scholarly journals Changes in Fatigue and Cognition in Patients with Relapsing Forms of Multiple Sclerosis Treated with Natalizumab

2013 ◽  
Vol 15 (3) ◽  
pp. 120-128 ◽  
Author(s):  
Jeffrey Wilken ◽  
Robert L. Kane ◽  
Cynthia L. Sullivan ◽  
Mark Gudesblatt ◽  
Sylvia Lucas ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Cognitive Performance ◽  
Baseline Score ◽  
Open Label ◽  
Impact Scale ◽  
Disability Status ◽  
Automated Neuropsychological Assessment Metrics ◽  
Fatigue Severity ◽  
Fatigue Impact Scale ◽  
Median Change

Fatigue and cognitive impairment are debilitating features of multiple sclerosis (MS). ENER-G was a 12-month, open-label, multicenter, single-arm observational study designed to evaluate changes in fatigue and cognition in MS patients treated with natalizumab. Adults with relapsing MS and initiating natalizumab were enrolled. The primary endpoint was change in Visual Analog Scale for Fatigue (VAS-F) score over 12 weeks. Changes in Modified Fatigue Impact Scale (MFIS) score, Fatigue Severity Scale (FSS) score, and cognitive performance, using Automated Neuropsychological Assessment Metrics (ANAM), were also assessed. Patients (N = 89) had a mean age of 41 years and a median Expanded Disability Status Scale score of 3.0, and 83% had used at least two prior MS therapies. Significant improvements were observed and maintained at 12 weeks in VAS-F (mean ± SD baseline score, 77.7 ± 10.2; mean ± SD change, −14.9 ± 17.1; P < .0001), MFIS (mean baseline score, 59.1 ± 12.2; mean change, −7.4 ± 11.8; P < .0001), and FSS (median baseline score, 6.3 [range, 3.9–7.0]; median change, −0.4 [range, −2.9–1.4]; P < .0001). Cognitive performance remained stable or improved (depending on the ANAM measure). Thus significant improvements in fatigue were maintained over time, and cognitive performance improved or remained stable up to 48 weeks after initiation of natalizumab in MS patients with some degree of fatigue.

scholarly journals Treatment of Fatigue in Multiple Sclerosis Patients: A Neurocognitive Approach

2011 ◽  
Vol 2011 ◽  
pp. 1-5 ◽  
Author(s):  
Mauro Catalan ◽  
Alessandra De Michiel ◽  
Alessio Bratina ◽  
Susanna Mezzarobba ◽  
Lorella Pellegrini ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Motor Planning ◽  
Rehabilitation Program ◽  
Severity Scale ◽  
Impact Scale ◽  
Disability Status ◽  
Neurocognitive Rehabilitation ◽  
Fatigue Severity ◽  
Fatigue Impact Scale ◽  
Multiple Sclerosis Patients

The objective of the study was to treat fatigue in patients with multiple sclerosis (MS) by a neurocognitive rehabilitation program aimed at improving motor planning by using motor imagery (MI). Twenty patients with clinically definite MS complaining of fatigue were treated for five weeks with exercises of neurocognitive rehabilitation twice a week. Patients were evaluated by Fatigue Severity Scale (FSS), Modified Fatigue Impact Scale (MFIS), MSQoL54, Expanded Disability Status Scale (EDSS), and MS Functional Composite (MSFC). After treatment, a decrease in fatigue was detected with both FSS () and MFIS (). MSFC () and MSQoL54 () scores improved compared to baseline. At six-month followup, the improvement was confirmed for fatigue (FSS, ; MFIS ) and for the physical subscale of MSQoL54 (). No differences in disability scales were found. These results show that neurocognitive rehabilitation, based on MI, could be a strategy to treat fatigue in MS patients.

scholarly journals Greater sensitivity to multiple sclerosis disability worsening and progression events using a roving versus a fixed reference value in a prospective cohort study

2017 ◽  
Vol 24 (7) ◽  
pp. 963-973 ◽  
Author(s):  
Ludwig Kappos ◽  
Helmut Butzkueven ◽  
Heinz Wiendl ◽  
Timothy Spelman ◽  
Fabio Pellegrini ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Reference Value ◽  
Cumulative Probability ◽  
Baseline Score ◽  
Disability Progression ◽  
Open Label ◽  
Disability Status ◽  
Relapsing Remitting ◽  
Fixed Reference ◽  
Relapsing Remitting Multiple Sclerosis

Background: Confirmed Expanded Disability Status Scale (EDSS) progression occurring after a fixed-study entry baseline is a common measure of disability increase in relapsing-remitting multiple sclerosis (RRMS) studies but may not detect all disability progression events, especially those unrelated to overt relapses. Objective: To evaluate possible measures of disability progression unrelated to relapse using EDSS data over ≈5.5 years from the Tysabri® Observational Program (TOP). Methods: TOP is an ongoing, prospective, open-label study in RRMS patients receiving intravenous 300 mg natalizumab every 4 weeks. Measures of increasing disability were assessed using as a reference either study baseline score or a “roving” system that resets the reference score after ⩾24- or ⩾48-week confirmation of a new score. Results: This analysis included 5562 patients. Approximately 70% more EDSS progression events unrelated to relapse and 50% more EDSS worsening events overall were detected with a roving reference score (cumulative probability: 17.6% and 29.7%, respectively) than with a fixed reference baseline score (cumulative probability: 10.1% and 20.3%, respectively). Conclusion: In this long-term observational RRMS dataset, a roving EDSS reference value was more efficient than a study baseline EDSS reference in detecting progression/worsening events unrelated to relapses and thus the transition to secondary progressive disease.

