Fatigue in Multiple Sclerosis: Mechanisms, Evaluation, and Treatment

Abstract

Among patients with multiple sclerosis (MS), fatigue is the most commonly reported symptom, and one of the most debilitating. Despite its high prevalence and significant impact, fatigue is still poorly understood and often under-emphasized because of its complexity and subjective nature. In recent years, an abundance of literature from specialists in sleep medicine, neurology, psychiatry, psychology, physical medicine and rehabilitation, and radiology have shed light on the potential causes, impact, and treatment of MS-related fatigue. Though such a diversity of contributions clearly has advantages, few recent articles have attempted to synthesize this literature, and existing overviews have focused primarily on potential causes of fatigue rather than clinical evaluation or treatment. The aims of this review are to examine, in particular for sleep specialists, the most commonly proposed primary and secondary mechanisms of fatigue in MS, tools for assessment of fatigue in this setting, and available treatment approaches to a most common and challenging problem.

Development and Feasibility of an Evidence-Based Patient Education Program for Managing Fatigue in Multiple Sclerosis

“…In the following practical part of each session, participants try out newly acquired strategies. At the end, the homework for the next session is explained (only in sessions [1][2][3][4][5].…”

“…1 Fatigue is a common symptom that 75% to 95% of patients struggle with at some point in the course of the disease. 2 Many patients consider fatigue to be their most disabling symptom, even more so than weakness or pain. 3 Fatigue is a com-after 6 months.…”

Quality of Life-Spasticity-Fatigue Score in Patients With Multiple Sclerosis and Serum Vitamin D Level

“…The most commonly proposed primary mechanisms of fatigue in MS involve the immune system or sequelae from CNS damage. Specific causes are thought to include proinflammatory cytokines, endocrine influences, axonal loss, and altered patterns of cerebral activation [35].…”

Zespół zmęczenia, depresja oraz jakość życia u pacjentów ze stwardnieniem rozsianym

“…In MS we distinguish central fatigue that is a feeling of weariness due to demyelination in central nervous system and peripheral fatigue that is muscle fatigue caused by neuromuscular transmission disorder [4]. Fatigue can also be categorized as primary, resulting from pathophysiology of the disease and secondary, as an effect of sleep disorder, pain, stress, depression or other concomitant diseases [5,6]. Fatigue affects three areas of functioning: physical, psychosocial and cognitive [7].…”