title: Cognitive fatigue in individuals with multiple sclerosis undergoing immunoablative therapy and hematopoietic stem cell transplantation.
abstract: BACKGROUND
  Fatigue presents as a significant problem in multiple sclerosis (MS). Cognitive fatigue (CF) can be defined as a decrease in, or inability to maintain task performance throughout the duration of a continuous cognitive task. CF was evaluated using the Paced Auditory Serial Addition Test (PASAT) both pre- and post-immunoablation and hematopoietic stem cell transplantation (IA-HSCT) over a 3-year follow-up period. The magnitude of CF was examined and the impact of scoring methodology was evaluated.
  
  
  METHODS
  Twenty-three individuals with rapidly progressive MS and poor prognosis underwent high dose immunosuppression and subsequent HSCT. Individuals completed the 3″ and 2″ PASAT at baseline and every 6 months thereafter over a period of 36 months. As scoring methodology can impact its sensitivity to CF, the PASAT was scored according to three scoring methods.
  
  
  RESULTS
  CF was noted across all three scoring methods at baseline and at the majority of time points post-IA-HSCT on both the 3″ and 2″ PASAT. The magnitude of CF remained consistent both pre-and post-IA-HSCT.
  
  
  CONCLUSIONS
  While results suggest that the procedure itself does not ameliorate an individual's susceptibility to CF; neither does it seem to negatively impact levels of CF. As such, results support the notion that the IA-HSCT procedure, despite its aggressive nature, does not exacerbate CF in this particular sample.
authors.affiliation: University of Ottawa, School of Psychology, Ottawa, Canada; The Ottawa Hospital Research Institute, Ottawa, Canada. Electronic address: jberard@ottawahospital.on.ca.
authors.forename: Jason A
authors.initials: JA
authors.lastname: Berard
authors.affiliation: The Ottawa Hospital Research Institute, Ottawa, Canada.
authors.forename: Marjorie
authors.initials: M
authors.lastname: Bowman
authors.affiliation: The Ottawa Hospital Research Institute, Ottawa, Canada; University of Ottawa, Faculty of Medicine, Ottawa, Canada.
authors.forename: Harold L
authors.initials: HL
authors.lastname: Atkins
authors.affiliation: The Ottawa Hospital Research Institute, Ottawa, Canada; University of Ottawa, Faculty of Medicine, Ottawa, Canada.
authors.forename: Mark S
authors.initials: MS
authors.lastname: Freedman
authors.affiliation: University of Ottawa, School of Psychology, Ottawa, Canada; The Ottawa Hospital Research Institute, Ottawa, Canada; University of Ottawa, Faculty of Medicine, Ottawa, Canada; Neuropsychology Service, The Ottawa Hospital, Ottawa, Canada.
authors.forename: Lisa A S
authors.initials: LA
authors.lastname: Walker
mesh_terms: D000328:Adult; D003072:Cognition Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000601:surgery*; D005221:Fatigue / Q000175:diagnosis / Q000453:epidemiology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D007165:Immunosuppression Therapy / Q000009:adverse effects / Q000379:methods; D008297:Male; D009103:Multiple Sclerosis / Q000175:diagnosis / Q000453:epidemiology / Q000601:surgery*; D011597:Psychomotor Performance / Q000502:physiology*; D019172:Transplantation Conditioning / Q000009:adverse effects / Q000379:methods*; D055815:Young Adult
keywords: Cognitive fatigue; Fatigue; HSCT; Multiple sclerosis; Neuropsychology; PASAT