Qualitative and quantitative assessment of fatigue in multiple sclerosis (MS)

Abstract

It was the aim of the present study to develop a synoptic multidimensional test system for assessment of fatigue in multiple sclerosis (MS) patients objectifying physical and mental fatigue as well as the subjective and objective standpoint in these two fatigue forms. Seventy nine patients with relapsing remitting multiple sclerosis (RRMS) and 51 age-matched healthy controls (H) were analysed by means of the physical fatigue test (hand dynamometer) and an objective mental fatigue test (vigilance test from the computerised Test Battery for Attentional Performance). Furthermore, subjective tiredness caused by test procedures, subjective persisting tiredness (Modified Fatigue Impact Scale; MFIS: physical and cognitive scale) and mood (Beck Depression Inventory; BDI-18) were analysed.MS patients differed significantly from the controls in their objective physical and mental performance under fatigue, as well as in their subjective estimation of tiredness. MS patients showed an inverse relationship between below-average objective performance and high subjective feeling of tiredness when compared to controls. Subjectively severely tired MS patients achieved clearly poorer performances on the hand dynamometer test and slightly poorer performances on the vigilance test when compared to subjectively rarely tired MS patients. Depressed MS patients estimated their subjective tiredness in the MFIS significantly higher than non-depressed MS patients, but attained the same objective performance. This set of standardised tests enables meaningful comparisons between objective fatigue performance and subjective fatigue estimations in the physical and mental sphere and considers the influence of depression. Depression affects the subjective tiredness but not the objective fatigue performance.

Independent effect of fatigue on health-related quality of life in patients with idiopathic Parkinson’s disease

“…Fatigue is a subjective feeling of tiredness that can be alleviated by periods of rest [4,5]. It may be seen due to several diseases or idiopathically.…”

The dynamics of finger tremor in multiple sclerosis is affected by whole body position

“…Congruent with the contribution of fatigue to tremor differences between the MS and elderly subjects is that group differences were magnified when standing which is a more physically demanding task than sitting. A caveat to this suggestion of fatigue contributing to group tremor differences is that the experimentally induced fatigue examined by Morrison and colleagues [6,44] is most likely distinct from MS-related fatigue [38][39][40]. Unfortunately, no fatigue data were collected in the current investigation so no in-depth assessment of the association between fatigue and tremor dynamics was conducted.…”

“…Fatigue is a common symptom for persons with MS [38][39][40] and can negatively influence motor output [41,42]. Within the exercise literature, it has been reasonably well documented that fatigue typically leads to an increase in tremor amplitude [3,4,43].…”

The Relationship Between Fatigue and Depression in Multiple Sclerosis Patients

“…5 MS yorgunluğu, şiddeti, sıklığı, gün-lük yaşam aktivitelerine etkisi, dinlenme sonrası ya da sırasında uzun süre kaybolmayışı ile sağlıklı bireylerin tanımladığı yorgunluktan ayrılmaktadır. 6 Sağlıklı kontrollerle karşılaştırıldığında MS hastaları, ısı ve fiziksel aktivite ile ağırlaşan ve gün boyunca kötüleşebilen, daha sık ve şiddetli yorgunluktan bahsetmektedir. 7 MS hastalarının aile yaşamları, sosyal ve profesyonel aktiviteleri bu yorgunluktan ileri derecede etkilenmektedir.…”