Poster 202: Decrease in Quality of Life in Multiple Sclerosis Patients with Vesicourethral and Sexual Dysfunction

Objective Sexual dysfunction (SD) severely affects the quality of life in patients with multiple sclerosis (MS). The aim of this study is to investigate the type and frequency of sexual complaints in MS patients, to analyse their relationship to various clinical and psychosocial variables and to clarify the differences between MS patients with and without SD. Methods Thirty-five relapsing-remitting (RR), nine secondary progressive and seven primary progressive MS patients were included in this study. A structured face-to-face interview regarding sexual function and other physical problems which may interfere with sexual functioning was administered to each patient. They also filled out Multiple Sclerosis Intimacy and Sexuality Questionnaire-19 (MSISQ-19), which includes items for primary (direct physical), secondary (indirect physical) and tertiary (psychosocial) causes of SD. Disability, cognitive functions and psychological functioning were also evaluated. Results Forty-one patients (80.4%) reported primary SD; decreased libido was the most frequent complaint (80.5%). These patients were older and more disabled, however 39% had low disability scores. SD was a common problem for both men and women. Patients with RRMS were affected less in all items of primary SD. Several items of secondary SD-problems with memory and concentration, bladder symptoms, bowel symptoms-showed correlation with different items of primary SD; these were altered genital sensation, decreased libido, increased time for arousal, decreased lubrication/difficulties with erection. Total MSISQ-19 scores were correlated with disease duration, age, disability, disease course, Beck depression scale, temporary and long-standing anxiety and low level of education. Conclusion SD is an underestimated, common symptom of MS. It may occur in MS even in the absence of severe disability. Physicians’ awareness of this problem may help to bring about appropriate treatments and management, and improve the quality of life for these patients.

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Quality of life in multiple sclerosis patients in Spain

Multiple Sclerosis Journal ◽

10.1191/1352458502ms851oa ◽

2002 ◽

Vol 8 (6) ◽

pp. 527-531 ◽

Cited By ~ 20

Author(s):

C-H Chang ◽

D Cella ◽

O Fernández ◽

G Luque ◽

P de Castro ◽

...

Keyword(s):

Quality Of Life ◽

Multiple Sclerosis ◽

Well Being ◽

Cross Sectional Study ◽

Self Report ◽

Regression Analyses ◽

Cross Sectional ◽

Scale Scores ◽

Multiple Sclerosis Patients

Objective: The cross-sectional study evaluated the psychometric properties of the Functional Assessment of Multiple Sclerosis (FAMS) Spanish version and its use in measuring quality of life (QOL) of multiple sclerosis (MS) patients in Spain. Methods: The FAMS is a factorially derived self-report scale designed to assess six primary aspects of QOL of patients with MS: Mobility, Symptoms, Emotional Well-Being, General Contentment, Thinking and Fatigue, and Family/Social Well-Being. Its Spanish translated version was used to assess QOL of 625 MS patients recruited in an outpatient clinic setting from 58 hospitals in Spain. Internal consistency of the Spanish FAMS was evaluated. Multiple regression analyses were performed to identify significant predictors from demographic, clinical and treatment characteristics, and Kurtzke Expanded Disability Status Scale (EDSS) scores in predicting FAMS scale scores. Results: Most of the patients are females (66%), and 74% were of the relapsing-remitting (RR) clinical subtype. Cronbach’s alpha coefficients were high (range=0.78-0.96), indicating subscale homogeneity comparable to that of the original English version. Linear multivariate regression analyses revealed that the EDSS is a dominant variable in predicting all the FAMS subscales, especially mobility (R2=0.51) and the total scores. Conclusions: The Spanish FAMS is a psychometrically valid instrument that allows clinicians and clinical researchers the ability to measure the QOL concerns of MS patients in Spain.

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Fatigue, mood and quality of life improve in MS patients after progressive resistance training

Multiple Sclerosis Journal ◽

10.1177/1352458509360040 ◽

2010 ◽

Vol 16 (4) ◽

pp. 480-490 ◽

Cited By ~ 129

Author(s):

U. Dalgas ◽

E. Stenager ◽

J. Jakobsen ◽

T. Petersen ◽

HJ Hansen ◽

...

