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Fatigue and multiple sclerosis

Jana Pöttgen, Rona Moss-Morris, Janina-Maria Wendebourg, Lena Feddersen, Stefanie Lau, Sascha Köpke, Björn Meyer, Tim Friede, Iris-Katharina Penner, Christoph Heesen, Stefan M Gold
OBJECTIVE: Fatigue is a major disabling symptom in many chronic diseases including multiple sclerosis (MS), but treatment options are limited.Here, we tested the effectiveness of a self-guided , interactive, online fatigue management programme (ELEVIDA) based on principles of cognitive behavioural therapy (CBT) and related psychotherapeutic approaches (eg, mindfulness) for reducing fatigue in MS. METHODS: Patients with MS and self-reported fatigue were recruited via the website of the German MS Society and assigned via an automated randomisation generator (1:1, no blocking or stratification) to a 12-week online intervention (ELEVIDA, n=139, 82% female, mean age 40...
March 16, 2018: Journal of Neurology, Neurosurgery, and Psychiatry
Asaff Harel, Dylan Sperling, Maria Petracca, Achillefs Ntranos, Ilana Katz-Sand, Stephen Krieger, Fred Lublin, Zichen Wang, Yangbo Liu, Matilde Inglese
OBJECTIVES: The accuracy of 'no evidence of disease activity' (NEDA) in predicting long-term clinical outcome in patients with relapsing remitting multiple sclerosis (RRMS) is unproven, and there is growing evidence that NEDA does not rule out disease worsening. We used diffusion tensor imaging (DTI) to investigate whether ongoing brain microstructural injury occurs in patients with RRMS meeting NEDA criteria. METHODS: We performed a retrospective study to identify patients with RRMS visiting our centre over a 3-month period who had undergone prior longitudinal DTI evaluation at our facility spanning ≥2 years...
March 16, 2018: Journal of Neurology, Neurosurgery, and Psychiatry
Elisea De Somma, Rajiv W Jain, Kelvin W C Poon, Kaitlyn A Tresidder, Julia P Segal, Nader Ghasemlou
There is mounting scientific evidence showing the importance of innate biological rhythms on disease onset and progression. Perhaps the most important of these is the circadian rhythm, a cycle of oscillations lasting approximately 24 hours. Recent work has shown that circadian rhythms are intrinsically linked to the immune system in a bidirectional fashion, and disruption of these cycles can contribute to changes in pathology and quality of life (including fatigue, mood, and disability). This is particularly true in diseases of the nervous and immune systems...
March 13, 2018: Neuroscience and Biobehavioral Reviews
James H Rimmer, Cassandra Herman, Brooks Wingo, Kevin Fontaine, Tapan Mehta
BACKGROUND: Hybrid research designs targeting adults with neurologic disability are critical for improving the efficiency of models that can identify, track and intervene on identified health issues. METHODS: Our Russian doll framework encompasses three study phases. Phase 1 involves prospectively following a cohort of participants with disability to examine the relationships between rates of health and functional deficits (e.g., pain, fatigue, deconditioning), functional measures (e...
March 14, 2018: BMC Medical Research Methodology
Lea Ann Matura, Susan Malone, Rosario Jaime-Lara, Barbara Riegel
Fatigue, a commonly reported symptom, is defined as an overwhelming, debilitating, and sustained sense of exhaustion that decreases the ability to function and carry out daily activities. To date, cancer researchers have been in the forefront in investigating the possible biological mechanisms of fatigue, identifying inflammation, dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis, and activation of the autonomic nervous system. The purpose of this systematic review is to describe fatigue and what is known about the biological mechanisms described in cancer in five chronic, noninfectious illnesses: heart failure, multiple sclerosis, chronic kidney disease, rheumatoid arthritis, and chronic obstructive pulmonary disease...
January 1, 2018: Biological Research for Nursing
Caroline C Kingdon, Erinna W Bowman, Hayley Curran, Luis Nacul, Eliana M Lacerda
BACKGROUND: People with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) continue to struggle to have their condition recognised as disabling in the face of public and professional prejudice and discrimination. OBJECTIVE: The aim of this study was to compare the functional status and well-being of people with well-characterised ME/CFS with people with multiple sclerosis (PWMS), as well as healthy controls (HCs). METHODS: In this cross-sectional study, we used data collected as part of the UK ME/CFS Biobank to compare actual participant scores from the Medical Outcomes Survey Short Form-36 v2™ (SF-36v2™) between groups, as a proxy for impact of disability, and from a bespoke questionnaire seeking data on employment and income...
