Cognitive and Physical Fatigue in Multiple Sclerosis: Relations Between Self-Report and Objective Performance

AbstractRecently, there has been renewed interest in the study of cognitive fatigue. It is known that fatigue is one of the most disabling symptoms in numerous neurological populations, including stroke, multiple sclerosis, Parkinson's disease, and traumatic brain injury. Behavioral studies of cognitive fatigue are hampered by lack of correlation of self-report measures with objective performance. Neuroimaging studies provide new insight about cognitive fatigue and its neural correlates. Impairment within the cortico-striatal network, involved in effort–reward calculation, has been suggested to be critically related to fatigue. The current review surveys the recent neuroimaging literature, and suggests promising avenues for future research. (JINS, 2013, 19, 1–5)

Download Full-text

Effect of Self - Care Program on the Self- Esteem of Multiple Sclerosis Patients

European Psychiatry ◽

10.1016/s0924-9338(09)71173-3 ◽

2009 ◽

Vol 24 (S1) ◽

pp. 1-1

Author(s):

H. Madani ◽

H. Navipoor ◽

P. Roozbayani

Keyword(s):

Multiple Sclerosis ◽

Self Care ◽

Care Program ◽

Self Esteem ◽

The Self ◽

Self Report ◽

The Mean ◽

Muscular Spasm ◽

Multiple Sclerosis Patients ◽

Paired T Test

Aims:According to decreased self- esteem in multiple sclerosis (MS) patients, it is necessary to utilize appropriate methods in order to improve self- esteem in MS patients. So this study was conducted on patients with MS supported by the Iranian MS society for determining the effect of self - care program on their self- esteem.Method:In this semi - experimental study 34 patients with MS who were not in the acute phase of disease were selected. The data were collected via personal questionnaires, problem list, Cooper and smith standard questionnaire for self- esteem and self report check lists. Self - care program(self - care for muscular spasm, fatigue, constipation and amnesia and …) was educated, then it was performed for one month period and the data were analyzed using paired t- test, wilcoxon, croscal - wallis and manwithney tests.Results:Application of self - care program improve the self- esteem and reduced some symptoms such as muscular spasm, fatigue, constipation and amnesia in MS patients. The mean valve of self- esteem increased from 54 before performing the program to 68 after the program ( p < 0.05).Conclusion:Using self-care program can be an effective method for improving self- esteem of MS patients.

Download Full-text

Evaluation of the six-minute walk in multiple sclerosis subjects and healthy controls

Multiple Sclerosis Journal ◽

10.1177/1352458507082607 ◽

2008 ◽

Vol 14 (3) ◽

pp. 383-390 ◽

Cited By ~ 342

Author(s):

Myla D Goldman ◽

Ruth Ann Marrie ◽

Jeffrey A Cohen

Keyword(s):

Multiple Sclerosis ◽

Short Form ◽

Intraclass Correlation ◽

Rest Period ◽

Practice Effect ◽

Physical Component Score ◽

Physical Fatigue ◽

Subjective Measures ◽

Impact Scale ◽

Fatigue Impact Scale

Objective To assess the characteristics of the 6-min walk (6MW) in multiple sclerosis (MS) subjects of varied disability, and controls. To assess the correlation of 6MW to subjective measures of fatigue, health status and ambulation using the modified fatigue impact scale (MFIS), short form-36 Health Questionnaire physical component score and MS walking scale (MSWS). Methods Forty MS expanded disability status scale [(EDSS) 0—6.5] and 20 control subjects were recruited from a MS outpatient clinic. Subjects completed survey material and three 6MWs with 1-h interval rest in a single study visit. Results There was no practice effect or fatigability with repeat 6MW tests with a one-h rest period between test sessions. The 6MW had excellent intra-[intraclass correlation coefficient (ICC) = 0.95] and inter-rater (ICC = 0.91) reliability. MS subjects demonstrated reduced 6MW distance and speed compared with controls ( P < 0.0001). Within the MS population 6MW distance was significantly reduced with increasing disability ( P = 0.05). Compared with the EDSS, the 6MW had a stronger correlation to subjective measures of ambulation and physical fatigue: MSWS ( r = -0.81 versus 0.69) and MFISphy (0.66 versus 0.63). Conclusions The 6MW is a feasible, reproducible, and reliable measure in MS. MS subjects demonstrate motor fatigue in both 6MW distance and speed compared with controls. In MS subjects there is an inverse relationship between motor fatigue and disability. 6MW has a strong correlation to subjective measures of ambulation and physical fatigue. Multiple Sclerosis 2008; 14: 383—390. http://msj.sagepub.com

Download Full-text

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.

