies can help establish the role of MRI in predicting fatigue in patients with NMOSD.

NMOSD is a rare chronic autoimmune disease with a prevalence of 0.5 to 4 per 100,000. It is characterized by the presence of antibodies against the aquaporin-4 water channel. Symptoms include severe optic neuritis and attacks of persistent vomiting and hiccups., and fatigue can be a major burden for patients with NMOSD as with other neuroimmunological diseases.


Seok JM, Cho W, Son DH, et al. Association of subcortical structural shapes with fatigue in neuromyelitis optica spectrum disorder. Sci Rep. 2022;12(1):1579. doi:10.1038/s41598-022-05531-1