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The Impact of Fatigue on Patients with Multiple Sclerosis
Open accessAbstract
Although fatigue is recognized as a symptom of MS, there have been insufficient methods for evaluating this symptom. We administered the Fatigue Impact Scale to 85 MS patients and 20 hypertensive patients. Neurologic impairment, mental health, and general health status were also assessed. MS patients reported significantly higher fatigue impact than hypertensive patients. Most MS patients reported fatigue as either their worst (14%), or one of their worst (55%) symptoms. Disease classification and neurologic impairment had little bearing on Fatigue Impact Scale scores in the MS sample. The best predictive models for mental health and general health status in the MS sample both included the Fatigue Impact Scale as a significant factor. This study demonstrates that: 1) fatigue is a very prevalent and severe problem in MS, 2) fatigue impact cannot be predicted by clinical measures of neurologic impairment, 3) fatigue has a significant effect on the mental health and general health status of MS patients.
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“is often considered to be the worst symptom of disease (Fisk et al., 1994”
From Systematic review and meta-analysis of interventions for depression and anxiety in persons with multiple sclerosis (2016) · cites this paper as Fisk et al., 1994
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Management of Fatigue in Persons with Multiple Sclerosis
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“There is strong consensus in literature that many psychosocial factors influence adjustment to fatigue, including the family’s response, coping behaviors, psychological distress, and fatigue-related disability (1, 5).”
BackgroundFatigue in Multiple Sclerosis: Neural Correlates and the Role of Non-Invasive Brain Stimulation
Chalah, M. A., Riachi, N. J., Ahdab, R., Créange, A., Lefaucheur, J., & Ayache, S. S. (2015) · Frontiers in Cellular Neuroscience · doi:10.3389/fncel.2015.00460 · Cited by 146
“Although fatigue is reported by the majority of individuals as their most common and disabling symptom (Krupp et al., 1989, 2010; Fisk et al., 1994a,b; Colosimo et al., 1995; Bakshi, 2003; Lobentanz et al., 2004; Flensner et al., 2008), no clear definition exists in the literature; which makes it…”
BackgroundWeiland, T. J., Jelinek, G. A., Marck, C. H., Hadgkiss, E. J., van der Meer, D. M., Pereira, N. G., & Taylor, K. L. (2015) · PLoS ONE · doi:10.1371/journal.pone.0115541 · Cited by 146
“With the exception of the landmark NARCOMS study, which reported the prevalence of clinically significant fatigue to be 74% [41], this figure concurs strongly with previous reports [10,14,42,43].”
BackgroundResultFatigue and Regulation of the Hypothalamo-Pituitary-Adrenal Axis in Multiple Sclerosis
Gottschalk, M., Kümpfel, T., Flachenecker, P., Uhr, M., Trenkwalder, C., Holsboer, F., & Weber, F. (2005) · Archives of Neurology · doi:10.1001/archneur.62.2.277 · Cited by 139
“tween fatigue and neurologic disability as determined with the EDSS in our study population, which is in line with several other publications.(21,22,24) This reflects the observation that fatigue often occurs in the early stages of the disease and is often the leading symptom despite a low EDSS score.”
ResultModalities of fatigue in multiple sclerosis: correlation with clinical and biological factors
lriarte, J., Subirá, M. L., & de Castro, P. (2000) · Multiple Sclerosis Journal · doi:10.1177/135245850000600212 · Cited by 138
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Gait variability in people with multiple sclerosis
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“Krupp and colleagues [26] reported that the 100-mm VAS was more sensitive than the Fatigue Severity Scale [5] and the Fatigue Impact Scale [27] at detecting ‘beneficial effects of fatigue treatment’.”
MethodEEG correlates of fatigue during administration of a neuropsychological test battery
Barwick, F. H., Arnett, P. A., & Slobounov, S. (2011) · Clinical Neurophysiology · doi:10.1016/j.clinph.2011.06.027 · Cited by 137
“However, Kiroy et al. (1996) found an increase in both theta and beta power in participants who performedmental tasks, something that may reflect compensatory mechanisms for their low vigilance level.”
