scholarly journals THE EFFECT OF CHEMOKINE CXCL-13 ON THE CLINICAL AND FUNCTIONAL STATUS OF PATIENTS WITH MULTIPLE SCLEROSIS IN REMISSION

2019 ◽  
Vol 19 (1S) ◽  
pp. 117-119
Author(s):  
N V Sursiakova ◽  
E M Kuklina ◽  
T V Baidina ◽  
I V Nekrasova
Keyword(s):  
Multiple Sclerosis ◽  
Functional State ◽  
Venous Blood ◽  
Prognostic Significance ◽  
Multiple Sclerosis Functional Composite ◽  
Healthy Donors ◽  
Impact Scale ◽  
Clinical And Functional Status ◽  
Fatigue Severity

Introduction. CXCL-13 can be involved in the development of MS, and its level in peripheral blood may have diagnostic and / or prognostic significance. The purpose of this study is to assess the level of CXCL-13 in serum and its relationship with the clinical and functional state of patients with remitting MS in remission. Materials and methods. The study involved 67 patients (28 men and 39 women) with a relapsing MS in remission. All patients were examined by scales and questionaries EDSS, Multiple Sclerosis Functional Composite, Multiple Sclerosis Impact Scale 29, Fatigue Severity Scale. On the day of the clinical examination venous blood samples were taken from patients and healthy donors, serum was isolated, and the level of CXCL-13 was assessed by enzyme immunoassay method. Results and discussion. It was revealed that CXCL-13 in the serum in patients with MS was significantly lower than in healthy volunteers. A relationship was found between serum CXCL-13 and the severity of neurological deficit according to EDSS, with walking speed of 25 feet, with an assessment of the quality of life and fatigue. Conclusions. Despite the association of CXCL-13 with the clinical and functional state of MS patients, at present time this chemokine cannot be considered to be a diagnostic or prognostic marker in MS patients.

scholarly journals Functional Electrical Stimulation Cycling Exercise in People with Multiple Sclerosis

2019 ◽  
Vol 21 (6) ◽  
pp. 258-264 ◽  
Author(s):  
Lara A. Pilutti ◽  
Thomas Edwards ◽  
Robert W. Motl ◽  
Emerson Sebastião
Keyword(s):  
Multiple Sclerosis ◽  
Electrical Stimulation ◽  
Cognitive Processing ◽  
Cycling Exercise ◽  
Impact Scale ◽  
Leg Cycling ◽  
Related Quality ◽  
Health Related ◽  
Fatigue Severity

Abstract Background: Functional electrical stimulation (FES) cycling is an advanced rehabilitation modality that involves systematic mild electrical stimulation of focal muscle groups to produce leg cycling movement against an adjustable work rate. The present study reports on the efficacy of an assessor-blinded, pilot randomized controlled trial of supervised FES cycling exercise in people with multiple sclerosis (MS) on secondary trial outcomes, including cognition, fatigue, pain, and health-related quality of life. Methods: Eleven adult participants with MS were randomized to receive FES cycling exercise (n = 6) or passive leg cycling (n = 5) for 24 weeks. Cognitive processing speed was assessed using the Symbol Digit Modalities Test. Symptoms of fatigue and pain were assessed using the Fatigue Severity Scale, the Modified Fatigue Impact Scale, and the short-form McGill Pain Questionnaire. Physical and psychological health-related quality of life were assessed using the 29-item Multiple Sclerosis Impact Scale. Results: Eight participants (four, FES; four, passive leg cycling) completed the intervention and outcome assessments. The FES cycling exercise resulted in moderate-to-large improvements in cognitive processing speed (d = 0.53), fatigue severity (d = −0.92), fatigue impact (d = −0.45 to −0.68), and pain symptoms (d = −0.67). The effect of the intervention on cognitive performance resulted in a clinically meaningful change, based on established criteria. Conclusions: We provide preliminary evidence for the benefits of FES cycling exercise on cognition and symptoms of fatigue and pain. Appropriately powered randomized controlled trials of FES cycling exercise are necessary to determine its efficacy for people with MS.

scholarly journals Quality of life in multiple sclerosis: The differential impact of motor and cognitive fatigue

