Data from: Patients with primary biliary cholangitis and fatigue present with depressive symptoms and selected cognitive deficits, but with normal attention performance and brain structure

Background: In primary biliary cholangitis (PBC) fatigue is a major
clinical challenge of unknown etiology. By demonstrating that fatigue in
PBC is associated with an impaired cognitive performance, previous studies
have pointed out the possibility of brain abnormalities underlying fatigue
in PBC. Whether structural brain changes are present in PBC patients with
fatigue, however, is unclear. To evaluate the role of structural brain
abnormalities in PBC patients severely affected from fatigue we,
therefore, performed a case-control cerebral magnetic resonance imaging
(cMRI) study and correlated changes of white and grey brain matter with
the cognitive and attention performance. Methods: 20 female patients with
PBC and 20 female age-matched controls were examined in this study. The
assessment of fatigue, psychological symptoms, cognitive and attention
performance included clinical questionnaires, established cognition tests
and a computerized test battery of attention performance. T1-weighted cMRI
and diffusion tensor imaging (DTI) scans were acquired with a 3 Tesla
scanner. Structural brain alterations were investigated with voxel-based
morphometry (VBM) and DTI analyses. Results were correlated to the
cognitive and attention performance. Results: Compared to healthy
controls, PBC patients had significantly higher levels of fatigue and
associated psychological symptoms. Except for an impairment of verbal
fluency, no cognitive or attention deficits were found in the PBC cohort.
The VBM and DTI analyses revealed neither major structural brain
abnormalities in the PBC cohort nor correlations with the cognitive and
attention performance. Conclusions: Despite the high burden of fatigue and
selected cognitive deficits, the attention performance of PBC patients
appears to be comparable to healthy people. As structural brain
alterations do not seem to be present in PBC patients with fatigue,
fatigue in PBC must be regarded as purely functional. Future studies
should evaluate, whether functional brain changes underlie fatigue in PBC.