Regional brain atrophy in primary fatigued patients with multiple sclerosis

Primary fatigued patients with multiple sclerosis have extended regional atrophy of supratentorial brain parenchyma, involving the cerebral cortex, nearby white matter and the caudate head, areas which are functionally related to attentional control. We suggest that impaired central motor activation is due to interruption of the cortico-subcortical motor circuits involving the motor cortex.