Modulation of alertness by sustained cognitive demand in MS as surrogate measure of fatigue and fatigability

Neumann, M; Sterr, Annette; Claros-Salinas, Dolores; Gütler, Rolf; Ulrich, Rolf; Dettmers, Christian

doi:10.1016/j.jns.2014.03.024

Cited by 50 publications

(48 citation statements)

References 14 publications

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“…Contrary to findings from previous fatigue studies in other disease conditions including chronic fatigue syndrome and multiple sclerosis [24, 25], perceived cognitive impairment in the participants with prostate cancer during radiation therapy in this study was not associated with reaction time or attention using the Stroop test, nor was it related to issues with verbal memory and working memory as measured by CAMCI®. This may be related to differences in severity or chronicity of the fatigue condition experienced by these clinical populations and the use of different instruments to measure cognitive function.…”

Section: Discussioncontrasting

confidence: 99%

“…Previous studies reported deficits in processing speed and attention associated with fatigue in patients with disorders including chronic fatigue syndrome and multiple sclerosis [24, 25]. Therefore, we hypothesized that changes in fatigue symptoms during EBRT would be related to changes in cognitive function as demonstrated by altered task performance reaction time and attention issues using the Computer Assessment of Mild Cognitive Impairment (CAMCI®) (Psychology Software Tools, Inc., Sharpsburg, PA, USA), which is a self-administered computer-based tool developed to measure cognitive function [26].…”

Section: Introductionmentioning

confidence: 99%

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Association of Fatigue Intensification with Cognitive Impairment during Radiation Therapy for Prostate Cancer

Feng

Espina

Saligan³

2018

Oncology

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Purpose: Cancer-related fatigue is a common complaint during cancer treatment and is often associated with cognitive impairment. This study examined cognitive deficits that were associated with fatigue symptoms during external-beam radiation therapy (EBRT) in men with localized prostate cancer. Methods: A total of 36 participants were enrolled and followed up at baseline, 24 h, 7 days, 14 days after EBRT initiation, at midpoint, and at completion of EBRT. Fatigue was measured by self-report using the Functional Assessment of Cancer Therapy – Fatigue (FACT-F), and cognitive impairment by the Computer Assessment of Mild Cognitive Impairment (CAMCI®). Results: Subjects with increased fatigue during EBRT reported a significant decline in cognitive function and had difficulties with CAMCI®’s route finding and item recall tasks during EBRT. Increased fatigue during EBRT was associated with perceived cognitive difficulties in executive function and recognition memory, but not with attention or verbal memory. Conclusions: Our results suggest that there might be specific cognitive domains that are associated with increased fatigue during EBRT. These findings will provide important information for targeting specific cognitive domains using pharmacotherapy or behavioral interventions. CAMCI® is a valuable tool for psycho social providers to detect subtle cognitive impairment in fatigued cancer patients in a clinical setting.

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Section: Discussioncontrasting

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Association of Fatigue Intensification with Cognitive Impairment during Radiation Therapy for Prostate Cancer

Feng

Espina

Saligan³

2018

Oncology

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“…Cognitive fatigability has been measured by alertness measurements or increasing reaction time in the course of the day [9] or after a standardized cognitive load [10]. Motor fatigability may be easier to diagnose than cognitive fatigability.…”

Section: Introductionmentioning

confidence: 99%

Fatigability Assessment Using the Fatigue Index Kliniken Schmieder (FKS) Is Not Compromised by Depression

Dettmers¹,

Riegger²,

Müller³

et al. 2016

Health

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Background: Attractor-based kinematic gait analysis using the Fatigue Index Kliniken Schmieder (FKS), have been suggested as a sensitive tool to determine motor fatigability in persons with Multiple Sclerosis (pwMS). Hypothesis: Depression does not affect the FKS to a similar degree as in pwMS. Methods: We recruited 32 patients with major depression. Data were collected with two accelerometers attached to both ankles. Data were recorded for one minute at the beginning and at the end of the treadmill test. Attractor attributes were used to analyze the data. Results: The mean Fatigue Index Kliniken Schmieder (FKS) was 2.1. The change of the attractor (δM) was 3.7 and the change of variability (δD) was 0.6. Mean values were clearly below values of pwMS with fatigability from a previous publication. However, the individual level values from six individuals-five of them showed pain related comorbidity besides depression-fell within the lower pathological range. There was no correlation between Hamilton depression scale and the attractor attributes (δM and δD). Discussion: Depression does not affect gait as motor fatigability does in pwMS.Results from subjects with pain during the treadmill test show a moderately increased variability and moderately altered attractors.

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“…We differentiate between the demanding or continuous cognitive task and the measure of fatigability used alongside this task. If we apply the definition of cognitive fatigability as a significant decline in processing speed, reaction time, or accuracy over time, after completing demanding cognitive tasks, 1,5 oOf the 21 studies outlined in Table 1, 9 eleven show support for proposed measures of cognitive fatigability 6,7,11,13,15,17,20,21,23 , indicated by an (*), next to the author's name, whilst 10 8 do not. 9,12,14,16,18,19,25,26 [ Table 1 Here]…”

Section: Introductionmentioning

confidence: 99%

“…Collectively, empirical studies to date show marked inconsistency in this regard, where some show significant small to moderate associations with self-reported fatigue 11,13,14,19,20,23,24 , and others demonstrate no, or inconsistent, relationships across different PROs or subscales 6,7,9,15,17,21 . In addition, Oonly four studies have specifically assessed self-reported cognitive fatigue in conjunction with cognitive fatigability outcomes, which in the majority of cases show relatively strong positive associations when compared to more general measures of self-reported fatigue 6,22,23,25 . The divergent correlational findings between measures of self-reported fatigue and cognitive fatigability across studies, and the differences between the magnitude of correlations between self-reported general and cognitive fatigue measures, have tended not to be explored further by most authors.…”

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confidence: 99%

Operationalising cognitive fatigability in multiple sclerosis: A Gordian knot that can be cut?

2016

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Background: Researchers have attempted to operationalise objective measures of cognitive fatigability in MS to overcome the perceived subjectivity of patient reported outcomes of fatigue (PROs). Measures of cognitive fatigability examine decrements in performance during sustained neurocognitive tasks.Objective: This editorial briefly summarises available evidence for measures of cognitive fatigability in MS and considers their overall utility.Results: Findings Studies suggest there may be a construct that is distinct from self-reported fatigue, reflecting a new potential intervention target. However, assessments vary and findings across and within measures are inconsistent. Few measures have been guided by a coherent theory, and those identified are likely to be influenced by other confounds, such as cognitive impairment caused more directly by disease processes, depression, and assessment biases.Conclusions: Future research may benefit from (a) developing a guiding theory of cognitive fatigability, (b) examining ecological and construct validity of existing assessments, and (c) exploring whether the more promising cognitive fatigability measures are correlated with impaired functioning after accounting for possible confounds. Given the issues raised, we caution that our purposes as researchers may be better served by continuing our search for a more objective cognitive fatigability construct that runs in parallel with improving, rather than devaluing, current PROs.

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Modulation of alertness by sustained cognitive demand in MS as surrogate measure of fatigue and fatigability

Cited by 50 publications

References 14 publications

Association of Fatigue Intensification with Cognitive Impairment during Radiation Therapy for Prostate Cancer

Association of Fatigue Intensification with Cognitive Impairment during Radiation Therapy for Prostate Cancer

Fatigability Assessment Using the Fatigue Index Kliniken Schmieder (FKS) Is Not Compromised by Depression

Operationalising cognitive fatigability in multiple sclerosis: A Gordian knot that can be cut?

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