March 13, 2018: PharmacoEconomics Open
Bryan D Loy, Michelle H Cameron, Patrick J O'Connor
Persistent fatigue is a common problem (∼20-45% of U.S. population), with higher prevalence and severity in people with medical conditions such as cancer, depression, fibromyalgia, heart failure, sleep apnea and multiple sclerosis. There are few FDA-approved treatments for fatigue and great disagreement on how to measure fatigue, with over 250 instruments used in research. Many instruments define fatigue as "a lack of energy", thus viewing energy and fatigue states as opposites on a single bipolar continuum...
April 2018: Medical Hypotheses
Neil H Riordan, Isabela Morales, Giselle Fernández, Nicole Allen, Neal E Fearnot, Michael E Leckrone, Dedra Jones Markovich, Darla Mansfield, Dorita Avila, Amit N Patel, Santosh Kesari, Jorge Paz Rodriguez
BACKGROUND: Multiple sclerosis (MS) is a progressively debilitating neurological condition in which the immune system abnormally erodes the myelin sheath insulating the nerves. Mesenchymal stem cells (MSC) have been used in the last decade to safely treat certain immune and inflammatory conditions. METHODS: A safety and feasibility study was completed on the use of umbilical cord MSC (UCMSC) as a treatment for MS. In this 1-year study, consenting subjects received seven intravenous infusions of 20 × 106 UCMSC over 7 days...
March 9, 2018: Journal of Translational Medicine
Amy-Lee Sesel, Louise Sharpe, Sharon L Naismith
BACKGROUND: Psychosocial interventions are often used as an adjunct to the medical management of multiple sclerosis (MS). However, the efficacy of such approaches for a range of psychosocial indications remains unclear. OBJECTIVE: To determine the efficacy of psychosocial therapies for people with MS (PwMS). METHODS: We searched 6 electronic databases (Medline, Embase, PsycINFO, Cochrane Central Register of Controlled Trials, CINAHL, and Clinicaltrials...
March 8, 2018: Psychotherapy and Psychosomatics
Felix Proessl, Nathaniel B Ketelhut, Thorsten Rudroff
This cross-sectional study aims to determine whether leg strength asymmetries are associated with walking ability, objective measures of fatigability, or subjective perceptions of fatigue. Maximal knee extensor strength was assessed in 19 patients with multiple sclerosis (PwMS), and a symmetry index was calculated. Walking ability was determined through the total distance covered during a 6-min walk test (6MWT) and fatigability by calculating the change in distance covered between minutes 6 and 1. Perceptions of fatigue were assessed using the Fatigue Severity Scale and by obtaining ratings of perceived exertion during the first and final minute of the 6MWT...
March 6, 2018: International Journal of Rehabilitation Research. Revue Internationale de Recherches de Réadaptation
Barbara Seebacher, Raija Kuisma, Angela Glynn, Thomas Berger
Background: Motor imagery (MI) is increasingly used in neurorehabilitation to facilitate motor performance. Our previous study results demonstrated significantly improved walking after rhythmic-cued MI in people with multiple sclerosis (pwMS). The present feasibility study was aimed to obtain preliminary information of changes in walking, fatigue, quality of life (QoL) and MI ability following cued and non-cued MI in pwMS. The study further investigated the feasibility of a larger study and examined the reliability of a two-dimensional gait analysis system...
2018: Archives of Physiotherapy
Guido Giunti, Vasiliki Mylonopoulou, Octavio Rivera Romero
BACKGROUND: Multiple sclerosis (MS) is one of the world's most common neurologic disorders. Fatigue is one of most common symptoms that persons with MS experience, having significant impact on their quality of life and limiting their activity levels. Self-management strategies are used to support them in the care of their health. Mobile health (mHealth) solutions are a way to offer persons with chronic conditions tools to successfully manage their symptoms and problems. Gamification is a current trend among mHealth apps used to create engaging user experiences and is suggested to be effective for behavioral change...
March 2, 2018: JMIR MHealth and UHealth
Cesare Cavalera, Marco Rovaris, Laura Mendozzi, Luigi Pugnetti, Massimo Garegnani, Gianluca Castelnuovo, Enrico Molinari, Francesco Pagnini
BACKGROUND: Multiple sclerosis (MS) has a relevant impact on quality of life (QOL) and is associated with increased risks of psychological morbidity. Mindfulness-based interventions (MBIs) are among the most studied interventions, although few well-conducted studies have tested them in this field. Furthermore, the participation in typical MBIs may be impaired by time and logistics. OBJECTIVE: We aimed to test the efficacy of an online MBI to improve QOL, psychological well-being, sleep, and fatigue...