2021 ◽  
Vol 7 (1) ◽  
pp. 205521732199604
Author(s):  
Sabina David Ruban ◽  
Claudia Christina Hilt ◽  
Thor Petersen
Keyword(s):  
Quality Of Life ◽  
Multiple Sclerosis ◽  
Short Form ◽  
Cross Sectional Study ◽  
University Hospital ◽  
Cognitive Fatigue ◽  
Cross Sectional ◽  
Impact Scale ◽  
Assessment And Treatment

Background Multiple sclerosis is a chronic disease leading to reduced quality of life. Objectives To investigate whether motor and cognitive fatigue impact differently on aspects of quality of life among patients with multiple sclerosis, independently from bodily disability. Methods 79 patients with multiple sclerosis from Aalborg University Hospital, Denmark were included in an observational, cross-sectional study. Each subject completed two separate questionnaires regarding fatigue (Fatigue Scale for Motor and Cognitive Functions and Modified Fatigue Impact Scale) and one regarding quality of life (Short Form 36). Disability was measured with the Expanded Disability Status Scale (EDSS)-scores obtained from patient records. Results All fatigue scores were significantly correlated to all areas of quality of life (p < 0,05). This remained significant after adjustment for age, disease duration and EDSS-score. When looking at each type of fatigue separately, cognitive fatigue correlated mainly with mental health aspects of quality of life and motor fatigue with physical health areas of quality of life. Conclusion Increased motor and cognitive fatigue lead to a differential reduction in physical and mental quality of life, independently of bodily disability. This underlines the importance of proper assessment and treatment of fatigue among patients with multiple sclerosis.

scholarly journals The effect of functional limitations and fatigue on the quality of life in people with multiple sclerosis

2009 ◽  
Vol 67 (3b) ◽  
pp. 812-817 ◽  
Author(s):  
Leandro Alberto Calazans Nogueira ◽  
Felipe Resende Nóbrega ◽  
Kátia Nogueira Lopes ◽  
Luiz Claudio Santos Thuler ◽  
Regina Maria Papais Alvarenga
Keyword(s):  
Quality Of Life ◽  
Multiple Sclerosis ◽  
Functional Limitations ◽  
Case Series ◽  
Lower Limbs ◽  
Case Series Study ◽  
Modified Ashworth Scale ◽  
Mild Disability ◽  
Fatigue Severity

The purpose of this study was to determine the effect of functional limitations and fatigue on the quality of life (QoL) in people with multiple sclerosis (MS). A descriptive case series study at Lagoa Hospital - Rio de Janeiro, Brazil was carried. The main outcome measurements were demographic variables, QoL (SF-36 v.1), disability (EDSS), motor function of the upper limb (Box & Blocks test), Tone (Modified Ashworth Scale), gait (Hauser ambulatory index) and fatigue (Fatigue Severity Scale). Sixty one patients fulfilled the study criteria. The mean age of patients was 39 years and 74% of patients were female. The most of cases presented mild disability (EDSS<3.5). A decrease was found in all domains of QoL. It was found association between physical functioning and the variables of EDSS, fatigue, lower limb tone and gait. Gait, disability, hypertonia of the lower limbs and fatigue negatively affected QoL in people with MS.

Comparing the effects of multi-session anodal trans-cranial direct current stimulation of primary motor and dorsolateral prefrontal cortices on fatigue and quality of life in patients with multiple sclerosis: a double-blind, randomized, sham-controlled trial

2020 ◽  
Vol 34 (8) ◽  
pp. 1103-1111
Author(s):  
Marzieh Mortezanejad ◽  
Fatemeh Ehsani ◽  
Nooshin Masoudian ◽  
Maryam Zoghi ◽  
Shapour Jaberzadeh
Keyword(s):  
Quality Of Life ◽  
Multiple Sclerosis ◽  
Prefrontal Cortex ◽  
Direct Current ◽  
Dorsolateral Prefrontal Cortex ◽  
Fatigue Severity Scale ◽  
Severity Scale ◽  
Dorsolateral Prefrontal ◽  
Fatigue Severity

