Fatigue after a first attack of suspected multiple sclerosis.

Area of Science:

• Neurology
• Clinical Research
• Patient Outcomes

Background:

• Fatigue affects over 75% of multiple sclerosis (MS) patients.
• Fatigue at clinically isolated syndrome (CIS) onset predicts future MS diagnosis.
• The long-term fatigue trajectory post-CIS is not well understood.

Purpose of the Study:

• To investigate the long-term course of fatigue in patients experiencing CIS.
• To determine if fatigue levels change after a clinically definite multiple sclerosis (CDMS) diagnosis.

Main Methods:

• Prospective follow-up of 235 CIS patients (aged 18-50).
• Annual assessments using Krupp's Fatigue Severity Scale (FSS) and Hospital Anxiety and Depression Scale (HADS).
• Longitudinal data analyzed using mixed-effects models; Expanded Disability Status Scale (EDSS) recorded post-CDMS.

Main Results:

• Baseline fatigue predicted CDMS diagnosis (HR: 2.6).
• Fatigue Severity Scale (FSS) scores remained consistent in monophasic CIS and CDMS patients during initial follow-up.
• FSS scores significantly increased by 0.86 units after CDMS diagnosis (p=0.01), then stabilized.

Conclusions:

• Fatigue is a persistent symptom following CIS, often increasing after the onset of clinically definite MS.
• Fatigue levels appear to stabilize after an initial rise post-diagnosis.
• Understanding fatigue progression is crucial for managing MS symptoms.