BackgroundMethodFatigue and quality of life in pediatric multiple sclerosis
MacAllister, W. S., Christodoulou, C., Troxell, R. M., Milazzo, M. C., Block, P., Preston, T., Bender, H. A., Belman, A. L., & Krupp, L. (2009) · Multiple Sclerosis Journal · doi:10.1177/1352458509345902 · Cited by 134
Kargarfard, M., Etemadifar, M., Baker, P., Mehrabi, M., & Hayatbakhsh, M. R. (2012) · Archives of Physical Medicine and Rehabilitation · doi:10.1016/j.apmr.2012.05.006 · Cited by 133
“Reliability nd validity of the MFIS have been established in patients with S.(6,7,31)”
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Bol, Y., Duits, A., Hupperts, R., Vlaeyen, J. W. S., & Verhey, F. R. J. (2008) · Journal of Psychosomatic Research · doi:10.1016/j.jpsychores.2008.05.003 · Cited by 138
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Mullins, L. L., Cote, M. P., Fuemmeler, B. F., Jean, V. M., Beatty, W. W., & Paul, R. H. (2001) · Rehabilitation Psychology · doi:10.1037/0090-5550.46.2.139 · Cited by 132
Fatigue in multiple sclerosis: Mechanisms and management
Vucic, S., Burke, D. J., & Kiernan, M. C. (2010) · Clinical Neurophysiology · doi:10.1016/j.clinph.2009.12.013 · Cited by 132
“, 1988) and impacting on their quality of life (Fisk et al., 1994; Kos et al., 2008).”
BackgroundLakin, L., Davis, B. E., Binns, C. C., Currie, K. M., & Rensel, M. R. (2021) · Neurology and Therapy · doi:10.1007/s40120-021-00239-2 · Cited by 152
Randomised controlled trial of a self-guided online fatigue intervention in multiple sclerosis
Pöttgen, J., Moss-Morris, R., Wendebourg, J.-M., Feddersen, L., Lau, S., Köpke, S., Meyer, B., Friede, T., Penner, I.-K., Heesen, C., et al. (2018) · Journal of Neurology, Neurosurgery & Psychiatry · doi:10.1136/jnnp-2017-317463 · Cited by 129
Pain affects depression through anxiety, fatigue, and sleep in multiple sclerosis.
Amtmann, D., Askew, R. L., Kim, J., Chung, H., Ehde, D. M., Bombardier, C. H., Kraft, G. H., Jones, S. M. W., & Johnson, K. L. (2015) · Rehabilitation Psychology · doi:10.1037/rep0000027 · Cited by 129
“PAIN-INT, Pain Interference; BPI, Brief Pain Inventory; PIQ-6, Pain Impact Questionnaire-6; HADS, Hospital Anxiety and Depression Scale; MAF, Multidimensional Assessment of Fatigue; MFIS, Modified Fatigue Impact Scale; FSS, Fatigue Severity Scale; WHIIRS, Women's Health Initiative Insomnia Rating Scale; MOS-SAD, Medic…”
MethodInfluentialFatigue Management in Multiple Sclerosis
Tur, C. (2016) · Current Treatment Options in Neurology · doi:10.1007/s11940-016-0411-8 · Cited by 127
Fatigue and its association with sociodemographic variables among multiple sclerosis patients
Lerdal, A., Celius, E. G., & Moum, T. (2003) · Multiple Sclerosis Journal · doi:10.1191/1352458503ms943oa · Cited by 126
Modafinil effects in multiple sclerosis patients with fatigue
Lange, R., Volkmer, M., Heesen, C., & Liepert, J. (2009) · Journal of Neurology · doi:10.1007/s00415-009-0152-7 · Cited by 126
An examination of four models predicting fatigue in multiple sclerosis
STROBER, L., & ARNETT, P. (2005) · Archives of Clinical Neuropsychology · doi:10.1016/j.acn.2005.04.002 · Cited by 151
Twomey, R., Aboodarda, S. J., Krüger, R. L., Culos-Reed, S. N., Temesi, J., & Millet, G. Y. (2017) · Neurophysiologie Clinique · doi:10.1016/j.neucli.2017.03.002 · Cited by 147
The impact of outpatient rehabilitation on quality of life in multiple sclerosis
Patti, F., Ciancio, M. R., Reggio, E., Lopes, R., Palermo, F., Cacopardo, M., & Reggio, A. (2002) · Journal of Neurology · doi:10.1007/s00415-002-0778-1 · Cited by 118
Merkelbach, S., Sittinger, H., & Koenig, J. (2002) · The Journal of Nervous and Mental Disease · doi:10.1097/00005053-200206000-00007 · Cited by 116
“…which is generally thought to involve subjective feelings of tiredness, weakness, and/or lack of energy after prolonged or excessive periods of either physical or mental activity (Bakshi et al., 2000; Fisk et al., 1994; Krupp and Christodoulou, 2001; Schwid et al., 1999; van der Werf et al., 1998).”
