Editing Fatigue (section)

===Damage to brain white matter===
Studies have found [[Signs and symptoms of multiple sclerosis#Fatigue|MS fatigue]] correlates with damage to NAWM (normal appearing [[white matter]]) (which will not show on normal [[Magnetic resonance imaging|MRI]] but will show on [[Diffusion MRI|DTI (diffusion tensor imaging)]]).<ref>{{cite journal |last1=Palotai |first1=Miklos |last2=Guttmann |first2=Charles RG |title=Brain anatomical correlates of fatigue in multiple sclerosis |journal=Multiple Sclerosis Journal |date=June 2020 |volume=26 |issue=7 |pages=751–764 |doi=10.1177/1352458519876032 |pmid=31536461 }}</ref><ref name="pmid37180990"/><ref>{{cite journal |last1=Preziosa |first1=Paolo |last2=Rocca |first2=Maria A. |last3=Pagani |first3=Elisabetta |last4=Valsasina |first4=Paola |last5=Amato |first5=Maria Pia |last6=Brichetto |first6=Giampaolo |last7=Bruschi |first7=Nicolò |last8=Chataway |first8=Jeremy |last9=Chiaravalloti |first9=Nancy D. |last10=Cutter |first10=Gary |last11=Dalgas |first11=Ulrik |last12=DeLuca |first12=John |last13=Farrell |first13=Rachel |last14=Feys |first14=Peter |last15=Freeman |first15=Jennifer |last16=Inglese |first16=Matilde |last17=Meani |first17=Alessandro |last18=Meza |first18=Cecilia |last19=Motl |first19=Robert W. |last20=Salter |first20=Amber |last21=Sandroff |first21=Brian M. |last22=Feinstein |first22=Anthony |last23=Filippi |first23=Massimo |title=Structural and functional magnetic resonance imaging correlates of fatigue and dual-task performance in progressive multiple sclerosis |journal=Journal of Neurology |date=March 2023 |volume=270 |issue=3 |pages=1543–1563 |doi=10.1007/s00415-022-11486-0 |pmid=36436069 |hdl=10026.1/20405 |url=https://discovery.ucl.ac.uk/id/eprint/10171992/20/Chataway_JOON-D-22-02550.R1.pdf |hdl-access=free }}</ref><ref>{{cite journal |last1=Novo |first1=Ana Margarida |last2=Batista |first2=Sonia |last3=Alves |first3=Carolina |last4=d'Almeida |first4=Otília C. |last5=Marques |first5=Inês Brás |last6=Macário |first6=Carmo |last7=Santana |first7=Isabel |last8=Sousa |first8=Lívia |last9=Castelo-Branco |first9=Miguel |last10=Cunha |first10=Luís |title=The neural basis of fatigue in multiple sclerosis: A multimodal MRI approach |journal=Neurology Clinical Practice |date=December 2018 |volume=8 |issue=6 |pages=492–500 |doi=10.1212/CPJ.0000000000000545 |pmid=30588379 |pmc=6294533 }}</ref><ref>{{cite journal |last1=Bisecco |first1=Alvino |last2=Caiazzo |first2=Giuseppina |last3=d'Ambrosio |first3=Alessandro |last4=Sacco |first4=Rosaria |last5=Bonavita |first5=Simona |last6=Docimo |first6=Renato |last7=Cirillo |first7=Mario |last8=Pagani |first8=Elisabetta |last9=Filippi |first9=Massimo |last10=Esposito |first10=Fabrizio |last11=Tedeschi |first11=Gioacchino |last12=Gallo |first12=Antonio |title=Fatigue in multiple sclerosis: The contribution of occult white matter damage |journal=Multiple Sclerosis Journal |date=November 2016 |volume=22 |issue=13 |pages=1676–1684 |doi=10.1177/1352458516628331 |pmid=26846989 }}</ref><ref>{{cite journal |last1=Rocca |first1=Maria A. |last2=Parisi |first2=Laura |last3=Pagani |first3=Elisabetta |last4=Copetti |first4=Massimiliano |last5=Rodegher |first5=Mariaemma |last6=Colombo |first6=Bruno |last7=Comi |first7=Giancarlo |last8=Falini |first8=Andrea |last9=Filippi |first9=Massimo |title=Regional but Not Global Brain Damage Contributes to Fatigue in Multiple Sclerosis |journal=Radiology |date=November 2014 |volume=273 |issue=2 |pages=511–520 |doi=10.1148/radiol.14140417 |pmid=24927473 }}</ref> The correlation becomes unreliable in patients aged over 65 due to damage due to ageing.<ref>{{cite journal |last1=Muñoz Maniega |first1=Susana |last2=Chappell |first2=Francesca M |last3=Valdés Hernández |first3=Maria C |last4=Armitage |first4=Paul A |last5=Makin |first5=Stephen D |last6=Heye |first6=Anna K |last7=Thrippleton |first7=Michael J |last8=Sakka |first8=Eleni |last9=Shuler |first9=Kirsten |last10=Dennis |first10=Martin S |last11=Wardlaw |first11=Joanna M |title=Integrity of normal-appearing white matter: Influence of age, visible lesion burden and hypertension in patients with small-vessel disease |journal=Journal of Cerebral Blood Flow & Metabolism |date=February 2017 |volume=37 |issue=2 |pages=644–656 |doi=10.1177/0271678X16635657 |pmid=26933133 |pmc=5381455 }}</ref>