A longitudinal study on effects of a six-week course for energy conservation for multiple sclerosis patients

2008 ◽  
Vol 14 (4) ◽  
pp. 500-505 ◽  
Author(s):  
C. Sauter ◽  
K. Zebenholzer ◽  
J. Hisakawa ◽  
J. Zeitlhofer ◽  
K. Vass
Keyword(s):  
Multiple Sclerosis ◽  
Sleep Quality ◽  
Energy Conservation ◽  
Fatigue Severity Scale ◽  
Severity Scale ◽  
Fatigue Management ◽  
Impact Scale ◽  
Fatigue Severity ◽  
Fatigue Impact Scale

Objective Fatigue management and energy conservation are effective strategies to minimize fatigue in multiple sclerosis (MS). Sustained results have not yet been reported. Methods A fatigue management course was provided for 32 MS patients. They were tested prior to, directly after participation in the course and in a 7—9 month follow-up with the Fatigue Severity Scale, the MS-specific Fatigue Scale, the Modified Fatigue Impact Scale (MFIS), the Pittsburgh Sleep Quality Index and a self-rating scale for depression. The Expanded Disability Status Score (EDSS) and the MS functional composite (MSFC) were evaluated before and after participation in the course. Results The total score and the Cognitive and Physical subscores of the MFIS showed significant improvements on both points of time. Scores in the Fatigue Severity Scale, MS-specific Fatigue Scale and Psychosocial Fatigue Impact Scale did not improve significantly. MS functional composite and EDSS remained unchanged after six weeks of course participation. Subjective sleep quality improved directly after participation in the course and after 7—9 months. The depression score decreased significantly to a normal level at the end of training and in the 7—9 month follow-up. Conclusion Fatigue management enables MS patients to cope with their fatigue and energy more effectively. Follow-up evaluations showed stable results after 7—9 months. Multiple Sclerosis 2008; 14: 500—505. http://msj.sagepub.com

Clinical trial of a formal group fatigue program in multiple sclerosis

2010 ◽  
Vol 16 (6) ◽  
pp. 724-732 ◽  
Author(s):  
CL Hugos ◽  
LF Copperman ◽  
BE Fuller ◽  
V. Yadav ◽  
J. Lovera ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Self Efficacy ◽  
Mixed Model ◽  
Control Program ◽  
Formal Group ◽  
Control Programs ◽  
Fatigue Management ◽  
Impact Scale ◽  
Fatigue Severity ◽  
Fatigue Impact Scale

Fatigue: Take Control is a novel program to teach fatigue management to people with multiple sclerosis (MS) following recommendations in the Fatigue and Multiple Sclerosis guideline. Fatigue: Take Control includes six 2-hour group sessions with DVD viewing, discussion and homework and accompanying participant and leader workbooks. While many people have participated in Fatigue: Take Control programs, its efficacy has not been determined. The objective of this study was to determine whether participation in Fatigue: Take Control reduces fatigue and increases self-efficacy in people with MS. Thirty participants were randomly assigned to a group who immediately participated in the program (FTC) or a wait-list group (WL). The primary outcome was the Modified Fatigue Impact Scale (MFIS) and secondary outcomes were the Multiple Sclerosis Self-Efficacy Scale (MSSE) and the Fatigue Severity Scale (FSS). The MFIS was administered on 10 occasions. Other measures were administered on four occasions. A mixed model tested the effects using all observations. Compared with the WL, the FTC group had significantly more improvement on the MFIS [F(1, 269) = 7.079, p = 0.008] and the MSSE [F(1, 111) = 5.636, p = 0.019]. No significant effect was found for the FSS. Across all visits, fatigue was significantly lower and self-efficacy was significantly higher for the FTC group compared with the WL group. This pilot study demonstrated significant effects in fatigue and self-efficacy among subjects taking the Fatigue: Take Control program, suggesting that this comprehensive program based on the Fatigue and Multiple Sclerosis guideline may be beneficial in MS.

scholarly journals Poor Sleep in Multiple Sclerosis Correlates with Beck Depression Inventory Values, but Not with Polysomnographic Data

2016 ◽  
Vol 2016 ◽  
pp. 1-5 ◽  
Author(s):  
Christian Veauthier ◽  
Gunnar Gaede ◽  
Helena Radbruch ◽  
Klaus-Dieter Wernecke ◽  
Friedemann Paul
Keyword(s):  
Multiple Sclerosis ◽  
Beck Depression Inventory ◽  
Pittsburgh Sleep Quality Index ◽  
Poor Sleep ◽  
Severity Scale ◽  
Analog Scale ◽  
Impact Scale ◽  
Fatigue Severity ◽  
Fatigue Impact Scale ◽  
The Relationship