BackgroundThe Ecological Validity of Clinical Tests of Memory and Attention in Multiple Sclerosis
Higginson, C. I., Arnett, P. A., & Voss, W. D. (2000) · Archives of Clinical Neuropsychology · doi:10.1093/arclin/15.3.185 · Cited by 116
“Heinrichs (1990) suggests three possible explanations for these limitations (p.”
BackgroundSvenningsson, A., Eva, F., Celius, E. G., Fuchs, S., Schreiber, K. I., Berkö, S., Sun, J., Penner, I., & for the TYNERGY trial investigators (2013) · PLoS ONE · doi:10.1371/journal.pone.0058643 · Cited by 116
“Fatigue is one of the major symptoms in multiple sclerosis (MS), affecting 54 to 95% of patients [1,2,3].”
Backgroundde Vries, J., & van Heck, G. (1997) · European Journal of Psychological Assessment · doi:10.1027/1015-5759.13.3.164 · Cited by 133
Pilutti, L. A., Lelli, D. A., Paulseth, J. E., Crome, M., Jiang, S., Rathbone, M. P., & Hicks, A. L. (2010) · Archives of Physical Medicine and Rehabilitation · doi:10.1016/j.apmr.2010.08.027 · Cited by 113
Psychometric study of Turkish version of Fatigue Impact Scale in multiple sclerosis patients
Armutlu, K., Keser, İ., Cetisli-Korkmaz, N., Akbıyık, D. İ., Sümbüloğlu, V., Güney, Z., & Karabudak, R. (2007) · Journal of the Neurological Sciences · doi:10.1016/j.jns.2007.01.073 · Cited by 114
“Fatigue Impact Scale (FIS) (Fisk et al., 1994) is a commonly used fatigue scale in both clinical and experimental studies [11].”
Fatigue and depression in multiple sclerosis: pharmacological and non-pharmacological interventions
Brenner, P., & Piehl, F. (2016) · Acta Neurologica Scandinavica · doi:10.1111/ane.12648 · Cited by 123
Penner, I., Bechtel, N., Raselli, C., Stöcklin, M., Opwis, K., Kappos, L., & Calabrese, P. (2007) · Multiple Sclerosis Journal · doi:10.1177/1352458507079267 · Cited by 111
“Several studies found no association between fatigue in multiple sclerosis and physical disability [2,4,13,14,16,20].”
BackgroundInfluentialPathophysiology, assessment and management of multiple sclerosis fatigue: an update
Rottoli, M., Gioia, S. L., Frigeni, B., & Barcella, V. (2016) · Expert Review of Neurotherapeutics · doi:10.1080/14737175.2017.1247695 · Cited by 109
“Fatigue is one of the most common symptoms, affecting almost 80% of MS patients with 55% of them reporting it as one of the worst symptoms experienced [4].”
BackgroundChristogianni, A., Bibb, R., Davis, S. L., Jay, O., Barnett, M. H., Evangelou, N., & Filingeri, D. (2018) · Temperature · doi:10.1080/23328940.2018.1475831 · Cited by 110
“[44] Fisk JD, Pontefract A, Ritvo PG, et al.”
BackgroundFatigue et traumatisme crânien
Belmont, A., Agar, N. Y. R., Hugeron, C., Gallais, B., & Azouvi, P. (2006) · Annales de Réadaptation et de Médecine Physique · doi:10.1016/j.annrmp.2006.04.017 · Cited by 111
Exercise and rehabilitation for individuals with multiple sclerosis.
Brown, T., & Kraft, G. (2005) · Physical Medicine and Rehabilitation Clinics of North America · doi:10.1016/j.pmr.2005.01.005 · Cited by 122
“[44] Fisk JD, et al.”
BackgroundInfluentialValidity and reliability of the MSQ LI in cognitively impaired patients with multiple sclerosis
Marrie, R. A., Miller, D. M., Chelune, G. J., & Cohen, J. A. (2003) · Multiple Sclerosis Journal · doi:10.1191/1352458503ms971oa · Cited by 109
Fatigue and psychiatric illness in a large community sample of persons with multiple sclerosis
Chwastiak, L., Gibbons, L. E., Ehde, D. M., Sullivan, M. D., Bowen, J. D., Bombardier, C. H., & Kraft, G. H. (2005) · Journal of Psychosomatic Research · doi:10.1016/j.jpsychores.2005.06.001 · Cited by 113
“In one study of MS clinic patients, 69% of subjects reported that fatigue was their worst symptom, and 60% of subjects reported that fatigue made their other symptoms worse [3].”
