Fatigue in amyotrophic lateral sclerosis: Frequency and associated factors

Abstract

We aimed to quantify fatigue frequency and evolution in amyotrophic lateral sclerosis (ALS), and to correlate fatigue with factors such as age, sex, educational level, disease duration, functionality, quality of life, dyspnoea, depression and sleepiness. Sixty ALS patients (test group: TG) selected by El Escorial criteria and 60 normal individuals (control group: CG) matched according to sex and age, were followed every three months, during 9 months, by means of self-report scales: Fatigue Assessment Instrument (Fatigue Severity Scale plus three qualitative subscales); ALS Functional Rating Scale; McGill Quality of Life Questionnaire; dyspnoea analogical scale; Beck Depression Inventory and Epworth Sleepiness Scale. Fatigue was reported by 83% of TG (median: 3.6, interquartile range 1.5-5.4), compared with 20% of CG (median: 1, 1-1), and was significantly greater in the TG (p<0.001, Mann-Whitney test). Fatigue severity increased by the ninth month of the study (p=0.0008, Friedman, Müller-Dunn post test). There was no correlation between fatigue and other parameters, except for an inverse correlation with age at disease onset (p=0.0395, Spearman rank correlation). In conclusion, fatigue was frequent in ALS, greater in the youngest patients and worsened during follow-up. Possibly, ALS related fatigue is an independent factor, which deserves individualized approach and treatment.

Design requirements and potential target users for brain-computer interfaces – recommendations from rehabilitation professionals

“…[33] Second, many users would suffer from fatigue (e.g. users with ALS [34,35]), which could decrease efficient and satisfactory BCI use, leading to technology abandonment. Third, as many as 50-90% of people with Rett syndrome [36] and 25-50% of people with cerebral palsy have concurrent epileptic seizures [37,38] which may interfere with BCI use.…”

Symptom Management and End-of-Life Care in Amyotrophic Lateral Sclerosis

“…(43 Lou J-S 2003) Modafinil in doses ranging from 100 to 300 mg daily in a placebo controlled trial for 4 weeks resulted in a statistically significant improvement in the Clinical Global Impression score (the study’s primary endpoint) in 19/25 on active drug and in 1/7 on placebo (p=0.003) as well as improvement on the Visual Analogue Scale (VAS) for energy (p=0.039) and the VAS for stamina (p=0.009) but not in the Fatigue Severity Scale (p=0.066. (44 Rabkin 2009).…”

Palliative care for patients in the USA with amyotrophic lateral sclerosis: current challenges

“…[16][17][18] Fatigue is more than just feeling tired; fatigue has been described as feeling an overwhelming exhaustion, having a complete lack of energy. Fatigue in the ALS patient can be both generalized and muscle specific.…”