Does fatigue occur in MS patients without disability?

Alvarenga-Filho, Hélcio; Alvarenga, Regina Maria Papais; Carvalho, Sónia; Clemente, Heleine Norman; Vasconcelos, Cláudia Cristina Ferreira; Dias, Ricardo Marques

doi:10.3109/00207454.2014.909415

Cited by 16 publications

(18 citation statements)

References 35 publications

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“…In our study we ob tained sim i lar re sults -27.9% of MS pa tients were de pressed. An as so ci a tion between fa tigue and de pres sion was found, sim i lar to the results ob tained in other stud ies that showed cor re la tion between de pres sion and fa tigue [33,34,36,37,40,41]. Depres sive symp toms in crease the fa tigue ei ther di rectly or as a re sult of its psy cho log i cal con se quences [42][43][44][45].…”

Section: Discussionsupporting

confidence: 85%

“…Neu ro log i cal dis abil ity mea sured by EDSS was also strongly re lated to fa tigue in other stud ies [30][31][32][33][34][35]. But there are stud ies which dem on strate that percep tion of fa tigue oc curs in MS in de pend ently of the neu rolog i cal im pair ment [36][37][38]. We should con sider that as sessing ce re bral func tional sys tem score which is a part of EDSS, fa tigue is al ready eval u ated on a scale from 0 to 3.…”

Section: Discussionmentioning

confidence: 91%

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Fatigue and associated factors in multiple sclerosis patients in Latvia

Setlere

Abelsen

Pastare

et al. 2018

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Background and objectives. Fatigue is one of the most common symptoms of multiple sclerosis (MS). The aim of this study was to determine the presence of fatigue in MS patients in Latvia and its relation to lifestyle factors, neurological disability and depression. Material and methods. This cross-sectional study included 117 participants (44 patients with MS and 73 healthy control group). Applied research instruments were: Expanded Disability Status Scale (EDSS), Patient Health Questionnaire (PHQ-9), Fatigue Severity Scale (FSS), and the general questionnaire for the collection of socio-demographic, lifestyle habits and clinical data constructed for the purposes of this study. Results. Mean FSS score was 3,9±1,9 in MS group. 26 (59,1%) patients had FSS score of 3,8 or more and were classified as a fatigue group (MSF) while 18 (40,9%) patients had FSS of 3,7 or less and were classified as a non-fatigue (MSNF) group. There was statistically significant difference between MSF and MSNF groups considering PHQ9 score (p=0,019), FSS score (p&lt;0,001) and EDSS score (p&lt;0,001). Significant correlations of fatigue with depression (r=0,48, p=0,001), fatigue with neurological disability (r=0,49, p=0,001) and fatigue with smoking (r=0,29, p=0,054) were confirmed. Conclusions. Fatigue is a common symptom in MS patients in Latvia. This study supports significant association between fatigue and clinical factors (disability, depression) and modifiable lifestyle factor – smoking.

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Section: Discussionsupporting

confidence: 85%

Section: Discussionmentioning

confidence: 91%

Fatigue and associated factors in multiple sclerosis patients in Latvia

Setlere

Abelsen

Pastare

et al. 2018

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“…The distanced walked by nonfatigued group was significantly higher than in fatigued group. Although some previous studies found no correlation between EDSS scores and the levels of perceived fatigue and that fatigue appears because of mood, sleep disorders, and low levels of physical activity in the absence of gait alterations (Alvarenga‐Filho et al, ). Further research on how to assess motor fatigue and on how to establish the reason why this may be related to neurological impairment and gait alterations in MS patients is required.…”

Section: Discussionmentioning

confidence: 92%

“…This may explain the differences observed in our study between the mild group and the healthy group. Nevertheless, other studies have not reported fewer distances walked during performance of the 6MWT in PwMS, and they suggest that this test is inappropriate for detecting or inducing motor fatigue in MS patients with EDSS ≈ 1 (Alvarenga‐Filho et al, ).…”

