title: Correlation of self-assessed fatigue and alertness in multiple sclerosis.
abstract: BACKGROUND
  Fatigue is the most common symptom in multiple sclerosis patients, but is difficult to measure; quantification thus relies on self-assessed questionnaires.
  
  
  OBJECTIVE
  To evaluate a battery of neuropsychological tests regarding their capacity to objectify self-reported fatigue.
  
  
  METHODS
  We assessed the correlation between age, gender, education, Kurtzke's Expanded Disability Status Scale, depression, fatigue and neuropsychological testing using a cross-sectional approach in 110 multiple sclerosis patients. Fatigue was measured with the Fatigue Severity Scale. Cognition was measured using a series of neuropsychological tests including three subtests of the Test of Attentional Performance, the Brief Repeatable Battery of Neuropsychological Tests and the Faces Symbol Test.
  
  
  RESULTS
  According to the Fatigue Severity Scale 51.4% of the cohort were fatigued (scores > or =4). Age, education and depression showed a significant correlation with the Fatigue Severity Scale. Only 5.5% of the cohort exhibited cognitive impairment in the Brief Repeatable Battery of Neuropsychological Tests scores. After correction for age, education, Expanded Disability Status Scale and depression, Fatigue Severity Scale scores were an independent predictor of performance in the alertness subtest of the Test of Attentional Performance (standardized coefficient beta = 0.298, p = 0.014).
  
  
  CONCLUSIONS
  The alertness subtest of the Test of Attentional Performance may offer an objective method of evaluating self-reported fatigue, and may therefore - in addition to the Fatigue Severity Scale - be a suitable tool for the assessment of multiple sclerosis patients complaining of fatigue.
authors.affiliation: NeuroCure Clinical Research Center, Charité - University Medicine Berlin, Germany.
authors.forename: Nicholetta
authors.initials: N
authors.lastname: Weinges-Evers
authors.forename: Alexander U
authors.initials: AU
authors.lastname: Brandt
authors.forename: Markus
authors.initials: M
authors.lastname: Bock
authors.forename: Caspar F
authors.initials: CF
authors.lastname: Pfueller
authors.forename: Jan
authors.initials: J
authors.lastname: Dörr
authors.forename: Judith
authors.initials: J
authors.lastname: Bellmann-Strobl
authors.forename: Peter
authors.initials: P
authors.lastname: Scherer
authors.forename: Carsten
authors.initials: C
authors.lastname: Urbanek
authors.forename: Claudia
authors.initials: C
authors.lastname: Boers
authors.forename: Stephanie
authors.initials: S
authors.lastname: Ohlraun
authors.forename: Frauke
authors.initials: F
authors.lastname: Zipp
authors.forename: Friedemann
authors.initials: F
authors.lastname: Paul
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D001288:Attention; D003071:Cognition; D003430:Cross-Sectional Studies; D004185:Disability Evaluation; D056344:Executive Function; D005221:Fatigue / Q000175:diagnosis* / Q000209:etiology / Q000523:psychology; D005260:Female; D005858:Germany; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D020529:Multiple Sclerosis, Relapsing-Remitting / Q000150:complications / Q000175:diagnosis* / Q000523:psychology; D009483:Neuropsychological Tests; D011237:Predictive Value of Tests; D012647:Self-Assessment; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D014796:Visual Perception; D055815:Young Adult