Fatigue predicts disease worsening in relapsing-remitting multiple sclerosis patients. (December 2016)

• Record Type: Journal Article
• Authors: Cavallari, Michele; Palotai, Miklos; Glanz, Bonnie I; Egorova, Svetlana; Prieto, Juan Carlos; Healy, Brian C; Chitnis, Tanuja; Guttmann, Charles RG
• Is Part Of: Multiple sclerosis. Volume 22:Number 14(2016)
• Page Start: 1841
• Page End: 1849
• Publication Date: 2016-12
• Subjects: Fatigue -- progressive multiple sclerosis -- neuropsychology -- quality of life -- Expanded Disability Status Scale -- disability; Central nervous system -- Diseases -- Periodicals; Myelin sheath -- Diseases -- Periodicals; Inflammation -- Periodicals; Multiple sclerosis -- Periodicals; Central Nervous System Diseases -- Periodicals; Demyelinating Diseases -- Periodicals; Inflammation -- Periodicals; Multiple Sclerosis -- Periodicals; Système nerveux central -- Maladies -- Périodiques; Gaine de myéline -- Maladies -- Périodiques; Inflammation (Pathologie) -- Périodiques; Sclérose en plaques -- Périodiques; Electronic journals; 616.834005
• DOI: 10.1177/1352458516635874
• Languages: English
• ISSNs: 1352-4585

Abstract

Background: It is unclear whether fatigue is a consequence or a predictive trait of disease worsening. Objective: To investigate the predictive value of fatigue toward conversion to confirmed moderate–severe disability in patients with relapsing-remitting multiple sclerosis (RRMS). Methods: We retrospectively selected from the Comprehensive Longitudinal Investigations in MS at the Brigham and Women's Hospital (CLIMB) study cohort RRMS patients who converted to confirmed (⩾2 years) Expanded Disability Status Scale (EDSS) score ⩾3 within a follow-up period ⩾3 years. We contrasted the Modified Fatigue Impact Scale (MFIS) score of 33 converters, obtained at least 1 year before conversion to EDSS ⩾3, with that of 33 non-converter RRMS patients matched for baseline characteristics. Results: Total MFIS score was higher in converter versus non-converter MS patients (median 37 vs 13; p < 0.0001). EDSS and Center for Epidemiological Studies Depression scale (CES-D) scores were also higher in the converters (median EDSS 1.5 vs 0, p < 0.0001; median CES-D 30 vs 24, p < 0.0001) and were both associated with MFIS score (EDSS: rho = 0.42, p = 0.0005; CES-D: rho = 0.72, p < 0.0001). After adjusting for EDSS and CES-D in multivariate analysis, MFIS remained a significant predictor of subsequent conversion to confirmed EDSS ⩾3. Conclusion: Fatigue is a promising indicator of risk for conversion to confirmed moderate–severe disability in RRMS patients.