Download Full-text

Feasibility and Acceptability of Self-Report and Biologically Measured Energy Intake in Adults With Multiple Sclerosis

Archives of Physical Medicine and Rehabilitation ◽

10.1016/j.apmr.2021.01.035 ◽

2021 ◽

Vol 102 (4) ◽

pp. e11

Author(s):

Stephanie Silveira ◽

Barbara Gower ◽

Tapan Mehta ◽

Brenda Jeng ◽

Robert Motl

Keyword(s):

Multiple Sclerosis ◽

Energy Intake ◽

Self Report ◽

Measured Energy

Download Full-text

Validation of the NARCOMS Registry: pain assessment

Multiple Sclerosis Journal ◽

10.1191/1352458505ms1167oa ◽

2005 ◽

Vol 11 (3) ◽

pp. 338-342 ◽

Cited By ~ 28

Author(s):

Ruth Ann Marrie ◽

Gary Cutter ◽

Tuula Tyry ◽

Olympia Hadjimichael ◽

Timothy Vollmer

Keyword(s):

Multiple Sclerosis ◽

Convergent Validity ◽

Disease Duration ◽

Self Report ◽

Research Committee ◽

Retest Reliability ◽

The North ◽

Disability Status ◽

Pain Question ◽

Test Retest Reliability

The North American Research Committee on Multiple Sclerosis (NARCOMS) Registry is a multiple sclerosis (MS) self-report registry with more than 24 000 participants. Participants report disability status upon enrolment, and semi-annually using Performance Scales (PS), Patient Determined Disease Steps (PDDS) and a pain question. In November 2000 and 2001, we also collected the Pain Effects Scale (PES). Our aim was to validate the NARCOMS pain question using the PES as our criterion measure. We measured correlations between the pain question and age, disease duration, various PS subscales and PDDS to assess construct validity. We correlated pain question responses in participants who reported no change in PDSS or the PS subscales between questionnaires to determine test—retest reliability. We measured responsiveness in participants who reported a substantial change in the sensory, spasticity PS subscales. The correlation between the pain question and PES was r=0.61 in November 2000, and r=0.64 in November 2001 (both P<0.0001). Correlations between the pain question and age, and disease duration were low, indicating divergent validity. Correlations between the pain question and spasticity, sensory PS subscales and PDSS were moderate, indicating convergent validity. Test—retest reliability was r=0.84 (P<0.0001). Responsiveness was 70.7%. The pain question is a valid self-report measure of pain in MS.

Download Full-text

Lower self-report fatigue in multiple sclerosis is associated with localized white matter tract disruption between amygdala, temporal pole, insula, and other connected structures

Multiple Sclerosis and Related Disorders ◽

10.1016/j.msard.2018.11.005 ◽

2019 ◽

Vol 27 ◽

pp. 298-304 ◽

Cited By ~ 5

Author(s):

Tom A. Fuchs ◽

Caila B. Vaughn ◽

Ralph H.B. Benedict ◽

Bianca Weinstock-Guttman ◽

Sanjeevani Choudhery ◽

...

Keyword(s):

Multiple Sclerosis ◽

White Matter ◽

Self Report ◽

White Matter Tract ◽

Temporal Pole

Download Full-text

Transcutaneous tibial nerve stimulation for the treatment of bladder storage symptoms in people with multiple sclerosis: Protocol of a single-arm feasibility study

HRB Open Research ◽

10.12688/hrbopenres.13107.1 ◽

2020 ◽

Vol 3 ◽

pp. 66

Author(s):

Hawra B. Al Dandan ◽

Rose Galvin ◽

Katie Robinson ◽

Dorren McClurg ◽

Susan Coote

Keyword(s):

