Exploring the Impact of Fatigue in Progressive Multiple Sclerosis: A Mixed-Methods Analysis

Area of Science:

• Neurology
• Rehabilitation Medicine
• Patient-Reported Outcomes

Background:

• Literature on fatigue in progressive multiple sclerosis (MS) is limited.
• This study explored the lived experiences of fatigue in patients with progressive MS.

Purpose of the Study:

• To investigate the nature, impact, and severity of fatigue in patients with primary progressive MS (PPMS) and secondary progressive MS (SPMS).
• To understand how fatigue affects the daily lives of individuals with progressive MS.

Main Methods:

• Adult patients with PPMS (n=21) and SPMS (n=23) completed validated fatigue and depression questionnaires (PGI-F, FSMC, MFIS, PHQ-2, PDDS).
• Semi-structured telephone interviews were conducted to gather qualitative data on MS symptoms and daily life impacts, with a focus on fatigue.

Main Results:

• Fatigue was the most commonly reported MS symptom (86.4%), often described as "exhausting" or "having little energy."
• Over 90% of patients experienced fatigue daily, significantly impacting social functioning, emotional well-being, and cognition.
• High scores on fatigue measures (FSMC, MFIS) correlated with perceived fatigue severity (PGI-F) and depression (PHQ-2).

Conclusions:

• Fatigue is a highly prevalent, burdensome, and disabling symptom in progressive MS, profoundly affecting quality of life.
• Findings underscore the need for improved fatigue measurement tools in clinical and research settings.
• Effective treatments targeting fatigue symptoms and exacerbations are crucial for patients with progressive MS.