Keyword(s):

Quality Of Life ◽

Multiple Sclerosis ◽

Resistance Training ◽

Beneficial Effect ◽

Control Group ◽

Progressive Resistance Training ◽

Multiple Sclerosis Patients ◽

Progressive Resistance

Fatigue occurs in the majority of multiple sclerosis patients and therapeutic possibilities are few. Fatigue, mood and quality of life were studied in patients with multiple sclerosis following progressive resistance training leading to improvement of muscular strength and functional capacity. Fatigue (Fatigue Severity Scale, FSS), mood (Major Depression Inventory, MDI) and quality of life (physical and mental component scores, PCS and MCS, of SF36) were scored at start, end and follow-up of a randomized controlled clinical trial of 12 weeks of progressive resistance training in moderately disabled (Expanded Disability Status Scale, EDSS: 3—5.5) multiple sclerosis patients including a Control group ( n = 15) and an Exercise group ( n = 16). Fatigue (FSS > 4) was present in all patients. Scores of FSS, MDI, PCS—SF36 and MCS—SF36 were comparable at start of study in the two groups. Fatigue improved during exercise by —0.6 (95% confidence interval (CI) —1.4 to 0.4) a.u. vs. 0.1 (95% CI —0.4 to 0.6) a.u. in controls ( p = 0.04), mood improved by —2.4 (95% CI —4.1 to 0.7) a.u. vs. 1.1 (—1.2 to 3.4) a.u. in controls ( p = 0.01) and quality of life (PCS—SF36) improved by 3.5 (95% CI 1.4—5.7) a.u. vs. —1.0 (95% CI —3.4—1.4) a.u. in controls ( p = 0.01). The beneficial effect of progressive resistance training on all scores was maintained at follow-up after further 12 weeks. Fatigue, mood and quality of life all improved following progressive resistance training, the beneficial effect being maintained for at least 12 weeks after end of intervention.

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The impact of sexual dysfunction on the quality of life measured by MSQoL-54 in patients with multiple sclerosis

Multiple Sclerosis Journal ◽

10.1177/1352458508093619 ◽

2008 ◽

Vol 14 (8) ◽

pp. 1131-1136 ◽

Cited By ~ 89

Author(s):

DK Tepavcevic ◽

J Kostic ◽

ID Basuroski ◽

N Stojsavljevic ◽

T Pekmezovic ◽

...

Keyword(s):

Quality Of Life ◽

Multiple Sclerosis ◽

Sexual Dysfunction ◽

Sexual Function ◽

Health Distress ◽

Pain Subscale ◽

Related Quality ◽

Vaginal Lubrication ◽

The Impact

Objective Sexual dysfunction (SD) is a common but often overlooked symptom in multiple sclerosis (MS). The aim of this study was to estimate the frequency, type, and intensity of SD in our patients with MS and to investigate its influence on all the domains of quality of life. Methods The study population comprised a cohort of 109 patients with MS (McDonald's criteria, 2001). SD was quantified by a Szasz sexual functioning scale. Health-related quality of life was measured by a disease-specific instrument MSQoL-54 (Serbian version). Results The presence of at least one symptom of SD was found in about 84% of the men and in 85% of the women. The main complaints in women were reduced libido, difficulties in achieving orgasm, and decreased vaginal lubrication; in men, the main complaints were reduced libido, incomplete erections, and premature ejaculation. In women, statistically significant negative correlations between the presence and level of SD and quality of life domains were reached for all subscales ( P < 0.01), except for the Pain subscale ( P = 0.112). In men, negative correlations were also observed for all domains, but they were statistically significant for physical health, physical role limitations, social function, health distress, sexual function, and sexual function satisfaction ( P < 0.01). We found that the presence of all the analyzed types of sexual problems statistically significantly lowered scores on the sexual function and the sexual function satisfaction subscales in both men and women ( P < 0.01). The most prominent impact on both domains was observed for the total loss of erection in men and for anorgasmia in women. Conclusions Our results reveal that frequent occurrence of SD in MS patients prominently affects all aspects of their quality of life.