Section: Discussionmentioning

confidence: 99%

Gait pattern changes after six‐minute walk test in persons with multiple sclerosis

Escudero-Uribe

Hochsprung

Izquierdo-Ayuso

2018

Physiotherapy Res Intl

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“…Multiple sclerosis (MS) is a neurological disorder that compromises the integrity of signaling pathways in the central nervous system through chronic inflammatory responses and neurodegeneration ( Trapp and Nave, 2008 ). Although the clinical progression of MS varies widely between individuals ( Lublin and Reingold, 1996 ; Confavreux and Vukusic, 2006 ), one of the most common symptoms of the disease is a heightened level of fatigue ( Fisk et al, 1994 ; Alvarenga-Filbo et al, 2015 ; Loy et al, 2017 ; Penner and Paul, 2017 ), the underlying mechanisms of which are poorly understood.…”

Section: Introductionmentioning

confidence: 99%

Adjustments in Torque Steadiness During Fatiguing Contractions Are Inversely Correlated With IQ in Persons With Multiple Sclerosis

et al. 2018

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Fatigue is one of the most debilitating symptoms of multiple sclerosis (MS), and the underlying mechanisms are poorly understood. When exposed to a physical or cognitive challenge, individuals with MS tend to exhibit greater declines in task performance (performance fatigability) and increased levels of self-reported fatigue (perceived fatigability), but these effects may be attenuated by greater intellectual capacity. The purpose of our study was to examine the influence of intelligence on fatigability in persons with MS. We hypothesized that greater intellectual capacity confers some protection against heightened levels of fatigue and fatigability associated with MS. Twelve adults with relapsing-remitting MS were compared with 12 control (CO) subjects who were matched for age, sex, and premorbid intellectual capacity. Performance fatigability was measured as the decline in maximal voluntary contraction (MVC) torque after 60 isometric contractions (10 s contraction at 25% MVC, 5 s rest) performed with the knee extensor muscles. Perceived fatigability was assessed with the modified fatigue impact scale (MFIS) questionnaire (trait fatigability) and the Borg rating of perceived exertion (RPE, state fatigability). Persons with MS reported greater MFIS scores (MS: 43 ± 14; CO: 11 ± 8, P ≤ 0.001). Initial MVC torque for the knee extensors did not differ between the groups (MS: 112 ± 38 N⋅m; CO: 107 ± 44 N⋅m) and the decline (performance fatigability) was similar for both groups (MS: -16 ± 19 N⋅m; CO: -13 ± 16 N⋅m). RPE increased during the fatiguing contraction for both groups (P < 0.001) but was significantly greater in magnitude (main effect for group, P = 0.03) and increased more for the MS group (group × time interaction, P = 0.05). Torque steadiness declined during the fatiguing contractions (main effect for time, P = 0.05) and was less steady for the MS group (main effect for group, P = 0.02). Performance and full-4 IQ was correlated with the decline in torque steadiness for the MS group (r = -0.63, P < 0.05; r = -0.64, P < 0.05). Intellectual capacity was not associated with fatigability in persons with MS but was associated with adjustments in muscle activation during the fatiguing contractions.

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Does fatigue occur in MS patients without disability?

Abstract: Fatigue occurs in patients with MS in the absence of motor dysfunction and is associated with the disease itself, the sedentary lifestyle, and mood disorders. The 6MWT is not useful to demonstrate motor fatigue in subjects without neurological disability.

Cited by 16 publications

References 35 publications

Fatigue and associated factors in multiple sclerosis patients in Latvia

Fatigue and associated factors in multiple sclerosis patients in Latvia

Gait pattern changes after six‐minute walk test in persons with multiple sclerosis

Adjustments in Torque Steadiness During Fatiguing Contractions Are Inversely Correlated With IQ in Persons With Multiple Sclerosis

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