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Invisible symptoms and associated factors in multiple sclerosis patients

Behnaz Sedighi1, Parya Jangipour Afshar2, Maryam Abedini Parizi1

  • 1Neurology Research Center, Kerman University of Medical Sciences, Kerman, Iran.

Journal of Education and Health Promotion
|April 22, 2026
PubMed
Abstract

Insights

Invisible symptoms like fatigue and mood disorders significantly impact multiple sclerosis (MS) patients. The Expanded Disability Status Scale (EDSS) is linked to most symptoms, with physical disease worsening pain and cognitive issues.

Area of Science:

  • Neurology
  • Clinical Research
  • Patient Health

Background:

  • Invisible symptoms in multiple sclerosis (MS) are controversial.
  • Their impact on Expanded Disability Status Scale (EDSS) and daily life requires clarification.
  • This study investigates invisible symptoms and associated factors in MS patients.

Purpose of the Study:

  • To determine the prevalence of invisible symptoms in MS patients.
  • To identify factors associated with these symptoms, including fatigue, mood disorder, cognitive impairment, pain, and sexual dysfunction.
  • To explore the relationship between EDSS and invisible symptoms.

Main Methods:

  • Cross-sectional study of 155 MS patients.
  • Data collected from a referral clinic in Kerman (2023-2024).
  • Regression analysis used to identify associated factors.

Main Results:

  • Fatigue and mood disorder were the most common invisible symptoms.
  • EDSS positively correlated with sexual impairment, fatigue, and pain.
  • Women experienced more sexual impairment; physical disease increased cognitive impairment and pain.

Conclusions:

  • EDSS is associated with most invisible symptoms in MS, excluding cognitive impairment.
  • Increased physical disease severity correlates with heightened pain and cognitive impairment.
  • Findings highlight the broad impact of EDSS and physical disease on MS patient experience.
Keywords:
Invisible symptomsIranmultiple sclerosis

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