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Memory performance in multiple sclerosis patients correlates with central brain atrophy

Multiple Sclerosis Journal ◽

10.1191/1352458506ms1286oa ◽

2006 ◽

Vol 12 (4) ◽

pp. 428-436 ◽

Cited By ~ 28

Author(s):

H Hildebrandt ◽

H K Hahn ◽

J A Kraus ◽

A Schulte-Herbrüggen ◽

B Schwarze ◽

...

Keyword(s):

Quality Of Life ◽

Multiple Sclerosis ◽

Brain Atrophy ◽

Motor Performance ◽

Memory Performance ◽

Cognitive Tests ◽

Duration Of Symptoms ◽

Central Brain ◽

Multiple Sclerosis Patients

Objective To assess whole brain and central brain atrophy as well as their differential relation to memory, cognitive performance, fatigue, depression and quality of life in patients with relapsingremitting multiple sclerosis (RRMS). Methods A 3D flow compensated gradient recalled T1-weighted MRI was acquired in 45 RRMS patients. An automated analysis tool was used to calculate brain parenchymal fraction (BPF) and ventricular brain fraction (VF). All patients were assessed with neuropsychological tests focusing on memory and self-rating scales for depression, fatigue and quality of life. Age corrected partial correlations between brain atrophy, motor performance, psychological scales and test scores were calculated. Results BPF correlated moderately (0.35≤r<0.5) with duration of symptoms and disease, the Expanded Disability Status Scale (EDSS), the upper extremity motor performance, and with mental aspects of quality of life. VF correlated moderately with EDSS, upper and lower extremity motor performance and memory functions. Neither BPF nor VF correlated with fatigue and depression. Results of several cognitive tests correlated moderately with depression and fatigue, the Paced Auditory Serial Addition Test (PASAT) showing the largest correlation. Conclusions Memory performance shows a correlation with relative ventricular size in RRMS patients, indicating the strategic location of the ventricle system along the structures of the limbic system and its vulnerability in MS. The PASAT and several other cognitive tests show moderate correlations with depression and fatigue, arguing for an inter relation between the cognitive functioning and the emotional state of patients. However, this relation is independent of measurable brain atrophy.

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Quality of life of multiple sclerosis patients with comorbid migraine

Neurological Sciences ◽

10.1007/s10072-011-0519-2 ◽

2011 ◽

Vol 32 (S1) ◽

pp. 149-151 ◽

Cited By ~ 8

Author(s):

Veronica Villani ◽

L. Prosperini ◽

C. Pozzilli ◽

M. Salvetti ◽

G. Sette

Keyword(s):

Quality Of Life ◽

Multiple Sclerosis ◽

Multiple Sclerosis Patients

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Prevalence of bladder, bowel and sexual problems among multiple sclerosis patients two to five years after diagnosis

Multiple Sclerosis Journal ◽

10.1177/1352458506071210 ◽

2007 ◽

Vol 13 (1) ◽

pp. 106-112 ◽

Cited By ~ 140

Author(s):

M W Nortvedt ◽

T Riise ◽

J Frugaård ◽

J Mohn ◽

A Bakke ◽

...

Keyword(s):

Quality Of Life ◽

Multiple Sclerosis ◽

Bowel Dysfunction ◽

Sexual Problems ◽

Health Related Quality ◽

Related Quality ◽

Bowel And Bladder Dysfunction ◽

Health Related ◽

Multiple Sclerosis Patients

Most multiple sclerosis (MS) patients experience some sexual, bladder and/or bowel dysfunction during the course of the disease - one of MS most disabling features. This study estimated the frequency of these problems among patients, two to five years after diagnosis, and investigated how these problems are associated with health-related quality of life (using the Multiple Sclerosis Quality of Life-54 questionnaire). The study population comprised a cohort of patients (n=56), diagnosed in a three-year period, in Hordaland County, Norway. The patients were examined clinically, including scoring of the Expanded Disability Status Scale (EDSS), and completed questionnaires related to bowel and bladder dysfunction, sexual problems and health-related quality of life. More than half the patients had bladder and sexual problems. The frequency of self-reported bladder problems corresponded to the relatively high levels of residual urine found. The presence of these problems was associated with lower scores on the quality of life scales. Further, the bowel problems reported were markedly associated with the quality of life scores. Since treatments and preventive strategies can manage many of these problems, we suggest increasing the focus on these aspects of the disease when consulting patients, including at early stages.

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