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Fatigue and its relationships with cognitive functioning and depression in paediatric multiple sclerosis
B Goretti1, E Portaccio, A Ghezzi
1Department of Neurology, University of Florence, Florence, Italy.
Insights
Fatigue affects many pediatric multiple sclerosis (MS) patients and is linked to depression. Assessment challenges in children and adolescents with MS highlight the need for further research.
Area of Science:
- Neurology
- Pediatric Neurology
- Neuropsychology
Background:
- Limited data exists on fatigue and its psychosocial impacts in pediatric multiple sclerosis (MS).
- Understanding fatigue correlates is crucial for managing this condition in young patients.
Purpose of the Study:
- To investigate the relationship between fatigue, cognitive function, and depression in pediatric MS patients.
- To identify clinical and psychosocial factors associated with fatigue in this population.
Main Methods:
- A cohort of pediatric MS patients and healthy controls underwent fatigue assessment using the Pediatric Quality of Life Inventory-Multidimensional Fatigue Scale.
- Cognitive functioning was evaluated using a comprehensive neuropsychological battery.
- Depression was assessed via the Children's Depression Inventory (CDI) and a psychiatric interview (Kiddie-SADS-PL).
Main Results:
- Fatigue was reported by 9-14% of patients (self-report) and 23-39% (parent-report).
- Significant association found between fatigue and higher depression scores (CDI, p < 0.03).
- Self-reported cognitive fatigue correlated with poorer problem-solving skills; parent-reported cognitive fatigue linked to deficits in verbal learning, processing speed, attention, and comprehension.
Conclusions:
- Fatigue impacts a substantial number of pediatric MS patients.
- The study confirms a link between fatigue and depressive symptoms in pediatric MS.
- Challenges in pediatric fatigue assessment are noted, suggesting areas for future research.
Background:
There is limited information on fatigue and its clinical and psychosocial correlates in children and adolescents with multiple sclerosis (MS).
Objective:
To assess the relationships between fatigue, cognitive functioning and depression in paediatric MS.
Methods:
The study cohort consisted of patients with MS recruited for an Italian collaborative study on cognitive and psychosocial functioning in paediatric MS. The present assessment included evaluation of fatigue on the Pediatric Quality of Life Inventory-Multidimensional Fatigue Scale, cognitive functioning on an extensive neuropsychological battery and depression on the Children's Depression Inventory (CDI). A psychiatric interview through the Kiddie-SADS-Present and Lifetime Version was also administered.
Results:
In total, 57 patients with relapsing-remitting MS were compared with 70 healthy controls. Percentages of fatigued patients ranged from 9% to 14% according to self-reports, and from 23% to 39% according to parent reports. Fatigue was significantly related with higher scores on the CDI (p < 0.03). Higher levels of self-reported cognitive fatigue were associated with impaired performance on a problem-solving test, whereas higher levels of parent-reported cognitive fatigue were associated with impairment on tests of verbal learning, processing speed, complex attention and verbal comprehension.
Conclusions:
Our data show that fatigue can affect a sizeable proportion of paediatric MS patients, and confirm the association between fatigue and depressive symptoms in MS. They also highlight the difficulties of fatigue assessment in the paediatric population and provide a few clues to further research in the field.
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Multiple Sclerosis l: Introduction
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