Objective: To compare the effects of anodal trans-cranial direct current stimulation (a-tDCS) over primary motor and dorsolateral prefrontal cortices on Fatigue Severity Scale and its lasting effect on fatigue reduction and improvement in quality of life in patients with multiple sclerosis. Design: A randomized, double-blinded, sham-controlled parallel clinical trial study. Setting: Neurological physiotherapy clinics. Subjects: Thirty-nine participants were randomly assigned to three groups: dorsolateral prefrontal cortex a-tDCS, primary motor a-tDCS (experimental groups) and sham a-tDCS. Finally, 36 participants completed the whole study ( n = 12 in each group). Interventions: Participants in the experimental groups received six-session a-tDCS (1.5 mA, 20 minutes) during two weeks (three sessions per week). The sham group received six sessions of 20-minute sham stimulation. Main measures: The Fatigue Severity Scale and quality of life were assessed before, immediately and four weeks after the intervention. Results: Findings indicated a significant reduction in the Fatigue Severity Scale and a significant increase in the quality of life in both experimental groups, immediately after the intervention ( P < 0.001), while Fatigue Severity Scale and quality of life changes were not significant in the sham a-tDCS group ( P > 0.05). In addition, improvement of the variables remained four weeks after the intervention in dorsolateral prefrontal cortex a-tDCS (mean differences (95% confidence interval): 0.03 (−0.63 to 0.68) as compared to primary motor (−0.62 (−0.11 to −1.14) and sham a-tDCS groups (−0.47 (−1.37 to 0.43)). Conclusion: Both primary motor and dorsolateral prefrontal cortex a-tDCS as compared to sham intervention can immediately improve fatigue and quality of life. However, the effects last up to four weeks only by the dorsolateral prefrontal cortex a-tDCS.

Fatigue in multiple sclerosis: a comparison of different rating scales and correlation to clinical parameters

2002 ◽  
Vol 8 (6) ◽  
pp. 523-526 ◽  
Author(s):  
P Flachenecker ◽  
T Kümpfel ◽  
B Kallmann ◽  
M Gottschalk ◽  
O Grauer ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Physical Disability ◽  
Rating Scales ◽  
Disease Duration ◽  
Correlation Coefficients ◽  
Clinical Activity ◽  
Impact Scale ◽  
Fatigue Severity ◽  
Underlying Mechanisms ◽  
Definition Of

Objectives: Fatigue is one of the most common, yet poorly defined, disabling symptoms in patients with multiple sclerosis (MS). To delineate more clearly the frequency and type of fatigue, we first compared four widely used fatigue scales in consecutive MS patients. Secondly, to further clarify the nature of fatigue, we investigated its relation to physical disability, course of the disease, immunotherapy, and depression. Patients and Methods: Between February and September 2000, 151 consecutive MS patients entering our outpatient clinic (94 relapsing-remitting, 50 secondary progressive, and 7 primary progressive patients; mean age 29.0-7.3 years, mean disease duration 9.9-6.7 years, median EDSS 3.5) filled in a standardized questionnaire including four fatigue scales - Fatigue Severity Scale (FSS), MS-specific FSS (MFSS), Modified Fatigue Impact Scale (MFIS), and Visual Analogue Scale (VAS). Patients were included in the ‘MS-related fatigue group’ (MS-F) when they stated in the questionnaire that fatigue: 1) is one of their three most disabling symptoms; 2) occurs daily or on most of the days; and 3) limits their activities at home or at work. Patients fulfilling none of these criteria were classified as ‘MS-related nonfatigue group’ (MS-NF). Depression was measured by Beck’s Depression Inventory (BDI). Results: Although all scales showed significant differences between MS-F and MS-NF, correlation between these scales was, at best, moderate (correlation coefficients ranging from 0.06 to 0.56). The most discriminative scales were FSS and MFIS, showing no overlap of the 10th and 90th percentiles for the MS-F and MS-NF groups, with cut-off values of 4.6 and 38, respectively. Depression (BDI≥18) was present in 24 of 148 patients who filled in the BDI (16%). FSS was significantly correlated with physical disability (r =0.33, p <0.0001) and BDI (r =0.41, p<0.0001), but not with age, disease duration, clinical activity, and treatment with interferon-b. In multivariate analysis, however, only BDI independently predicted fatigue. Conclusions: The association of fatigue and depression suggests that there might be either common underlying mechanisms or interdependence by a cause-and-effect relationship that requires further investigation. The weak correlation within various fatigue scales is best explained by the fact that fatigue is a multidimensional symptom and, therefore, the available tests measure and weight different aspects of fatigue. Our findings underline the necessity for a more exact definition of fatigue and the development of more valid tools if these are to be used to evaluate treatments.

scholarly journals Prevalence of fatigue in patients with multiple sclerosis and its effect on the quality of life