BackgroundInfluentialKrupp, L., & Christodoulou, C. (2001) · Current Neurology and Neuroscience Reports · doi:10.1007/s11910-001-0033-7 · Cited by 110
Multidisciplinary fatigue management programme in multiple sclerosis: a randomized clinical trial
Kos, D., Duportail, M., D'hooghe, M. B., Nagels, G., & Kerckhofs, E. (2007) · Multiple Sclerosis Journal · doi:10.1177/1352458507078392 · Cited by 111
“Fatigue is one of the most frequent and most disabling symptoms in individuals with multiple sclerosis (MS) [1,2].”
BackgroundPostural control strategy during standing is altered in patients with multiple sclerosis
Huisinga, J. M., Yentes, J. M., Filipi, M. L., & Stergiou, N. (2012) · Neuroscience Letters · doi:10.1016/j.neulet.2012.07.020 · Cited by 108
Fatigue and magnetic resonance imaging activity in multiple sclerosis
Mainero, C., Faroni, J., Gasperini, C., Filippi, M., Giugni, E., Ciccarelli, O., Rovaris, M., Bastianello, S., Comi, G., & Pozzilli, C. (1999) · Journal of Neurology · doi:10.1007/s004150050382 · Cited by 108
Validity of a French version of the fatigue impact scale in multiple sclerosis
Debouverie, M., Pittion‐Vouyovitch, S., Léonard-Louis, S., & Guillemin, F. (2007) · Multiple Sclerosis Journal · doi:10.1177/1352458507077942 · Cited by 108
“We used the 40-item Fatigue Impact Scale [2] as a template for the French version.”
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The relationship between fatigue and other clinical features of multiple sclerosis
Mills, R. J., & Young, C. A. (2010) · Multiple Sclerosis Journal · doi:10.1177/1352458510392262 · Cited by 106
Endurance exercise improves walking distance in MS patients with fatigue
Dettmers, C., Sulzmann, M., Ruchay-Plössl, A., Gütler, R., & Vieten, M. (2009) · Acta Neurologica Scandinavica · doi:10.1111/j.1600-0404.2008.01152.x · Cited by 105
“It is experienced as the worst symptom in 28–40% of MS patients (3, 4).”
BackgroundVanage, S. M., Gilbertson, K. K., & Mathiowetz, V. G. (2003) · American Journal of Occupational Therapy · doi:10.5014/ajot.57.3.315 · Cited by 104
“After consent, participants completed the FIS assessment (Fisk, Pontefract, et al., 1994) to obtain pre-energy conservation course (for Group A) and pre-control period (for Group B) fatigue impact scores.”
InfluentialMorrow, S., Weinstock‐Guttman, B., Munschauer, F. E., Hojnacki, D. W., & Benedict, R. (2009) · Multiple Sclerosis Journal · doi:10.1177/1352458509106213 · Cited by 102
Piche, T., Vanbiervliet, G., Cherikh, F., Antoun, Z., Huet, P., Gelsi, E., Demarquay, J.-F., Caroli‐Bosc, F., Benzaken, S., Rigault, M.-C., et al. (2005) · Gut · doi:10.1136/gut.2004.055251 · Cited by 101
„Fatigue“ bei Multipler Sklerose
Flachenecker, P., Müller, G., König, H., Meissner, H.-H., Toyka, K. V., & Rieckmann, P. (2005) · Der Nervenarzt · doi:10.1007/s00115-005-1990-x · Cited by 101
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“Also, 55% of all PwMS describe MS fatigue as one of their worst symptoms, which demonstrates the significant negative effect of MS fatigue on the mental health and general health status [6].”
BackgroundFatigue in multiple sclerosis persists over time
Téllez, N., Río, J., Tintoré, M., Nos, C., Galán, I., & Montalbán, X. (2006) · Journal of Neurology · doi:10.1007/s00415-006-0247-3 · Cited by 100
The cognitive performance of patients with multiple sclerosis during periods of high and low fatigue
Parmenter, B. A., Denney, D. R., & LYNCH, S. G. (2003) · Multiple Sclerosis Journal · doi:10.1191/1352458503ms859oa · Cited by 99
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Exercise in multiple sclerosis -- an integral component of disease management
Döring, A., Pfueller, C. F., Paul, F., & Dörr, J. (2011) · The EPMA Journal · doi:10.1007/s13167-011-0136-4 · Cited by 98
“Approximately 75-90% of all MS patients experience fatigue during disease progression [8,10,16] and some MS patients end up in a vicious circle: out of a wish to reduce fatigue they decrease physical activity which over time reduces endurance, muscle strength, and quality of life and may enhance fatigue, which then th…”
BackgroundGold, S. M., Kruger, S., Ziegler, K. J., Krieger, T., Schulz, K., Otte, C., & Heesen, C. (2011) · Journal of Neurology Neurosurgery & Psychiatry · doi:10.1136/jnnp.2010.230029 · Cited by 98
“Fatigue is experienced by up to two-thirds of MS patients and often perceived as the most debilitating symptom.(8) 9 Importantly, fatigue represents the leading cause for absence from work.”
