Fatigue, emotional functioning, and executive dysfunction in pediatric multiple sclerosis

Holland, Alice Ann; Graves, Donna; Greenberg, Benjamin; Harder, Lana

doi:10.1080/09297049.2012.748888

Cited by 40 publications

(49 citation statements)

References 70 publications

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“…6,[40][41][42] However, there was some evidence to suggest that fatigued caMS have impaired performance on some individual cognitive tasks, particularly motor-based tasks such as the Trail Making Test A and B, and on tasks requiring prolonged and complex mental activity, such as problem solving, complex attention and processing speed, and language comprehension tasks. 6,33 At present, the evidence does not substantially support a relationship between fatigue and any specific domain of cognitive functioning. Rather, it appears that fatigued patients may exhibit worse performance on prolonged tasks of executive functioning that may be particularly tiresome or effortful.…”

Section: Summary Of Evidencementioning

confidence: 94%

“…Parent-reports of their offspring's general fatigue ranged from 27% to 63%, sleep/rest fatigue from 35% to 63%, and cognitive fatigue from 23% to 76%. Parent and self-reports of fatigue were discordant in three out of four studies, 6,7,33 with a tendency for parents to report greater or more severe fatigue than caMS themselves.…”

Section: Overview Of Fatiguementioning

confidence: 99%

“…In contrast, no relationships were identified between parent-reported fatigue and performance on the Trail Making Test A, or between any measure of self-or parent-reported fatigue and working memory, sustained attention, and mental manipulation assessed on the Wechsler Intelligence Scale for Children4th Edition Digit Span Test, or verbal fluency measured by the Letter Fluency Subtest of the Delis-Kaplan Executive Function System. 33 In an unpublished study, Canas 38 reported no associations between fatigue and any domain of cognitive functioning at baseline, but reported that greater baseline fatigue predicted decreased performance on the Trail Making Test A and verbal learning at 14-month follow-up. However, with only 20 participants, this study was underpowered for the number of analyses run and number of predictor variables assessed; thus a relationship between fatigue and impaired performance on these tasks cannot be concluded.…”

Section: Fatigue and Neurocognitive Functioningmentioning

confidence: 99%

“…Two studies administered an extensive neuropsychological battery, 6,[40][41][42] whereas another study administered a brief neuropsychological battery using different tests. 33 This limited the extent to which patterns could be identified across studies with respect to the relationship between fatigue and specific domains of cognitive functioning.…”

Section: Fatigue and Neurocognitive Functioningmentioning

confidence: 99%

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Understanding fatigue in paediatric multiple sclerosis: a systematic review of clinical and psychosocial factors

Carroll

Chalder

Hemingway

et al. 2015

Develop Med Child Neuro

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AIM Fatigue in children and adolescents with multiple sclerosis (caMS) is currently poorly understood. This review aimed to provide greater insight into this area and direction for future research by evaluating evidence of associations between fatigue and clinical, psychological, and social factors in caMS.METHOD Studies were identified by searching online databases, hand-searching reference lists, and requesting unpublished literature from key authors. Studies that examined fatigue in relation to at least one clinical, psychological, or social factor in caMS were included. Data on design, sample characteristics, measures of fatigue, clinical, psychological, and social variables, and key findings were extracted. Twelve studies were narratively synthesized.RESULTS Clinical factors appeared largely unrelated to fatigue, whereas associations between fatigue and tests of neurocognitive functioning, and fatigue and diagnosable psychiatric disorders, were mixed. However, fatigue and depressed mood consistently correlated. A small number of studies indicated associations between fatigue and reduced quality of life and school performance.INTERPRETATION A sufficient explanatory model of fatigue in caMS is lacking as studies in this area are few and diverse. Future research should endeavour to identify potentially modifiable clinical and psychosocial factors that are associated with fatigue in caMS so that interventions targeting such factors may be developed.Multiple sclerosis is a chronic neurodegenerative disorder characterized by inflammation and demyelination in the central nervous system, most often diagnosed in adulthood. 1 In rare cases, multiple sclerosis is diagnosed in childhood or adolescence.2 Paediatric acquired demyelinating syndromes, including paediatric multiple sclerosis, have an incidence rate of approximately 1 in 100 000. 3 In adult multiple sclerosis, sensory and motor impairments, optic neuritis, and bladder and bowel dysfunction are among the most common physical symptoms. In paediatrics, physical symptoms are less predominant but cognitive deficits more troublesome, typically affecting attention and processing speed, language, memory, and visuomotor functioning. [4][5][6] Moreover, psychosocial factors such as depression, lower quality of life, and fatigue are concerning features of paediatric multiple sclerosis, yet these features have received limited research attention to date. 6,7 Fatigue is the most common and one of the most disabling symptoms of multiple sclerosis, experienced by around 80% of adults with the disease. [8][9][10] Multiple sclerosis-related fatigue refers to a severe and overwhelming feeling of exhaustion and lack of energy, which may result in functional impairment.11 A growing body of evidence suggests that fatigue is also a significant problem in paediatric populations, affecting approximately 30% of the general adolescent population and a substantial proportion of children and adolescents with chronic illnesses such as cancer, rheumatoid arthritis, chronic pain, and neur...

