Study uncovers predictors of fatigue in multiple sclerosis

A study in people with multiple sclerosis (MS) found that fatigue was largely influenced by psychological factors including depression and anxiety.

A team of researchers including neurologists and psychologists at Cardiff University has studied fatigue in people with MS and found that it was largely related to indirect psychological factors including depression, sleep quality, anxiety and coping ability.

Fatigue is a common symptom in MS that is influenced by a variety of direct and indirect factors, but it is poorly understood. This study aimed to examine the clinical, psychological and cognitive factors influencing different aspects of fatigue.

Sixty-one people with MS undertook assessments of the severity and impact of their fatigue, and their cognitive fatiguability, including assessments of physical disability, cognition (e.g. attention, learning, memory), and psychological factors (e.g. mood, sleep quality, pain, coping, self-efficacy).

Approximately half of participants were fatigued, 39% of participant’s fatigue worsened after a series of cognitive tests, and 56% demonstrated cognitive fatiguability during assessment. It was found that fatigue at baseline was associated with greater anxiety and depression, poorer sleep and more emotion-focused coping (attempts to reduce negative emotional responses). Those participants whose fatigue was worse following the series of cognitive tests, as a group demonstrated greater anxiety and depression, and less self-efficacy (the belief we have in our own abilities). Self-efficacy was the only psychological factor that was a predictor of cognitive fatiguability.

Professor Neil Robertson, Clinical Professor of Neurology in the Division of Psychological Medicine and Clinical Neurosciences said “Fatigue is a symptom of MS that many of the people we see in clinic say they find extremely debilitating. However the true extent of fatigue in MS and the factors underlying it aren’t fully understood.

In this study we investigated perceived fatigue, fatigue change following cognitive effort, cognitive fatiguability (how cognitive performance changes over time), and the factors that may influence these in MS. These findings will help guide appropriate interventions for people with fatigue in the future.”

The paper, ‘Perceived fatigue and cognitive performance change in multiple sclerosis: Uncovering predictors beyond baseline fatigue’ is published in Multiple Sclerosis and Related Disorders.