BackgroundCentral motor drive and perception of effort during fatigue in multiple sclerosis
Thickbroom, G. W., Sacco, P., Kermode, A. G., Archer, S. A., Byrnes, M. L., Guilfoyle, A. M., & Mastaglia, F. L. (2006) · Journal of Neurology · doi:10.1007/s00415-006-0159-2 · Cited by 97
Gruenewald, D. A., Higginson, I. J., Vivat, B., Edmonds, P., & Burman, R. (2004) · Multiple Sclerosis Journal · doi:10.1191/1352458504ms1116rr · Cited by 97
Fatigue in multiple sclerosis: The role of thalamus
Capone, F., Collorone, S., Cortese, R., Lazzaro, V. D., & Moccia, M. (2019) · Multiple Sclerosis Journal · doi:10.1177/1352458519851247 · Cited by 100
Symptomatic therapy in multiple sclerosis: a review for a multimodal approach in clinical practice
de, J., Airas, L. M., Bartholome, E. J., Grigoriadis, N., Mattle, H. P., Oreja‐Guevara, C., O’Riordan, J. I., Sellebjerg, F. T., Stankoff, B., Vass, K., et al. (2011) · Therapeutic Advances in Neurological Disorders · doi:10.1177/1756285611403646 · Cited by 93
“As a result the discrimination between cognitive and motor aspects of fatigue, which has been one objective of the fatigue impact scale [Fisk et al. 1994b, 1994a], remains poor, most of the scales having an emphasis on physical symptoms.”
BackgroundInfluentialGarg, H., Bush, S., & Gappmaier, E. (2015) · International Journal of MS Care · doi:10.7224/1537-2073.2015-013 · Cited by 95
A multidimensional assessment of multiple sclerosis: relationships between disability domains
Provinciali, L., Ceravolo, M. G., Bartolini, M., Logullo, F. O., & Danni, M. C. (2009) · Acta Neurologica Scandinavica · doi:10.1111/j.1600-0404.1999.tb00731.x · Cited by 95
Tartaglia, M. C., Narayanan, S., & Arnold, D. L. (2008) · European Journal of Neurology · doi:10.1111/j.1468-1331.2008.02090.x · Cited by 93
Řasová, K., Havrdová, E., Brandejský, P., Zálišová, M., Foubikova, B., & Martinková, P. (2006) · Multiple Sclerosis Journal · doi:10.1191/135248506ms1248oa · Cited by 96
Fatigue Perceived by Multiple Sclerosis Patients Is Associated With Muscle Fatigue
Steens, A., de Vries, A. J., Hemmen, J., Heersema, T., Heerings, M. A. P., Maurits, N. M., & Zijdewind, I. (2011) · Neurorehabilitation and neural repair · doi:10.1177/1545968311416991 · Cited by 95
Assessing fatigue in multiple sclerosis: Dutch modified fatigue impact scale.
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Emerging clinical picture of lymphangioleiomyomatosis
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“Fatigue is one of the most common and disabling symptoms in multiple sclerosis (MS), affecting up to 92% of MS patients.(1,2) It is a major reason for early retirement and therefore of major health-economic impact.”
BackgroundImpact of Fatigue in Parkinson’s Disease: The Fatigue Impact Scale for Daily Use (D-FIS)
Martínez‐Martín, P., Catalán, M. J., Benito‐León, J., Moreno, Á. O., Zamarbide, I., Cubo, E., van Blercon, N., Arillo, V. M. C., Pondal, M., Linazasoro, G., et al. (2006) · Quality of Life Research · doi:10.1007/s11136-005-4181-0 · Cited by 91
“D-FIS, Daily Fatigue Impact Scale-Spanish Version; SES, Schwab and England Scale; UPDRS, Unified Parkinson’s Disease Rating Scale; MS, Mental status; ADL, Activities of Daily Living; ME, Motor Examination; MADRS, Montgomery-Asberg Depression Rating Scale.”
