Unveiling the relationship between autonomic involvement, fatigue, and cognitive dysfunction in early...

Area of Science:

• Neurology
• Autonomic Nervous System Research
• Multiple Sclerosis Studies

Background:

• Fatigue is a prevalent and debilitating symptom in patients with multiple sclerosis (PwMS).
• Previous research suggests a link between fatigue, especially cognitive fatigue, and self-reported autonomic nervous system (ANS) symptoms.
• The relationship between ANS involvement and cognitive impairment in PwMS has not been thoroughly investigated.

Purpose of the Study:

• To investigate the intricate relationship between fatigue, ANS symptoms, and cognitive function in early multiple sclerosis.
• To determine if ANS dysfunction contributes to fatigue and cognitive impairment in PwMS.

Main Methods:

• Prospective recruitment of early PwMS.
• Assessment using Brief International Cognitive Assessment for Multiple Sclerosis (BICAMS), State-Trait Anxiety Inventory (STAI), Beck Depression Inventory (BDI), Modified Fatigue Impact Scale (MFIS), and Composite Autonomic Symptoms Scale-31 (COMPASS-31).
• Comparative analysis between fatigued and non-fatigued groups, and between cognitively unimpaired and impaired groups, followed by multivariable analysis to identify fatigue predictors.

Main Results:

• Fatigued PwMS exhibited higher COMPASS-31 total scores, including orthostatic intolerance, secretomotor, and pupillomotor symptoms.
• No significant differences in fatigue or ANS symptoms were observed between cognitively impaired and unimpaired PwMS.
• The MFIS score strongly correlated with STAI, BDI, and COMPASS-31 total and sub-scores, with BDI and COMPASS-31 predicting fatigue.

Conclusions:

• Autonomic nervous system symptoms are significantly associated with fatigue in multiple sclerosis.
• Orthostatic intolerance appears to play a major role in the fatigue experienced by PwMS.
• Cognitive impairment in multiple sclerosis does not seem to be directly associated with ANS symptoms.