Objectives. Pittsburgh Sleep Quality Index (PSQI) values correlate with depression, but studies investigating the relationship between PSQI values and polysomnographic (PSG) data showed inconsistent findings.Methods. Sixty-five consecutive patients with multiple sclerosis (MS) were retrospectively classified as “good sleepers” (GS) (PSQI ≤ 5) and “poor sleepers” (PS) (PSQI > 5). The PSG data and the values of the Visual Analog Scale (VAS) of fatigue, Modified Fatigue Impact Scale (MFIS), Fatigue Severity Scale (FSS), Epworth Sleepiness Scale (ESS), and the Beck Depression Inventory (BDI) were compared.Results. No significant differences were found either for PSG data or for ESS, MFIS, and FSS values; but PS showed significantly increased BDI and VAS values.Conclusions. Poor sleep is associated with increased depression and fatigue scale values.

Does the Modified Fatigue Impact Scale offer a more comprehensive assessment of fatigue in MS?

2005 ◽  
Vol 11 (2) ◽  
pp. 198-202 ◽  
Author(s):  
N Téllez ◽  
J Río ◽  
M Tintoré ◽  
C Nos ◽  
I Galán ◽  
...  
Keyword(s):  
Interferon Beta ◽  
Cross Sectional Study ◽  
Unknown Etiology ◽  
Cross Sectional ◽  
Impact Scale ◽  
Disability Status ◽  
Fatigue Severity ◽  
Fatigue Impact Scale ◽  
The Relationship ◽  
Ideal Measure

Background: As a symptom of multiple sclerosis (MS), fatigue is difficult to manage because of its unknown etiology, the lack of efficacy of the drugs tested to date and the absence of consensus about which would be the ideal measure to assess fatigue. Objective: Our aim was to assess the frequency of fatigue in a sample of MS patients and healthy controls (HC) using two fatigue scales, the Fatigue Severity Scale (FSS) and the Modified Fatigue Impact Scale (MFIS) with physical, cognitive and psychosocial subscales. We also studied the relationship fatigue has with depression, disability and interferon beta. Methods: Three hundred and fifty-four individuals (231 MS patients and 123 HC) were included in this cross-sectional study. Fatigue was assessed using the FSS and MFIS. Depression was measured by the Beck Depression Inventory (BDI), and disability by the Expanded Disability Status Scale (EDSS). A status of fatigue was considered when the FSS≥ 5, of non-fatigue when the FSS≤4, and scores between 4.1 and 4.9 were considered doubtful fatigue cases. Results: Fifty-five percent of MS patients and 13% of HC were fatigued. The global MFIS score positively correlated with the FSS in MS and HC (r=0.68 for MS and r=0.59 for HC, p<0.0001). Nonetheless, the MFIS physical subscale showed the strongest correlation score with the FSS (r=0.75, p<0.0001). In addition, a prediction analysis showed the physical MFIS subscale to be the only independent predictor of FSS score (p<0.0001), suggesting other aspects of fatigue, as cognition and psychosocial functions, may be explored by the FSS to a lesser extent. Depression also correlated with fatigue (r=0.48 for the FSS and r=0.7 for the MFIS, p<0.0001) and, although EDSS correlated with fatigue as well, the scores decreased after correcting for depression. Interferon beta showed no relationship with fatigue. Conclusions: Fatigue is a frequent symptom found in MS patients and clearly related with depression. Each fatigue scale correlates with one another, indicating that they are measuring similar constructs. Nevertheless, spheres of fatigue as cognition and psychosocial functions are probably better measured by the MFIS, although this hypothesis will need to be confirmed with appropriate psychometrical testing.

Validation of the Russian version of the Fatigue Impact Scale and Fatigue Severity Scale in multiple sclerosis patients

2018 ◽  
Vol 138 (5) ◽  
pp. 408-416 ◽  
Author(s):  
Yury V. Gavrilov ◽  
Galina G. Shkilnyuk ◽  
Philipp O. Valko ◽  
Igor D. Stolyarov ◽  
Elena V. Ivashkova ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Fatigue Severity Scale ◽  
Severity Scale ◽  
Russian Version ◽  
Impact Scale ◽  
Fatigue Severity ◽  
Fatigue Impact Scale ◽  
Multiple Sclerosis Patients

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

2008 ◽  
Vol 14 (3) ◽  
pp. 383-390 ◽  
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

scholarly journals Assessing fatigue in multiple sclerosis: Psychometric properties of the five-item Modified Fatigue Impact Scale (MFIS-5)

2019 ◽  
Vol 5 (4) ◽  
pp. 205521731988798 ◽  
Author(s):  
Virginia Meca-Lallana ◽  
María Brañas-Pampillón ◽  
Yolanda Higueras ◽  
Antonio Candeliere-Merlicco ◽  
Yolanda Aladro-Benito ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Psychometric Properties ◽  
Impact Scale ◽  
Fatigue Impact Scale
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