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

Karthik Nagaraj, Arun B Taly, Anupam Gupta, Chandrajit Prasad, Rita Christopher, Karthik Nagaraj, Arun B Taly, Anupam Gupta, Chandrajit Prasad, Rita Christopher

Abstract

Objective: 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.

Keywords: Fatigue; multiple sclerosis; quality of life.

Conflict of interest statement

Conflict of Interest: None declared.

References

    1. Fisk JD, Pontefract A, Ritvo PG, Archibald CJ, Murray TJ. The impact of fatigue on patients with multiple sclerosis. Can J Neurol Sci. 1994;21:9–14.
    1. Freal JE, Kraft GH, Coryell JK. Symptomatic fatigue in multiple sclerosis. Arch Phys Med Rehabil. 1984;65:135–8.
    1. Krupp LB, Alvarez LA, LaRocca NG, Scheinberg LC. Fatigue in multiple sclerosis. Arch Neurol. 1988;45:435–7.
    1. Hadjimichael O, Vollmer T, Oleen-Burkey M. North American Research Committee on Multiple Sclerosis. Fatigue characteristics in multiple sclerosis: The North American Research Committee on Multiple Sclerosis (NARCOMS) survey. Health Qual Life Outcomes. 2008;6:100.
    1. Kargarfard M, Eetemadifar M, Mehrabi M, Maghzi AH, Hayatbakhsh MR. Fatigue, depression, and health-related quality of life in patients with multiple sclerosis in Isfahan, Iran. Eur J Neurol. 2012;19:431–7.
    1. Papuæ E, Stelmasiak Z. Factors predicting quality of life in a group of Polish subjects with multiple sclerosis: Accounting for functional state, socio-demographic and clinical factors. Clin Neurol Neurosurg. 2012;114:341–6.
    1. Nortvedt MW, Riise T, Myhr KM, Nyland HI. Quality of life in multiple sclerosis: Measuring the disease effects more broadly. Neurology. 1999;53:1098–103.
    1. Murphy N, Confavreux C, Haas J, König N, Roullet E, Sailer M, et al. Quality of life in multiple sclerosis in France, Germany, and the United Kingdom. Cost of Multiple Sclerosis Study Group. J Neurol Neurosurg Psychiatry. 1998;65:460–6.
    1. Lobentanz IS, Asenbaum S, Vass K, Sauter C, Klösch G, Kollegger H, et al. Factors influencing quality of life in multiple sclerosis patients: Disability, depressive mood, fatigue and sleep quality. Acta Neurol Scand. 2004;110:6–13.
    1. Casanova B, Coret F, Landete L. A study of various scales of fatigue and impact on the quality of life among patients with multiple sclerosis. Rev Neurol. 2000;30:1235–41.
    1. Amato MP, Ponziani G, Rossi F, Liedl CL, Stefanile C, Rossi L. Quality of life in multiple sclerosis: The impact of depression, fatigue and disability. Mult Scler. 2001;7:340–4.
    1. Pittion-Vouyovitch S, Debouverie M, Guillemin F, Vandenberghe N, Anxionnat R, Vespignani H. Fatigue in multiple sclerosis is related to disability, depression and quality of life. J Neurol Sci. 2006;243:39–45.
    1. Benedict RH, Wahlig E, Bakshi R, Fishman I, Munschauer F, Zivadinov R, et al. Predicting quality of life in multiple sclerosis: Accounting for physical disability, fatigue, cognition, mood disorder, personality, and behavior change. J Neurol Sci. 2005;231:29–34.
    1. Janssens AC, van Doorn PA, de Boer JB, van der Meché FG, Passchier J, Hintzen RQ. Impact of recently diagnosed multiple sclerosis on quality of life, anxiety, depression and distress of patients and partners. Acta Neurol Scand. 2003;108:389–95.
    1. Polman CH, Reingold SC, Edan G, Filippi M, Hartung HP, Kappos L, et al. Diagnostic criteria for multiple sclerosis: 2005 revisions to the “McDonald Criteria”. Ann Neurol. 2005;58:840–6.
    1. Kurtzke JF. Rating neurologic impairment in multiple sclerosis: An expanded disability status scale (EDSS) Neurology. 1983;33:1444–52.
    1. Krupp LB, LaRocca NG, Muir-Nash J, Steinberg AD. The fatigue severity scale. Application to patients with multiple sclerosis and systemic lupus erythematosus. Arch Neurol. 1989;46:1121–3.
