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Objective and Subjective Assessment of Fatigue in Multiple Sclerosis


   Post-graduate Research

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  Dr James Stone, Prof Mara Cercignani, Dr J Dekerle  No more applications being accepted  Funded PhD Project (UK Students Only)

Brighton United Kingdom Biophysics Medical Physics Psychology Physiology

About the Project

Fatigue is one of the key symptoms in Multiple Sclerosis that causes significant impairment to quality of life. This project will investigate the mechanisms of neuromuscular fatigue in MS combining quantitative MRI and neurophysiological techniques. Neuromuscular fatigue can have both peripheral and central origins. The central component can be measured by delivering a single supra-threshold transcranial magnetic stimulation (TMS) pulse over the point of maximal voluntary force. If the stimulus leads to greater force of muscular contraction than achieved with voluntary maximal contraction, it can be inferred that brain to muscle central drive is reduced. A mild reduction in central drive has been evidenced during physical exercise in healthy volunteers. It may be present at rest with greater impairment post-exercise in individuals with MS. In this study, the student will investigate this question with the addition of fMRI technique to this framework. The aims of the project are: 1) to develop methods to measure neuromuscular fatigue both in- and out of the MRI scanner; 2) to image maximal contraction and associated brain networks in healthy controls and patients with MS; 3) to investigate effect of physical exercise on both resting state activity and motor cortex glutamate (fMRI), and muscle fatigue and central drive (TMS) in patients with MS and controls; 4) to examine the above-mentioned fMRI and TMS-based measures with subjective fatigue in both populations. The student will have the opportunity to learn key techniques for neuroscience research as well as transferrable skills. Their contribution will include study design, patient recruitment, and data analysis. 


Funding Notes

Applicants should possess or expect to be awarded a minimum of a First or Upper Second Class Honours degree (or equivalent) in Neuroscience, Psychology, Biomedical Sciences or a relevant related subject. UK and EU or non-EU citizens can apply (home fees will be paid for UK citizens; non-UK citizens will be liable for the difference in fees between the home student and the overseas student rate). Informal enquiries should be directed to Dr James Stone ([Email Address Removed]). In order to apply please visit University of Brighton website. Please contact the BSMS Doctoral and Research Officer ([Email Address Removed]) to answer any queries.

References

1. Krupp L. Fatigue is intrinsic to multiple sclerosis (MS) and is the most commonly reported symptom of the disease. Mult Scler. 2006 Aug;12(4):367–8.
2. Bakshi R. Fatigue associated with multiple sclerosis: diagnosis, impact and management. Mult Scler. 2003 Jun;9(3):219–27.
3. Alvarenga-Filho H, Papais-Alvarenga RM, Carvalho SR, Clemente HN, Vasconcelos CC, Dias RM. Does fatigue occur in MS patients without disability? Int J Neurosci. 2015 Feb;125(2):107–15.
4. Honarmand K, Akbar N, Kou N, Feinstein A. Predicting employment status in multiple sclerosis patients: the utility of the MS functional composite. J Neurol. 2011 Sep 12;258(2):244–9.
5. Chalah MA, Riachi N, Ahdab R, Créange A, Lefaucheur J-P, Ayache SS. Fatigue in Multiple Sclerosis: Neural Correlates and the Role of Non-Invasive Brain Stimulation. Front Cell Neurosci. 2015 Jan;9:460.
6. Carroll TJ, Taylor JL, Gandevia SC. Recovery of central and peripheral neuromuscular fatigue after exercise. J Appl Physiol 2017 122: 1068–1076
7. Davranche K, Temesi J, Verges S, Hasbroucq T. Transcranial magnetic stimulation probes the excitability of the primary motor cortex: A framework to account for the facilitating effects of acute whole-body exercise on motor processes. J Sport Health Sci 2015, 4: 24-29
8. Micklewright D, St Clair Gibson A, Gladwell V, Al Salman A. Development and Validity of the Rating-of-Fatigue Scale. Sports Med. 2017 Nov;47(11):2375-2393.
9. Borg G. Borg’s Perceived Exertion and Pain Scales. Champaign, IL: Human Kinetics; 1998.
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