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Section: Summary Of Evidencementioning

confidence: 94%

Section: Overview Of Fatiguementioning

confidence: 99%

Section: Fatigue and Neurocognitive Functioningmentioning

confidence: 99%

Section: Fatigue and Neurocognitive Functioningmentioning

confidence: 99%

See 2 more Smart Citations

Understanding fatigue in paediatric multiple sclerosis: a systematic review of clinical and psychosocial factors

Carroll

Chalder

Hemingway

et al. 2015

Develop Med Child Neuro

View full text Add to dashboard Cite

show abstract

“…[22][23][24][25] Uniform sensitive assessment measures and longer periods of follow-up in large patient samples could clarify issues pertinent to rate of decline, relative risk factors, and effects on academic function. Psychosocial difficulties are frequent and contribute to cognitive dysfunction: fatigue is reported in 20%-50%, depression varies from 6% to 30%, [26][27][28][29][30] and other psychiatric disorders such as anxiety can also occur. 31 Fatigue and depression can impair the child's academic and daily functioning and quality of life.…”

mentioning

confidence: 99%

International Pediatric MS Study Group Global Members Symposium report

et al. 2016

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The International Pediatric Multiple Sclerosis Study Group held its inaugural educational program, "The World of Pediatric MS: A Global Update," in September 2014 to discuss advances and challenges in the diagnosis and management of pediatric multiple sclerosis (MS) and other neuroinflammatory CNS disorders. Highlights included a discussion on the revised diagnostic criteria, which enable the differentiation of MS, acute disseminated encephalomyelitis, neuromyelitis optica, and other neuroinflammatory disorders. While these criteria currently identify clinical and MRI features for a particular diagnosis, advances in biomarkers may prove to be useful in the future. An update was also provided on environmental factors associated with pediatric MS risk and possibly outcomes, notably vitamin D deficiency. However, optimal vitamin D intake and its role in altering MS course in children have yet to be established. Regarding MS outcomes, our understanding of the cognitive consequences of early-onset MS has grown. However, further work is needed to define the course of cognitive function and its long-term outcome in diverse patient samples and to develop strategies for effective cognitive rehabilitation specifically tailored to children and adolescents. Finally, treatment strategies were discussed, including a need to consider additional drug treatment options and paradigms (escalation vs induction), although treatment should be tailored to the individual child. Of critical importance, clinical trials of newer MS agents in children are required. Although our understanding of childhood MS has improved, further research is needed to have a positive impact for children and their families. Neurology ® 2016;87 (Suppl 2):S110-S116 GLOSSARY ADEM 5 acute disseminated encephalomyelitis; ADS 5 acute demyelinating syndrome; AQP4 5 aquaporin-4; CI 5 confidence interval; CIS 5 clinically isolated syndrome; DMT 5 disease-modifying treatment; EDSS 5 Expanded Disability Status Scale; EMA 5 European Medicines Agency; FDA 5 Food and Drug Administration; IPMSSG 5 International Pediatric MS Study Group; MOG 5 myelin oligodendrocyte glycoprotein; MS 5 multiple sclerosis; NMO 5 neuromyelitis optica; NMOSD 5 neuromyelitis optica spectrum disorder; RDA 5 Recommended Dietary Allowance.Advances in our understanding of epidemiology, pathogenesis, and treatment in multiple sclerosis (MS) have been rapid in the last few years and will have a positive effect for children with the disease. Such progress in the diagnosis and management of pediatric MS and neuroinflammatory disorders includes the following:1. Revised diagnostic criteria for MS, acute disseminated encephalomyelitis (ADEM), and neuromyelitis optica (NMO) across the age spectrum. 2. Improved understanding of the cognitive consequences of MS onset during childhood. 3. Additional drug treatment options, including immunosuppressant, immunomodulatory, and oral medications, and awareness of the need for clinical trials of these agents in children.

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Chronisch entzündliche ZNS-Erkrankungen

Bigi

Chan

2023

Transition Bei Neurologischen Erkrankungen

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Fatigue, emotional functioning, and executive dysfunction in pediatric multiple sclerosis

Cited by 40 publications

References 70 publications

Understanding fatigue in paediatric multiple sclerosis: a systematic review of clinical and psychosocial factors

Understanding fatigue in paediatric multiple sclerosis: a systematic review of clinical and psychosocial factors

International Pediatric MS Study Group Global Members Symposium report

Chronisch entzündliche ZNS-Erkrankungen

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