Management options in multiple sclerosis-associated fatigue.
BACKGROUND
Multiple sclerosis (MS) is a chronic, inflammatory, autoimmune disease of the CNS. Its characteristic early clinical course includes exacerbations and remissions of neurologic disability. Fatigue is one of the most common symptoms of MS and is associated with a reduced quality of life; it is described as the worst symptom of the disease by 50 - 60% of patients. Yet, due to limitations of available evidence, current therapeutic approaches for treating fatigue are based mainly on preliminary studies and expert consensus.


METHODS
This review summarizes current knowledge on the physiopathology, diagnosis and therapeutic options for MS-associated fatigue, including both pharmacological and non-pharmacological strategies.


CONCLUSIONS
Large, rigorously designed trials can provide more reliable results on the efficacy of interventions for fatigue, their functional impact on everyday activities and patient quality of life. Future research should also address a better understanding of the physiopathologic mechanisms of fatigue and the development and validation of objective assessment tools to be used together with patient self-ratings.
University of Florence, Department of Neurology, Viale Morgagni 85, 50134 Florence, Italy. mariapia.amato@unifi.it
Maria Pia
MP
Amato
Emilio
E
Portaccio
D001521:Behavior Therapy; D000697:Central Nervous System Stimulants / Q000627:therapeutic use; D015259:Dopamine Agents / Q000627:therapeutic use; D005081:Exercise Therapy; D005221:Fatigue / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D006801:Humans; D009103:Multiple Sclerosis / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*
D000697:Central Nervous System Stimulants; D015259:Dopamine Agents