Does fatigue occur in MS patients without disability?
BACKGROUND
Motor dysfunction and fatigue are the most common impairments that are associated with multiple sclerosis (MS). Walk tests and scales demonstrate the presence of fatigue in patients with MS with different levels of disability.


OBJECTIVE
To evaluate objective and subjective fatigue in MS patients without disability.


METHODS
Were selected MS patients with relapsing remitting clinical course, from 18 to 55 years old and EDSS 0 to 1.5; controls were paired for age, gender, body mass index, and physical activity level. Fatigue caused by pulmonary diseases, anemia, diabetes, thyroid disease, psychiatry diseases (except depression), and orthopedic and rheumatologic diseases are excluded. All participants performed the 6-minute walk test (6MWT), the MS Functional Composite (MSFC), and completed the Modified Fatigue Impact Scale (MFIS) and the Beck Depression Inventory. A multivariate model was applied to identify the variables associated with fatigue.


RESULTS
54 individuals were selected (31 patients; 23 controls). In the MSFC and 6MWT, no significant difference was observed between the groups. A MFIS total score indicated fatigue in 35% of the patients, 42% in the physical domain, 25.8% in the cognitive domain, and 29% in the psychosocial domain, which differed from the controls in all comparisons. Fatigue was associated with MS, low-physical activity, and mood disorders.


CONCLUSIONS
Fatigue occurs in patients with MS in the absence of motor dysfunction and is associated with the disease itself, the sedentary lifestyle, and mood disorders. The 6MWT is not useful to demonstrate motor fatigue in subjects without neurological disability.
Universidade Federal do Estado do Rio de Janeiro , Neurologia, Rio de Janeiro , Brazil.
Helcio
H
Alvarenga-Filho
Regina Maria
RM
Papais-Alvarenga
Sonia Regina
SR
Carvalho
Heleine Norman
HN
Clemente
Claudia Cristina
CC
Vasconcelos
Ricardo Marques
RM
Dias
D000293:Adolescent; D000328:Adult; D000704:Analysis of Variance; D016022:Case-Control Studies; D004185:Disability Evaluation; D006233:Persons with Disabilities / Q000523:psychology*; D005221:Fatigue / Q000209:etiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000150:complications* / Q000523:psychology*; D009460:Neurologic Examination; D011569:Psychiatric Status Rating Scales; D012720:Severity of Illness Index; D018709:Statistics, Nonparametric; D016138:Walking; D055815:Young Adult
disability; fatigue; multiple sclerosis