    1. WHOQoL Group. Development of the World Health Organization WHOQOL-BREF quality of life assessment. The WHOQOL Group. Psychol Med. 1998;28:551–8.
    1. Nogueira LA, Nóbrega FR, Lopes KN, Thuler LC, Alvarenga RM. The effect of functional limitations and fatigue on the quality of life in people with multiple sclerosis. Arq Neuropsiquiatr. 2009;67:812–7.
    1. Schwartz CE, Foley FW, Rao SM, Bernardin LJ, Lee H, Genderson MW. Stress and course of disease in multiple sclerosis. Behav Med. 1999;25:110–6.
    1. Yaldizli Ö, Glassl S, Sturm D, Papadopoulou A, Gass A, Tettenborn B, et al. Fatigue and progression of corpus callosum atrophy in multiple sclerosis. J Neurol. 2011;258:2199–205.
    1. Pellicano C, Gallo A, Li X, Ikonomidou VN, Evangelou IE, Ohayon JM, et al. Relationship of cortical atrophy to fatigue in patients with multiple sclerosis. Arch Neurol. 2010;67:447–53.
    1. Andreasen AK, Jakobsen J, Soerensen L, Andersen H, Petersen T, Bjarkam CR, et al. Regional brain atrophy in primary fatigued patients with multiple sclerosis. Neuroimage. 2010;50:608–15.
    1. Riccitelli G, Rocca MA, Forn C, Colombo B, Comi G, Filippi M. Voxelwise assessment of the regional distribution of damage in the brains of patients with multiple sclerosis and fatigue. AJNR Am J Neuroradiol. 2011;32:874–9.
    1. Calabrese M, Rinaldi F, Grossi P, Mattisi I, Bernardi V, Favaretto A, et al. Basal ganglia and frontal/parietal cortical atrophy is associated with fatigue in relapsing-remitting multiple sclerosis. Mult Scler. 2010;16:1220–8.
    1. Liepert J, Mingers D, Heesen C, Bäumer T, Weiller C. Motor cortex excitability and fatigue in multiple sclerosis: A transcranial magnetic stimulation study. Mult Scler. 2005;11:316–21.
    1. Perretti A, Balbi P, Orefice G, Trojano L, Marcantonio L, Brescia-Morra V, et al. Post-exercise facilitation and depression of motor evoked potentials to transcranial magnetic stimulation: A study in multiple sclerosis. Clin Neurophysiol. 2004;115:2128–33.
    1. Chiu SY, Ritchie JM, Rogart RB, Stagg D. A quantitative description of membrane currents in rabbit myelinated nerve. J Physiol. 1979;292:149–66.
    1. Schwarz JR, Reid G, Bostock H. Action potentials and membrane currents in the human node of Ranvier. Pflugers Arch. 1995;430:283–92.
    1. McDonald WI, Sears TA. The effects of experimental demyelination on conduction in the central nervous system. Brain. 1970;93:583–98.
    1. Heesen C, Nawrath L, Reich C, Bauer N, Schulz KH, Gold SM. Fatigue in multiple sclerosis: An example of cytokine mediated sickness behaviour? J Neurol Neurosurg Psychiatry. 2006;77:34–9.
    1. Motl RW, McAuley E. Symptom cluster and quality of life: Preliminary evidence in multiple sclerosis. J Neurosci Nurs. 2010;42:212–6.
    1. Newland PK, Naismith RT, Ullione M. The impact of pain and other symptoms on quality of life in women with relapsing-remitting multiple sclerosis. J Neurosci Nurs. 2009;41:322–8.
    1. Ghaem H, Borhani Haghighi A. The impact of disability, fatigue and sleep quality on the quality of life in multiple sclerosis. Ann Indian Acad Neurol. 2008;11:236–41.
    1. Crayton HJ, Rossman HS. Managing the symptoms of multiple sclerosis: A multimodal approach. Clin Ther. 2006;28:445–60.
    1. Krupp LB, Christodoulou C, Melville P, Scherl WF, MacAllister WS, Elkins LE. Donepezil improved memory in multiple sclerosis in a randomized clinical trial. Neurology. 2004;63:1579–85.
    1. Motl RW, McAuley E, Wynn D, Suh Y, Weikert M. Effects of change in fatigue and depression on physical activity over time in relapsing-remitting multiple sclerosis. Psychol Health Med. 2011;16:1–11.
    1. Forbes A, While A, Mathes L, Griffiths P. Health problems and health-related quality of life in people with multiple sclerosis. Clin Rehabil. 2006;20:67–78.

Source: PubMed

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