MethodInfluentialComplementary and alternative medicine for the treatment of multiple sclerosis
Yadav, V., Shinto, L. H., & BOURDETTE, D. N. (2010) · Expert Review of Clinical Immunology · doi:10.1586/eci.10.12 · Cited by 98
Schreurs, K. M. G., de Ridder, D. T. D., & Bensing, J. M. (2002) · Journal of Psychosomatic Research · doi:10.1016/s0022-3999(02)00326-4 · Cited by 94
“The impact of fatigue on daily life is considerable as it prevents sustained physical exertion, interferes with responsibilities, limits work and social role performance, and is related to less satisfaction with quality of life [2–6].”
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The effect of immunomodulatory treatment on multiple sclerosis fatigue
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Screening for Major Depression in the Early Stages of Multiple Sclerosis
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“For example, lack of energy, motor slow ing and sleep disturbance are common to both depression and MS."' 22 - 23 The BDI is heavily weighted for cognitive, affective, and behavioral symptoms of depression, with its total score not strongly related to somatic symptoms of depression.”
Value of the MoCA Test as a Screening Instrument in Multiple Sclerosis
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“FIS (Fisk et al., 1994a, 1994b).”
InfluentialThe Psychosocial Aspects of Multiple Sclerosis
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Self-citationBeing Kind to Your Future Self: Probability Discounting of Health Decision-Making
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“Fatigue should be monitored at the clinical visits, and there are useful instruments like the Fatigue Severity Scale (FSS) (Krupp et al. 1988) and Fatigue Impact Scale (FIS) (Fisk et al. 1994a) for such purposes. ª 2013 The Authors.”
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Subjective Cognitive Fatigue in Multiple Sclerosis Depends on Task Length
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“Based on the reviewed literature, three competing hypotheses that influence cognitive fatigue can be directly tested: (1) the cognitive load hypothesis (16), (2) the cognitive domain hypothesis (22–24), and (3) the temporal fatigue hypothesis (8–11).”
BackgroundSandi, D., Rudisch, T., Füvesi, J., Fricska‐Nagy, Z., Huszka, H., Biernacki, T., Langdon, D. W., Langane, É., Vécsei, L., & Bencsik, K. (2015) · Multiple Sclerosis and Related Disorders · doi:10.1016/j.msard.2015.07.006 · Cited by 82
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The Perceived Deficits Questionnaire
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“The FIS (Fisk et al., 1994a, b) was used to measure the impact of fatigue on participants’ lives.”
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Leisure-time physical activity and secondary conditions in women with physical disabilities
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Personality traits in multiple sclerosis: association with mood and anxiety disorders.
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“Modified Fatigue Impact Scale [47] We employed the five-item version of the FIS.”
Metadata
- Authors
- Fisk, J. D., Pontefract, A., Ritvo, P. G., Archibald, C. J., & Murray, T. J.
- Affiliations
- Dalhousie University (CA)
- Corresponding author
- Fisk, John D.
- ORCID
- Fisk, John D.
- Venue
- Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques
- Publisher
- Cambridge University Press (CUP)
- Published
- 1994-02
- Volume
- 21
- Issue
- 1
- Pages
- 9-14
- ISSN
- 0317-1671 (ISSN-L)
- 2057-0155
- OpenAlex
- W155259919
- Cited by
- 1,025
- References
- 26
- Citations by year
- 2026: 24 · 2025: 26 · 2024: 34 · 2023: 52 · 2022: 49 · 2021: 63 · 2020: 45 · 2019: 31 · 2018: 46 · 2017: 44 · 2016: 38 · 2015: 56 · 2014: 31 · 2013: 44 · 2012: 38
- FWCI
- 3.62
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Dalhousie University
- Topics
- Health Sciences › Medicine › Clinical Neurology › Multiple Sclerosis Research Studies
- Health Sciences › Medicine › Oncology › Cancer survivorship and care
- Health Sciences › Medicine › Psychiatry and Mental health › Fibromyalgia and Chronic Fatigue Syndrome Research
- Keywords
- multiple sclerosis, fatigue, Fatigue Impact Scale, fatigue effects, mental health, health status, neurological deficit, hypertension, symptom burden, disease classification
- MeSH terms
- Adult, Affect, Aged, Fatigue, Female, Humans, Hypertension, Male, Mental Health, Middle Aged, Multiple Sclerosis, Psychiatric Status Rating Scales, Surveys and Questionnaires
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