Journal of Biomedical Physics and Engineering

Fatigue Prevalence and its Association with MRI Findings in Multiple Sclerosis: A Cross-Sectional Study

Articles in Press

Document Type : Original Research

Authors

Alireza Torabi-Jahromi 1, 2
Zahra Rastgoftar 2, 3
Banafsheh Zeinali-Rafsanjani 1
Behnam Dousty 1, 2
Forough Alizadeh 1
Mohammad Bagher Shamsodidni 1
Parisa Pishdad 1

1 Medical Imaging Research Center, Department of Radiology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran

2 Student Research Committee, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran

3 Otolaryngology Research Center, Department of Otolaryngology, Shiraz University of Medical Sciences, Shiraz, Iran

10.31661/jbpe.v0i0.2511-2012
Abstract
Background: Fatigue is a common and disabling symptom in Multiple Sclerosis (MS), yet its underlying mechanisms and neuroimaging findings remain unclear, particularly in understudied populations such as Iran.
Objective: This study aimed to determine the prevalence of fatigue in MS compared with healthy controls and to explore its associations with brain and spinal cord Magnetic Resonance Imaging (MRI) findings.
Material and Methods: In this cross-sectional study, 100 MS patients and 100 age- and sex-matched controls were enrolled. Fatigue was assessed using the Fatigue Assessment Scale (FAS). MRI data for MS patients, including lesion counts and volumetric measures, were analyzed using the volBrain platform. Statistical analyses (Mann-Whitney U, Kruskal-Wallis, and Spearman’s correlation) were performed using SPSS.
Results: Significant fatigue (FAS ≥22) was reported by 92% of MS patients (mean =29.55±4.41) versus 62% of controls. In MS patients, fatigue correlated positively with total lesion count (rho=0.203, P=0.043) and juxtacortical lesion count. No significant associations were found with brain volume, spinal lesions, or demographic variables. Cervical plaques were present in 85% of patients, but were not significantly linked to fatigue. 
Conclusion: Fatigue is highly prevalent and more severe in MS patients than in healthy individuals, correlating with total and juxtacortical lesion burden. These findings suggest a role for lesion load in MS-related fatigue and underscore the need for longitudinal and functional imaging studies to clarify its mechanisms and guide targeted interventions.

Keywords

Multiple Sclerosis
Fatigue
Magnetic Resonance Imaging
Lesion Burden, Brain
Journal of Biomedical Physics and Engineering

Articles in Press, Corrected Proof
Available Online from 08 July 2026

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