2013 ◽  
Vol 04 (03) ◽  
pp. 278-282 ◽  
Author(s):  
Karthik Nagaraj ◽  
Arun B Taly ◽  
Anupam Gupta ◽  
Chandrajit Prasad ◽  
Rita Christopher
Keyword(s):  
Quality Of Life ◽  
Multiple Sclerosis ◽  
World Health ◽  
Fatigue Score ◽  
Duration Of Illness ◽  
Disability Status ◽  
Fatigue Severity ◽  
The Mean ◽  
Health Organization

ABSTRACTObjective: This prospective study was carried out to observe the prevalence of fatigue in patients with multiple sclerosis (MS) and its effect on quality-of-life (QoL). Study Design and Setting: Prospective observational study in a University Tertiary Research Hospital in India. Patients and Methods: A total of 31 patients (25 females) with definite MS according to McDonald ′s criteria presented in out-patient/admitted in the Department of Neurology (between February 2010 and December 2011) were included in the study. Disease severity was evaluated using the Kurtzke′s expanded disability status scale (EDSS). Fatigue was assessed using Krupp′s fatigue severity scale (FSS). QoL was assessed by the World Health Organization QoL-BREF questionnaire. Results: The mean age of patients was 30.1 ± 9.1 years. The mean age at first symptom was 25.23 ± 6.4 years. The mean number of relapses was 4.7 ± 3.6 in the patients. The mean duration of illness was 4.9 ± 4.4 years. The mean EDSS score was 3.5 ± 2.2. Mean fatigue score was 38.7 ± 18.5 (cut-off value 36 in FSS). The prevalence of fatigue in patients with MS was 58.1% (18/31). MS patients with fatigue were significantly more impaired (P < 0.05) on all QoL domains (i.e., physical, psychosocial, social, and environment) than MS patients without fatigue. Conclusion: Prevalence of fatigue was found to be high in the MS patients in the study. All four domains of QoL were significantly more impaired in the group with fatigue than in those without fatigue.

scholarly journals Determinants of quality of life in pediatric- and adult-onset multiple sclerosis

Neurology ◽  
2019 ◽  
Vol 94 (9) ◽  
pp. e932-e941 ◽  
Author(s):  
Kyla A. McKay ◽  
Olivia Ernstsson ◽  
Ali Manouchehrinia ◽  
Tomas Olsson ◽  
Jan Hillert
Keyword(s):  
Quality Of Life ◽  
Multiple Sclerosis ◽  
Psychological Status ◽  
Adult Onset ◽  
Processing Efficiency ◽  
Impact Scale ◽  
Neurologic Disability ◽  
Vas Scores ◽  
Eq Vas

ObjectiveTo evaluate quality of life (QoL), measured by the EQ-5D, in adults with pediatric-onset multiple sclerosis (POMS) or adult-onset multiple sclerosis (AOMS) and explore determinants of QoL in both groups.MethodsData were collected from the nationwide Swedish multiple sclerosis (MS) registry. Demographic characteristics, EQ-5D-3 level, Multiple Sclerosis Impact Scale (MSIS-29) score, Expanded Disability Status Scale (EDSS) score, Symbol Digit Modalities Test score, relapses, and disease-modifying therapy (DMT) exposure were collected on an approximately annual basis (2011–2019). Patients with definite MS with ≥2 EQ-5D measurements collected between ages 18 and 50 were included. The principal outcome was the EQ-5D visual analogue scale (EQ-VAS) score. Linear mixed models compared all available EQ-VAS scores between patients with POMS and patients with AOMS and determinants of EQ-VAS among patients with POMS and patients with AOMS (assessed separately).ResultsA total of 5,094 persons met inclusion criteria: 354 (6.9%) had POMS. A total of 21,357 unique EQ-5D scores were recorded. Most participants were female (70.0%) with a relapsing-onset disease course (98.1%). There was no difference in EQ-VAS scores between patients with POMS and patients with AOMS following adjustment for confounders (β-coefficient for patients with POMS vs patients with AOMS [reference]: 0.99; 95% confidence interval −0.89 to 2.87). Experiencing a relapse, severe neurologic disability (EDSS ≥6.0 vs <3.0), and higher MSIS-29 psychological score were consistently associated with lower QoL, while higher information processing efficiency and exposure to first-line DMTs were associated with higher QoL scores in both groups.ConclusionsThere were no differences in QoL between patients with POMS and patients with AOMS in adulthood. Findings provide support for a focus on reducing neurologic disability and improving psychological status as approaches to potentially improve the QoL of persons with MS.

