Fatigue associated with multiple sclerosis: diagnosis, impact and management

¹Buffalo Neuroimaging Analysis Center, The Jacobs Neurological Institute, University at Buffalo, State University of New York, Buffalo, New York 14203, USA. rbakshi@buffalo.edu

Multiple Sclerosis (Houndmills, Basingstoke, England)

|June 20, 2003

Summary

Multiple sclerosis (MS) fatigue is a common and disabling symptom. Research explores its causes, brain impacts, and treatments like modafinil.

Area of Science:

Background:

Fatigue is the most prevalent and disabling symptom in multiple sclerosis (MS).
It significantly impacts patient functioning and quality of life, often exceeding other MS-related symptoms in severity.
The exact causes and underlying mechanisms of MS-related fatigue are not yet fully understood.

Purpose of the Study:

To summarize the current understanding of multiple sclerosis-related fatigue.
To review potential etiologies, including neuroimaging findings.
To discuss interventions, both nonpharmacologic and pharmacologic, for managing MS fatigue.

Main Methods:

Review of existing literature on multiple sclerosis fatigue.
Analysis of studies investigating associations with disability, disease characteristics, depression, and quality of life.
Examination of neuroimaging studies (e.g., positron emission tomography) to explore brain correlates of fatigue.

Main Results:

MS-related fatigue is highly prevalent and disabling, surpassing other symptoms.
No consistent association found with disability level, disease subtype, or gender.
Associations noted with depression and reduced quality of life.
Positron emission tomography suggests frontal and subcortical brain hypometabolism in MS fatigue.

Conclusions:

MS-related fatigue necessitates intervention due to its profound impact.
Nonpharmacologic strategies like exercise and energy conservation are important.
Pharmacologic agents including amantadine, pemoline, and modafinil have been investigated for efficacy.

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