Cognitive Fatigability Interventions in Neurological Conditions: A Systematic Review

Area of Science:

• Neurology
• Rehabilitation Medicine

Background:

• Cognitive fatigability (CF) is a poorly understood aspect of neurological disease, distinct from general fatigue.
• Objective measurement of CF is less common than subjective self-reports.
• Effective interventions for CF are needed due to its significant impact on quality-of-life.

Purpose of the Study:

• To review available procedural, behavioral, and pharmacological treatments for objectively measured cognitive fatigability (CF).
• To identify interventions for individuals with neurological conditions experiencing CF.

Main Methods:

• Systematic literature search adhering to PRISMA guidelines across major databases (Ovid Medline, PsycInfo, EMBASE, Cochrane Library).
• Inclusion of English-language randomized control trials, case-controlled studies, and case reports/series published between 1980 and February 2019.
• Focus on studies objectively measuring CF in individuals aged 18-65 with neurological conditions, with risk of bias assessment.

Main Results:

• The search yielded 450 records, with two studies meeting the inclusion criteria.
• Both included studies focused on participants with multiple sclerosis.
• One study investigated a procedural intervention (transcranial direct current stimulation), and the other a pharmacological intervention (fampridine-SR).

Conclusions:

• The field of cognitive fatigability (CF) treatment is nascent, with a paucity of eligible studies.
• While one procedural intervention showed positive results, more research is required to draw firm conclusions.
• Further studies are necessary to determine the amenability of CF to various treatment modalities.