February 1, 2018: Multiple Sclerosis: Clinical and Laboratory Research
Melissa Colbeck
BACKGROUND: Quality of life for persons living with multiple sclerosis (MS) is significantly lower than population norms. Fatigue, both physical and cognitive, is one of the most prevalent and debilitating symptoms of MS that decrease quality of life. Cognitive fatigue presents similarly to sensory overresponsiveness, but the connection has not been explored. PURPOSE: This study aims to describe how sensory-processing preferences and cognitive fatigue relate to variances in quality of life for people with MS...
January 1, 2018: Canadian Journal of Occupational Therapy. Revue Canadienne D'ergothérapie
M Mäurer, K Schuh, S Seibert, M Baier, C Hentschke, R Streber, A Tallner, K Pfeifer
Background: Fatigue is a major symptom of multiple sclerosis (MS) in patients, and it has been shown to improve with physical exercise. Although fingolimod might lessen fatigue, it is unclear how patients treated with fingolimod react to physical activity regarding fatigue. Objective: This study evaluated the effect of an exercise intervention on fatigue in relapsing-remitting MS patients receiving fingolimod. Methods: People with MS (PwMS) were randomized to either a structured internet-based exercise program (e-training) or no e-training intervention...
January 2018: Multiple Sclerosis Journal—Experimental, Translational and Clinical
Jason A Berard, Andra M Smith, Lisa A S Walker
Objective: Cognitive fatigue (CF) can be defined as decreased performance with sustained cognitive effort. The present study examined the interrelatedness of disease severity, fatigue, depression, and sleep quality in order to evaluate their predictive roles of CF in MS. Four theoretical models examining these variables were assessed. Methods: Fifty-eight individuals with a diagnosis of MS were recruited. CF was measured by examining last third versus first third performance on the Paced Auditory Serial Addition Test (PASAT)...
February 17, 2018: Archives of Clinical Neuropsychology: the Official Journal of the National Academy of Neuropsychologists
Alessandro Serra, Clara G Chisari, Manuela Matta
Multiple sclerosis (MS) commonly causes eye movement abnormalities that may have a significant impact on patients' disability. Inflammatory demyelinating lesions, especially occurring in the posterior fossa, result in a wide range of disorders, spanning from acquired pendular nystagmus (APN) to internuclear ophthalmoplegia (INO), among the most common. As the control of eye movements is well understood in terms of anatomical substrate and underlying physiological network, studying ocular motor abnormalities in MS provides a unique opportunity to gain insights into mechanisms of disease...
2018: Frontiers in Neurology
Sven Jaeger, Friedemann Paul, Michael Scheel, Alexander Brandt, Josephine Heine, Daniel Pach, Claudia M Witt, Judith Bellmann-Strobl, Carsten Finke
OBJECTIVE: Since recent studies suggested a role of the striatum and prefrontal cortex for multiple sclerosis (MS)-related fatigue, we investigated resting-state functional connectivity alterations of striatal subdivisions and the dorsolateral prefrontal cortex (dlPFC). METHODS: Resting-state functional magnetic resonance imaging was acquired in 77 relapsing-remitting MS patients (38 fatigued (F-MS), 39 non-fatigued (NF-MS)) and 41 matched healthy controls (HC)...
February 1, 2018: Multiple Sclerosis: Clinical and Laboratory Research
Sarah D Broicher, Linard Filli, Olivia Geisseler, Nicole Germann, Björn Zörner, P Brugger, M Linnebank
OBJECTIVE: To assess the effects of PR-fampridine on cognitive functioning, fatigue and depression in patients with multiple sclerosis (PwMS). METHODS: Thirty-two PwMS were included in this trial. Cognitive performance was assessed in an open-label and randomized double-blind, placebo-controlled study design using a comprehensive neuropsychological test battery as well as questionnaires examining depression and fatigue. RESULTS: We found significant improvements in cognitive measures assessing alertness (tonic alertness, p = 0...
February 20, 2018: Journal of Neurology
U Palm, M A Chalah, A Créange, J-P Lefaucheur, S S Ayache
Fatigue and depression are frequent symptoms in multiple sclerosis (MS). Both are overlapping and shadowing each other and may impair the quality of life. For detection of depression symptoms in MS, the Multiple Sclerosis Depression Rating Scale (MSDRS) has been proposed recently. Here, we compare the performance of MSDRS in MS patients with and without fatigue to that of established rating scales, i.e. Hospital Anxiety and Depression Scale and Beck Depression Inventory. Twenty-nine MS patients were screened for fatigue and depression symptoms...
February 17, 2018: L'Encéphale
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