Cognitive Fatigability, not Fatigue predicts employment status in patients with MS three months after rehabilitation

Dettmers, Christian; Marchione, Sina; Weimer-Jaekel, A.; Godde, Benjamin; Joebges, Michael

doi:10.1016/j.msard.2021.103215

Cited by 9 publications

(10 citation statements)

References 24 publications

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“…MS-fatigue is a multifactorial construct that requires assessment of other inter-related constructs. 7 This will include measures of cognitive (Test Battery of Attention Performance -Alertness 36 ) and motor fatigability (6 min Walk Test, Distance Walked Index 37 ), cognitive performance (California Verbal Learning Test, Symbol Digit Modalities Test 26 38 ) and CRF (GXT on a cycle ergometer, protocol: start 25W, progression 10 W/min). Dynamic balance and motor function (Timed 25-Foot Walk Test, 39 Six Spot Step Test (SSST), 40 Functional Gait Assessment (FGA) 41 ) will also be assessed as well as self-reported balance confidence (Activities-specific Balance Confidence scale 42 ).…”

Section: Discussionmentioning

confidence: 99%

Randomised controlled pilot and feasibility study of multimodal agility-based exercise training (MAT) versus strength and endurance training (SET) to improve multiple sclerosis-related fatigue and fatigability during inpatient rehabilitation (ReFEx): study protocol

Wolf

Nielsen

Saliger³

et al. 2022

BMJ Open

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IntroductionSubjective fatigue and objectively assessed fatigability are common symptoms in persons with multiple sclerosis (pwMS). Recent work has suggested a positive effect of balance and motor control training (BMCT) in reducing fatigue. It is unclear whether this effect can also be attained during inpatient rehabilitation. Multimodal agility-based exercise training (MAT) has been developed as a framework that incorporates BMCT with added agility components but has not been applied to pwMS. Therefore, this study will evaluate the feasibility of a randomised controlled trial comparing MAT against strength and endurance training (SET) for the improvement of MS-related fatigue and fatigability in a German neurological rehabilitation centre.Methods and analysisA total of 24 pwMS (Expanded Disability Status Scale ≤5.0, Fatigue Scale for Motor and Cognitive Functions ≥53) will be randomly assigned to either SET or land and water-based MAT for 4–6 weeks during inpatient rehabilitation. Assessments of subjective fatigue, motor and cognitive fatigability, cognitive and cardiorespiratory performance, and balance confidence will be performed at admission and discharge. Subjective fatigue will also be assessed at 1, 4 and 12 weeks after discharge. Feasibility outcomes will include patients’ acceptance of study procedures and interventions, recruitment rate, retention rate, time needed to complete baseline assessments, intervention adherence and fidelity. All quantitative outcomes will be reported descriptively. A total of 12 pwMS (6 per group) will be interviewed to gain insights into participants’ experiences during study participation.Ethics and disseminationEthical approval has been obtained from the Ethics Committee of the University of Bonn (reference number: 543/20). Dissemination of findings is planned via peer-reviewed journals, conferences and media releases.Trial registration numberDRKS00023943.

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Section: Discussionmentioning

confidence: 99%

Randomised controlled pilot and feasibility study of multimodal agility-based exercise training (MAT) versus strength and endurance training (SET) to improve multiple sclerosis-related fatigue and fatigability during inpatient rehabilitation (ReFEx): study protocol

Wolf

Nielsen

Saliger³

et al. 2022

BMJ Open

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“…This is supported by studies showing that the individual's cognitive performance, as well as the subjective feeling of momentary exhaustion, uctuates signi cantly during the day, typically peeking in the late afternoon (Claros-Salinas et al, 2010; Powell et al, 2017). Additionally, Dettmers et al (2021) recently reported that cognitive fatigability rather than subjective fatigue predicts the employment status of pwMS. Thus, cognitive fatigue is characterized by subjective and objective changes.…”

Section: Introductionmentioning

confidence: 85%

Effects of repetitive twice-weekly tDCS stimulations on fatigue and fatigability in people with multiple sclerosis

