Is there a link between inflammation and fatigue in multiple sclerosis?

Area of Science:

• Neuroimmunology
• Central Nervous System Disorders

Background:

• Multiple sclerosis (MS) is an autoimmune CNS disease causing demyelination, synaptopathy, and neurodegeneration.
• Fatigue affects up to 90% of MS patients, significantly impacting quality of life.
• Current MS fatigue assessment relies on subjective scales, with limited therapeutic options.

Purpose of the Study:

• To investigate the relationship between multiple sclerosis (MS) fatigue and inflammatory or immunomediated markers.
• To identify potential objective biomarkers for MS fatigue assessment and management.

Main Methods:

• A systematic literature review adhering to PRISMA guidelines was performed.
• Databases (PubMed/Medline, Scopus) were searched for studies on inflammation and MS fatigue until February 2018.
• Included studies were published in English or French.

Main Results:

• Twenty-seven studies met the inclusion criteria.
• Inconsistent associations were found with the orexin A system, HPA axis, and CSF inflammatory markers.
• Serum proinflammatory cytokines (IL6, TNFα, IFNγ) showed a potential association with MS fatigue, despite limited data.
• No significant link was observed between MS fatigue and T-cell populations or other peripheral inflammatory markers (CRP, ESR, sICAM1).

Conclusions:

• Objective biomarkers for MS fatigue are needed due to the subjective nature of current assessment scales.
• Future research should compare immune measures and fatigue across different MS phenotypes and treatment statuses.
• Identifying reliable biomarkers could optimize MS fatigue evaluation and treatment strategies.