title: Fatigue and its relationships with cognitive functioning and depression in paediatric multiple sclerosis.
abstract: BACKGROUND
  There is limited information on fatigue and its clinical and psychosocial correlates in children and adolescents with multiple sclerosis (MS).
  
  
  OBJECTIVE
  To assess the relationships between fatigue, cognitive functioning and depression in paediatric MS.
  
  
  METHODS
  The study cohort consisted of patients with MS recruited for an Italian collaborative study on cognitive and psychosocial functioning in paediatric MS. The present assessment included evaluation of fatigue on the Pediatric Quality of Life Inventory-Multidimensional Fatigue Scale, cognitive functioning on an extensive neuropsychological battery and depression on the Children's Depression Inventory (CDI). A psychiatric interview through the Kiddie-SADS-Present and Lifetime Version was also administered.
  
  
  RESULTS
  In total, 57 patients with relapsing-remitting MS were compared with 70 healthy controls. Percentages of fatigued patients ranged from 9% to 14% according to self-reports, and from 23% to 39% according to parent reports. Fatigue was significantly related with higher scores on the CDI (p < 0.03). Higher levels of self-reported cognitive fatigue were associated with impaired performance on a problem-solving test, whereas higher levels of parent-reported cognitive fatigue were associated with impairment on tests of verbal learning, processing speed, complex attention and verbal comprehension.
  
  
  CONCLUSIONS
  Our data show that fatigue can affect a sizeable proportion of paediatric MS patients, and confirm the association between fatigue and depressive symptoms in MS. They also highlight the difficulties of fatigue assessment in the paediatric population and provide a few clues to further research in the field.
authors.affiliation: Department of Neurology, University of Florence, Florence, Italy.
authors.forename: B
authors.initials: B
authors.lastname: Goretti
authors.forename: E
authors.initials: E
authors.lastname: Portaccio
authors.forename: A
authors.initials: A
authors.lastname: Ghezzi
authors.forename: S
authors.initials: S
authors.lastname: Lori
authors.forename: L
authors.initials: L
authors.lastname: Moiola
authors.forename: M
authors.initials: M
authors.lastname: Falautano
authors.forename: R
authors.initials: R
authors.lastname: Viterbo
authors.forename: F
authors.initials: F
authors.lastname: Patti
authors.forename: R
authors.initials: R
authors.lastname: Vecchio
authors.forename: C
authors.initials: C
authors.lastname: Pozzilli
authors.forename: V
authors.initials: V
authors.lastname: Bianchi
authors.forename: S
authors.initials: S
authors.lastname: Cappiello
authors.forename: G
authors.initials: G
authors.lastname: Comi
authors.forename: M
authors.initials: M
authors.lastname: Trojano
authors.forename: M P
authors.initials: MP
authors.lastname: Amato
mesh_terms: D000293:Adolescent; D002648:Child; D003072:Cognition Disorders / Q000150:complications*; D015331:Cohort Studies; D003863:Depression / Q000150:complications*; D003866:Depressive Disorder / Q000150:complications; D005221:Fatigue / Q000150:complications* / Q000453:epidemiology / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D009103:Multiple Sclerosis / Q000150:complications* / Q000523:psychology; D020529:Multiple Sclerosis, Relapsing-Remitting / Q000150:complications* / Q000523:psychology; D009483:Neuropsychological Tests; D055815:Young Adult