Linnhoff

Haghikia

Zaehle

2022

Preprint

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Fatigue is associated with a dramatically decreased quality of life in people with multiple sclerosis (pwMS). It refers to a constant subjective feeling of exhaustion and a performance decline, known as fatigability. However, inconsistency and heterogeneity in defining and assessing fatigue have led to limited advances in understanding and treating MS-associated fatigue. Transcranial direct current stimulation (tDCS) has emerged as a promising, non-pharmaceutical treatment strategy for subjective fatigue. However, whether repetitive tDCS also have long-term effects on time-on-task performance has not yet been investigated. Thus, this pseudorandomized, single-blinded, and sham-controlled study aimed to investigate tDCS effects on behavioral and electrophysiological parameters. PwMS received eight twice-weekly 30-minute tDCS stimulations over the left dorsolateral prefrontal cortex. Fatigability was operationalized as time-on-task-related changes in reaction time variability and P300 amplitude. Additionally, subjective trait and state fatigue ratings were assessed. The results revealed a significant tDCS effect on subjective trait fatigue ratings that lasted at least four weeks after the stimulations. However, the ratings declined after both anodal and sham tDCS. No effects were found on subjective state fatigue and objective fatigability parameters. Linear Mixed Models and Bayesian Regression models likewise favored the absence of a tDCS effect on fatigability parameters. Our results confirm the complex relationship between MS-associated fatigue and fatigability. Reliable and clinically relevant parameters need to be established to extend the potential of tDCS for treating fatigability. Furthermore, our results indicate that consecutive stimulations rather than twice-weekly stimulations should be the preferred stimulation scheme in future studies.

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“…nachweisbaren Minderung der motorischen und/oder kognitiven Performance [ 18 ]. Dabei korreliert eine messbare Fatigability offensichtlich auch mit relevanten Funktionsbeeinträchtigungen [ 12 ].…”

Section: Begutachtung Neurologisch-psychiatrisch Relevanter Post-covi...unclassified

Neurologisch-psychiatrische Begutachtung des Post-COVID-Syndroms

2022

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ZusammenfassungInfektionen mit dem „severe acute respiratory syndrome coronavirus 2“ (SARS-CoV-2) können zu einer Multiorganerkrankung und in der Folge zu sehr unterschiedlichen klinischen Manifestationen der „coronavirus disease 2019“ (COVID-19) führen. Neben akuten Symptomen kommt den Langzeitbeschwerden im Kontext der Infektion vermehrte Aufmerksamkeit zu, man spricht vom Long- oder Post-COVID-Syndrom. Mit Blick auf die Sozialversicherungssysteme werden gutachterliche Beurteilungen solcher Gesundheitsprobleme zunehmend an Bedeutung gewinnen, wobei neurologische und psychiatrische Symptome die häufigsten Beschwerden sind. Neben rechtlichen Grundlagen der medikolegalen Begutachtung mit Schwerpunkt auf der gesetzlichen Unfallversicherung werden in der vorliegenden Übersicht grundlegende Aspekte der Begutachtung diskutiert und Orientierungshilfen für die Begutachtung der häufigsten neurologischen und psychiatrischen Symptome des Post-COVID-Syndroms geboten.

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Cognitive Fatigability, not Fatigue predicts employment status in patients with MS three months after rehabilitation

Cited by 9 publications

References 24 publications

Randomised controlled pilot and feasibility study of multimodal agility-based exercise training (MAT) versus strength and endurance training (SET) to improve multiple sclerosis-related fatigue and fatigability during inpatient rehabilitation (ReFEx): study protocol

Randomised controlled pilot and feasibility study of multimodal agility-based exercise training (MAT) versus strength and endurance training (SET) to improve multiple sclerosis-related fatigue and fatigability during inpatient rehabilitation (ReFEx): study protocol

Effects of repetitive twice-weekly tDCS stimulations on fatigue and fatigability in people with multiple sclerosis

Neurologisch-psychiatrische Begutachtung des Post-COVID-Syndroms

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