Fatigue in multiple sclerosis

Journal of the Neurological Sciences, 2012

Fatigue is the most common and debilitating symptom in multiple sclerosis (MS) and is believed to be distinctly different from fatigue seen in other chronic conditions. It can affect a patient's mood, sleep and have a detrimental effect on their quality of life. In the recent years much literature has emerged in an attempt to elucidate the potential causes and treatment of this common symptom. This review article aims to examine the most recent theories on the pathophysiology of fatigue in MS as well as its association with sleep and depression. We describe the pharmacological and non-pharmacological approaches to its treatment and propose a multidisciplinary, patient enabled and individualised manner to the management of fatigue in MS.

Journal of Neurology, 2001

Physical medicine and rehabilitation clinics of North America, 2005

Fatigue is a significant factor in the lives of many MS patients and the most commonly reported symptom in many studies. Fatigue is an important symptom to consider because it affects patients' social lives, occupations, and activities of daily living. Efforts to predict fatigue have been mixed, but it appears to be related to overall quality of life and mood. From a pathophysiologic perspective, fatigue in MS is multifactorial and complex,involving dysregulation of the immune system, changes in the nervous system related to the disease process, neuroendocrine and neurotransmitter changes, and other factors such as physical deconditioning, sleep disturbance, pain, and medication side effects. Various attempts to assess fatigue have been made, and many measures are now available for use in clinical practice and research. In clinical practice, these measures help guide treatment considerations. Recent research has provided valuable strategies to ameliorate fatigue in MS, and altho...

Health and Quality of Life Outcomes, 2008

Background: Fatigue is a common disabling symptom of multiple sclerosis (MS) and has a significantly negative impact on quality of life. Persons with MS enrolled in the North American Research Committee on Multiple Sclerosis (NARCOMS) Patient Registry are invited to complete follow-up surveys every six months to update their original registration information. One of these surveys was designed to focus on the severity and impact of fatigue, and its association with other clinical parameters of MS such as physical disability.

Frontiers in Neurology, 2014

Fatigue is one of the most common symptoms of multiple sclerosis. Despite advances in pharmacological and non-pharmacological treatment, fatigue continues to be the disabling symptom in persons with MS (pwMS), affecting almost 80% of pwMS. In current practice, both pharmacological and non-pharmacological interventions are used in combination, encompassing a multi-disciplinary approach. The body of research investigating the effect of these interventions is growing. This review systematically evaluated the existing evidence on the effectiveness and safety of different interventions currently applied for the management of fatigue in person with multiple sclerosis in improving patient outcomes, to guide treating clinicians.

Neurology International Open

One of the most frequent symptoms in multiple sclerosis (MS) is fatigue. It has a major impact on quality of life as well as on professional activity. Even nowadays it is still unclear what constitutes an adequate assessment of the perceived fatigue.The following overview will discuss different possibilities to assess fatigue with the help of questionnaires, clinical interviews or the objective measurement of cognitive performance. Furthermore, a structured guideline for the assessment of fatigue will be proposed. Clinical criteria for MS related fatigue include the main symptoms, their everyday relevance, the possible causal relation with the cause of disease (the underlying MS), as well as an exclusion of other possible somatic or psychological reasons. It is recommended to use the “Würzburger Erschöpfungs-Inventar bei Multipler Sklerose (WEIMUS)” (English: Würzburg Fatigue Inventory for Multiple Sclerosis) and especially the “Fatigue Scale for Motor and Cognitive Functions” (FSMC...

mechanisms have been proposed, but none of them fully explains the fatigue occurrence, underlying its complexity (Iriarte et al 2000). Recent studies highlight the role of axonal damage in the pathogenesis of cerebral atrophy and fatigue (Boërio et al 2006; Induruwa et al 2012). The relationship between depression and fatigue has been also postulated (Pittion-Vouyovitch et al, 2000; Motl et al 2012). Fatigue represents a major disabling symptom, affecting the quality of life of MS patients (Pittion-Vouyovitch et al 2000). It is defined as a decrease in physical and /or psychological energy, perceived by the patient as interfering with his normal activities (Mills et al 2011). Being a subjective symptom, its evaluation is difficult and variable interpreted (Flachenecker et al 2002; Chahin et al 2015). There are several rating scales that quantify the severity and impact of fatigue on daily physical, cognitive and psychosocial activities (Krupp et al 1989; Fisk et al 1994; Iriarte et al 1999), mostly being self-assessment questionnaires.

Physical Therapy Reviews, 2007

Fatigue is a multidimensional and multifactorial symptom experienced in many neurological and non-neurological conditions. Fatigue in these conditions may be affected by pathophysiological, psychological and pharmacological factors which, in turn, may impact upon physical, cognitive and psychosocial domains leading to activity restriction and disability. This narrative review compares and contrasts prevalence, pathophysiology, contributing factors and the subjective experience of fatigue in four chronic health conditions; multiple sclerosis (MS), Parkinson's disease, cancer and human immunovirus/autoimmune deficiency syndrome. Whilst all conditions share certain factors, some aspects of fatigue may be unique to each condition. In addition, the mechanisms of fatigue may be particularly complex in multiple sclerosis. It is recommended that the nature of MS-related fatigue is explored in depth through qualitative methodology in order to inform future quantitative investigation and to refine current measurement scales which may fail to capture all aspects of this phenomenon.

Neurorehabilitation and Neural Repair, 2007

Sciendo, 2023

Introduction. Fatigue is a complex and often debilitating symptom of multiple sclerosis (MS), affecting a large number of individuals with the condition. Research has shown that fatigue and impaired mobility are the two main causes of work loss in people with MS, with fatigue being one of the leading causes of unemployment. Aim. The research aimed to study the impact of fatigue on individuals with MS, including its effects on physical functioning, daily life activities, work, family, and social life. Material and method. The data was collected using the Fatigue Assessment Scale, a tool specifically designed for individuals with multiple sclerosis to assess the impact of fatigue on their work, home, and school life. The Fatigue Severity Scale measures fatigue levels, which distinguishes fatigue from clinical depression due to overlapping symptoms. Approximately 700 participants from all over the world participated in the study, with the majority coming from the USA, Canada, and Germany. Results. The results indicate that fatigue presents a significant challenge for individuals with MS, impacting activities of daily life including leisure, work, and treatment (kinesitherapy). The results also show a connection between gender and fatigue, although the dependence or independence between the two was not determined. Our findings suggest that fatigue is one of the three symptoms that causes significant difficulties for people with MS, affecting all areas of their functionality. Conclusions. In conclusion, this scientific paper highlights the importance of addressing fatigue in individuals with MS, as it can have a significant impact on their quality of life. Effective management strategies are essential to ensure the health, well-being, and recovery of affected SM patients. Further research is needed to understand the various causes of fatigue in MS and to develop effective interventions to address it.