scholarly journals Reduction in Fatigue Symptoms Following the Administration of Nutritional Supplements in Patients with Multiple Sclerosis

2021 ◽  
Vol 9 (3) ◽  
pp. 52
Author(s):  
Pasquale Ferorelli ◽  
Francesco Antonelli ◽  
Anna Shevchenko ◽  
Carlo Mischiati ◽  
Manfred Doepp ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Dietary Supplements ◽  
Nutritional Supplements ◽  
Therapeutic Interventions ◽  
Inflammatory Parameters ◽  
Impact Scale ◽  
Fatigue Severity ◽  
The Individual ◽  
Two Parameters ◽  
The Impact

Despite recent advances in immune-modulatory drugs, pharmacological therapies have been proven ineffective in severe presentations of multiple sclerosis (MS), including secondary progressive MS. At present, therapeutic interventions’ performance is primarily focused on ameliorating symptoms to improve the patient’s quality of life (QOL). Among complementary treatments, nutrition has been considered a decisive factor to control symptoms and enhance the wellness of MS patients. Although no special diets are associated with MS, the impact of diet and dietary supplements on the course of progressive forms of the disease has been studied during the last few years. Fatigue is among the most common and disabling symptoms reported by MS patients. Fatigue has been defined in the Multiple Sclerosis Council for Clinical Practice Guidelines (MSCCPG, 1998) as a “subjective lack of physical and/or mental energy that the individual perceives as an interference with habitual and desired activities”. This study aimed to compare the psychometric functioning of the “Fatigue Severity Scale” (FSS) and the “Modified Fatigue Impact Scale” (MFIS) in our sample of people with MS. Specifically, during chronic treatment, the change in these two parameters with two vitamin-rich dietary supplements (Citozym® and Ergozym®) was evaluated. The impact of these nutritional supplements revealed differences in antioxidant and anti-inflammatory parameters among the volunteers in the treatment group, with a subsequent improvement in fatigue. In conclusion, the results obtained have confirmed the effectiveness of complementary nutritional therapies, evaluated essentially based on hematological biomarkers, through which it is possible to act on disability to improve the QOL of MS patients.

Pharmacologic Therapy for Multiple Sclerosis–Related Fatigue

2005 ◽  
Vol 7 (1) ◽  
pp. 22-27 ◽  
Author(s):  
Jay H. Rosenberg
Keyword(s):  
Multiple Sclerosis ◽  
Sleep Disturbances ◽  
Well Being ◽  
Pharmacologic Therapy ◽  
Controlled Trials ◽  
Common Symptom ◽  
Impact Scale ◽  
Moderate Fatigue ◽  
The Central Nervous System ◽  
Fatigue Severity

Fatigue is the most common symptom of multiple sclerosis and is perhaps the symptom with the most devastating impact on patient well-being. It is reported by 75% to 95% of individuals, and more than half describe it as the worst symptom of the disease. The mechanisms underlying the development of fatigue remain unclear; although fatigue is believed to be a primary symptom of MS (ie, related to the demyelinating processes of the disease), fatigue may also occur secondarily to factors such as sleep disturbances, depression, or the effects of medications. The highly variable presentation of MS and the number of agents used for disease modification and symptom management make it important for potential contributors to MS-related fatigue to be identified and managed appropriately. If fatigue continues despite elimination or adequate management of secondary causes, pharmacologic therapy may be required. Several agents have been reported to improve MS-related fatigue; however, only three have been investigated in controlled trials. Amantadine has been studied in several small controlled trials, and appears to be effective in one quarter to one third of those with mild-to-moderate fatigue. It has shown efficacy on a number of scales, including the Visual Analog Scale for Fatigue (VAS-F) and the MS-Specific Fatigue Scale (MS-FS). The central nervous system (CNS) stimulant pemoline has demonstrated limited benefit in clinical trials and is often poorly tolerated, especially in higher doses. Recently, the wake-promoting agent modafinil has been shown to significantly improve MS-related fatigue on a number of commonly used fatigue assessment scales, including the Fatigue Severity Scale (FSS) and Modified Fatigue Impact Scale (MFIS).

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