Current perspectives on the diagnosis and management of fatigue in multiple sclerosis

Marchesi, Olga; Vizzino, Carmen; Filippi, Massimo; Rocca, Maria

doi:10.1080/14737175.2022.2106854

Cited by 20 publications

(20 citation statements)

References 148 publications

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“…The symptom of fatigue is a signi cant lack of physical and/or mental energy that is perceived by the individual to interfere with usual or desired activity. It is a subjective feeling of physical, cognitive or psychosocial exhaustion and tiredness, which can be perceived by the patients at rest 33 . Fatigue in MS has a prevalence of up to 81% being more frequent in the progressive forms of disease 34 .…”

Section: Discussionmentioning

confidence: 99%

Dilatation of the Bridging Cerebral Veins in Multiple Sclerosis Correlates with Fatigue and Suggests an Increase in Pressure

Bateman

Lechner‐Scott

2022

Preprint

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There is a physiological similarity between the hydrodynamics of hydrocephalus and multiple sclerosis (MS). Children with hydrocephalus have been found to have a significant enlargement of the cortical veins within the subarachnoid space, suggesting an increase in venous pressure. The purpose of this study is to discover if there is dilatation of the veins within the subarachnoid space in multiple sclerosis and to estimate the pressures required to maintain any enlargement found. 103 patients with MS were compared with a control group of 50 patients. Post contrast 3DT1 images were used. The cross-sectional area of the bridging cortical veins and the vein of Galen were measured. In MS, the superficial territory cortical veins were 29% larger and the veins of Galen were 25% larger than the controls. There is evidence of a significant increase in the bridging vein transmural pressure in MS, estimated to be approximately 6.5 mmHg in the superficial cortical veins. MS patients with significant fatigue have larger cortical veins than those who are not significantly fatigued.

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Section: Discussionmentioning

confidence: 99%

Dilatation of the Bridging Cerebral Veins in Multiple Sclerosis Correlates with Fatigue and Suggests an Increase in Pressure

Bateman

Lechner‐Scott

2022

Preprint

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“…Fatigue is one of the most common and disabling multiple sclerosis (MS) symptoms, but has no effective treatment options. 1 A recent randomized, doubleblind, placebo-controlled crossover trial of the comparative effectiveness of commonly prescribed treatments for fatigue, including amantadine, modafinil, and methylphenidate, found no significant differences in mean Modified Fatigue Impact Scale (MFIS) score between these treatments and placebo. 2 A dietary intervention to improve fatigue in people with MS (PwMS) is highly desirable given the low risk of adverse events and the potential to improve other parameters of a person's health, such as body mass index (BMI) and metabolic profile.…”

Section: Introductionmentioning

confidence: 99%

“…Fatigue is one of the most common and disabling multiple sclerosis (MS) symptoms, but has no effective treatment options. 1 A recent randomized, double-blind, placebo-controlled crossover trial of the comparative effectiveness of commonly prescribed treatments for fatigue, including amantadine, modafinil, and methylphenidate, found no significant differences in mean Modified Fatigue Impact Scale (MFIS) score between these treatments and placebo. 2…”

Section: Introductionmentioning

confidence: 99%

A low-fat diet improves fatigue in multiple sclerosis: Results from a randomized controlled trial

Chase,

Chen,

Martin

et al. 2023

Mult Scler

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Background: Fatigue can be a disabling multiple sclerosis (MS) symptom with no effective treatment options. Objective: Determine whether a low-fat diet improves fatigue in people with MS (PwMS). Methods: We conducted a 16-week randomized controlled trial (RCT) and allocated PwMS to a low-fat diet (active, total daily fat calories not exceeding 20%) or wait-list (control) group. Subjects underwent 2 weeks of baseline diet data collection (24-hour diet recalls (24HDRs)), followed by randomization. The active group received 2 weeks of nutrition counseling and underwent a 12-week low-fat diet intervention. One set of three 24HDRs at baseline and week 16 were collected. We administered a food frequency questionnaire (FFQ) and Modified Fatigue Impact Scale (MFIS) every 4 weeks. The control group continued their pre-study diet and received diet training during the study completion. Results: We recruited 39 PwMS (20—active; 19—control). The active group decreased their daily caloric intake by 11% (95% confidence interval (CI): −18.5%, −3.0%) and the mean MFIS by 4.0 (95% CI: −12.0, 4.0) compared to the control (intent-to-treat). Sensitivity analysis strengthened the association with a mean MFIS difference of −13.9 (95% CI: −20.7, −7.2). Conclusions: We demonstrated a significant reduction in fatigue with a low-fat dietary intervention in PwMS.

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“…7 Research results show that 70%-90% of patients with MS suffer from fatigue. 8 Despite the medical advances in recent years, there is currently no definitive treatment for MS, and most of the existing treatment approaches only lead to reduced symptoms or shorten the course of the disease. Meanwhile, it seems that exercise can be used as a complementary treatment along with pharmaceutical approaches.…”

mentioning

confidence: 99%

“…This fatigue affects the movement and cognitive ability of the patient and can seem as a decrease in energy, feeling unwell, movement weakness, and difficulty in maintaining concentration 7 . Research results show that 70%–90% of patients with MS suffer from fatigue 8 …”

mentioning

confidence: 99%

The Effect of a Six-Week Sensory-Motor Exercise Program on the Balance and Fatigue Severity in Women With Multiple Sclerosis

Hashemi Rad,

Aghayari

2023

Am J Phys Med Rehabil

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ObjectiveThis study aimed to investigate the impact of 6 wks of at-home sensory-motor exercises on balance and fatigue levels in women with multiple sclerosis, a progressive autoimmune disease affecting the central nervous system. Multiple sclerosis symptoms can significantly reduce quality of life.DesignIn this quasi-experimental study, 26 female patients with multiple sclerosis aged 20–40 yrs with an expanded disability status scale of 0–4 were randomly assigned to control and experimental groups. The experimental group performed sensory-motor exercises for 6 wks, three sessions a week, and for 1 hr at home. Balance and fatigue were evaluated with Sharpened-Romberg tests (for static balance), a 6-step test of Get-Up and Go (for dynamic balance), and a Fatigue Severity Scale. At the end of the sixth week, these tests were re-evaluated like the pretest stage.ResultsExperimental group showed better static balance and Fatigue Severity Scale than control group, but no difference in dynamic balance.ConclusionsConsidering the outbreak of COVID-19 and the resultant lockdown, the importance of exercise and physical activities in patients with multiple sclerosis, and the positive effects of sensory-motor exercises at home in the present study, these kinds of sensory-motor workouts are highly recommended to improve balance and reduce the fatigue in patients with multiple sclerosis.

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Current perspectives on the diagnosis and management of fatigue in multiple sclerosis

Cited by 20 publications

References 148 publications

Dilatation of the Bridging Cerebral Veins in Multiple Sclerosis Correlates with Fatigue and Suggests an Increase in Pressure

Dilatation of the Bridging Cerebral Veins in Multiple Sclerosis Correlates with Fatigue and Suggests an Increase in Pressure

A low-fat diet improves fatigue in multiple sclerosis: Results from a randomized controlled trial

The Effect of a Six-Week Sensory-Motor Exercise Program on the Balance and Fatigue Severity in Women With Multiple Sclerosis

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