Brain mapping inflammatory arthritis related fatigue in the pursuit of novel therapeutics

Kristian Stefanov* (Corresponding Author), Salim al-Wasity, Joel Thomas Parkinson, Gordon Waiter, Jonathan Cavanagh, Neil Basu

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


Despite advances in pharmacological treatments, chronic fatigue remains an unresolved issue for most people with inflammatory arthritis, severely disrupting their personal and working lives. Their fatigue does not strongly link with peripheral disease activity, but instead, associates with central nervous system-derived symptoms like chronic pain, sleep disturbance and depression. Thus, a neurobiological basis should be considered when pursuing novel fatigue-specific therapeutics. In this review, we will first focus on clinical imaging biomarkers that map candidate brain regions, critical in fatigue pathophysiology. Then we will evaluate neuromodulation techniques that could affect these culprit brain regions, serving as potential treatment strategies for fatigue in inflammatory arthritis. We will conclude with what work still needs to be done for neuroimaging and neuromodulation to become a part of a future clinical pathway to treat and manage fatigue.
Original languageEnglish
Pages (from-to)e99-e109
Number of pages11
JournalThe Lancet Rheumatology
Issue number2
Early online date24 Jan 2023
Publication statusPublished - Feb 2023


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