Multiple Sclerosis ◽

Nerve Stimulation ◽

Tibial Nerve ◽

Randomised Trial ◽

Self Report ◽

Urinary Symptoms ◽

Lower Urinary Tract Dysfunction ◽

Convenience Sample ◽

Tibial Nerve Stimulation ◽

Qualitative Interview Study

Background: Neurogenic lower urinary tract dysfunction (NLUTD) is common among people with multiple sclerosis (MS) with a pooled prevalence of 68.41% using self-report measures and 63.95% using urodynamic studies. Transcutaneous tibial nerve stimulation (TTNS) is a non-invasive option to manage bladder storage symptoms; however, the potential efficacy of TTNS among people with MS is based on a small number of studies with the absence of high-quality evidence relating to efficacy, and lack of clarity of the optimal electrical stimulation parameters and frequency, duration and number of treatment sessions. This study aims to assess whether TTNS is feasible and acceptable as a treatment for bladder storage symptoms in people with MS. Methods: We will use a single-arm experimental study to explore the feasibility and acceptability of TTNS in the treatment of bladder storage symptoms in MS. The CONSORT extension for pilot and feasibility studies will be followed to standardise the conduct and reporting of the study. The recruitment plan is twofold: 1) Open recruitment for people with MS through MS Ireland’s communication channels; 2) recruitment from a convenience sample of people with MS who have previously participated in a qualitative interview study of urinary symptoms. We will assess recruitment/retention rates, the urinary symptoms changes and the effect on quality of life pre and post intervention using ICIQ-OAB, 3-day bladder diary, King’s Health Questionnaire and collect self-reported data on adherence and adverse events. Acceptability of using TTNS will be evaluated at the end of intervention. This study has been reviewed and approved by the Education and Health Science’s Faculty Research Ethics Committee, University of Limerick [2020_06_07_EHS]. Conclusion: It is anticipated that assessing the feasibility and acceptability of TTNS for storage bladder symptoms in MS will inform the development of a definitive randomised trial. Trial registration: ClinicalTrials.gov NCT04528784 27/08/2020

Download Full-text

Validation of Discrete and Regression-Based Performance and Cognitive Fatigability Normative Data for the Paced Auditory Serial Addition Test in Multiple Sclerosis

Frontiers in Neuroscience ◽

10.3389/fnins.2021.730817 ◽

2021 ◽

Vol 15 ◽

Author(s):

Caitlin S. Walker ◽

Jason A. Berard ◽

Lisa A. S. Walker

Keyword(s):

Multiple Sclerosis ◽

Normative Data ◽

Cognitive Effort ◽

Similar Proportion ◽

Healthy Controls ◽

Performance Decrement ◽

Impaired Performance ◽

Objective Performance ◽

Serial Addition ◽

Over Time

Cognitive fatigability is an objective performance decrement that occurs over time during a task requiring sustained cognitive effort. Although cognitive fatigability is a common and debilitating symptom in multiple sclerosis (MS), there is currently no standard for its quantification. The objective of this study was to validate the Paced Auditory Serial Addition Test (PASAT) discrete and regression-based normative data for quantifying performance and cognitive fatigability in an Ontario-based sample of individuals with MS. Healthy controls and individuals with MS completed the 3″ and 2″ versions of the PASAT. PASAT performance was measured with total correct, dyad, and percent dyad scores. Cognitive fatigability scores were calculated by comparing performance on the first half (or third) of the task to the last half (or third). The results revealed that the 3″ PASAT was sufficient to detect impaired performance and cognitive fatigability in individuals with MS given the increased difficulty of the 2″ version. In addition, using halves or thirds for calculating cognitive fatigability scores were equally effective methods for detecting impairment. Finally, both the discrete and regression-based norms classified a similar proportion of individuals with MS as having impaired performance and cognitive fatigability. These newly validated discrete and regression-based PASAT norms provide a new tool for clinicians to document statistically significant cognitive fatigability in their patients.

Download Full-text

Effect of COVID-19 Lockdown on Patients with Multiple Sclerosis: an Italian Survey

10.47363/jnrrr/2021(3)138 ◽

2021 ◽

pp. 1-7

Author(s):

Marta Altieri ◽

◽

Mariangela Fratino ◽

Flavia Pauri ◽

Antonella Conte ◽

...

Keyword(s):

Multiple Sclerosis ◽

Family Caregiving ◽

Social Life ◽

Negative Impact ◽

Self Report ◽

Psychological Status ◽

Control Group ◽

Clinical Effects ◽

Future Expectations ◽

The Impact

Background: Italy was one of the first affected countries by coronavirus disease 2019 (COVID-19) pandemic. Public health measures like quarantine or national lockdown were adopted, with negative psychological and clinical effects on patients with chronic diseases. To investigate the impact of lockdown on patients with multiple sclerosis (MS), we developed a 36 items self-report questionnaire. Methods: Questionnaires were emailed to 120 patients with MS and 100 with chronic migraine (CM) as a control group, matched for age, sex, and education. The questionnaire was divided into five domains, evaluating concerns about 1) MS and therapy during COVID-19 pandemic, 2) personal and family caregiving, 3) working activities, 4) general and disease-related emotions during the lockdown, 5) future expectations concerning health status, social life, and working activity. Results: patients with MS had higher scores than those with CM in domains 4 and 5, investigating respectively general and disease-related emotions and future expectations (p= 0.05 and 0.02 respectively). About half of the patients with MS expressed some concern about the need to continue their therapy during the pandemic compared to people with CM (p= 0.0002). Conclusions: Covid-19 pandemic had a more negative impact on psychological status of patients with MS compared with those with CM

Download Full-text