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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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“The Fatigue Impact Scale (FIS) [13,14] is a 40-item questionnaire assessing fatigue in its cognitive, physical and social dimensions.”
MethodAeinehband, S., Brenner, P., Ståhl, S., Bhat, M., Fidock, M. D., Khademi, M., Olsson, T. P., Engberg, G., Jokinen, J., Erhardt, S., et al. (2015) · Brain Behavior and Immunity · doi:10.1016/j.bbi.2015.07.016 · Cited by 74
“…2, which included The Montgomery-Asberg Depression Rating Scale (MADRS-S) (Svanborg and Asberg, 1994) and the Modified Fatigue Impact Scale (MFIS) (Fisk et al., 1994), both administered as self-rating instruments, and a structured diagnostic interview (The Mini International Neuropsychiatric…”
MethodInfluentialContributing factors to depressed mood in multiple sclerosis
Voss, W. D., Arnett, P. A., Higginson, C. I., Randolph, J. J., Campos, M. D., & Dyck, D. G. (2002) · Archives of Clinical Neuropsychology · doi:10.1093/arclin/17.2.103 · Cited by 73
“Fatigue Fatigue was measured using the FIS (Fisk et al., 1994).”
MethodResultFatigue in Multiple Sclerosis: A Look at the Role of Poor Sleep
Strober, L. B. (2015) · Frontiers in Neurology · doi:10.3389/fneur.2015.00021 · Cited by 72
“However, regardless of the exact etiology, fatigue is known to be extremely detrimental to those with MS with nearly 55% of patients reporting fatigue to be among their worst symptoms (11) and 40% describing it as their most disabling symptom (8).”
Backgroundvan Kessel, K., Wouldes, T. A., & Moss-Morris, R. E. (2015) · Clinical Rehabilitation · doi:10.1177/0269215515584800 · Cited by 72
Assessment of Fatigue in Patients with Chronic Hepatitis C Using the Fatigue Impact Scale
Hassoun, Z., Willems, B. E., Deslauriers, J., Nguyen, B., & Huet, P. (2002) · Digestive Diseases and Sciences · doi:10.1023/a:1021040702370 · Cited by 71
“9 (the range found for chronic fatigue syndrome) (9) with a median of 0.”
BackgroundResultInfluentialEvaluation of health-related quality of life, fatigue and depression in neuromyelitis optica
Chanson, J., Zéphir, H., Collongues, N., Outteryck, O., Blanc, F., Fleury, M., Vermersch, P., & Seze, J. D. (2010) · European Journal of Neurology · doi:10.1111/j.1468-1331.2010.03252.x · Cited by 71
“Fatigue was assessed by the EMIF-SEP [20], the French version of the Fatigue Impact Scale [3].”
BackgroundMethodInfluentialEsclerose múltipla: adaptação transcultural e validação da escala modificada de impacto de fadiga
Pavan, K., Schmidt, K. B., Marangoni, B. E. M., Mendes, M. F., Tilbery, C. P., & Lianza, S. (2007) · Arquivos de Neuro-Psiquiatria · doi:10.1590/s0004-282x2007000400024 · Cited by 71
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“Some studies considered several factors such as patient’s level of disability, MS subtype and depression as predictive factors of fatigue in MS patients while other studies did not verify these findings [7–13].”
ResultFatigue in multiple sclerosis: multidimensional assessment and response to symptomatic treatment
Romani, A., Bergamaschi, R., Candeloro, E., Alfonsi, E., Callieco, R., & Cosi, V. E. (2004) · Multiple Sclerosis Journal · doi:10.1191/1352458504ms1051oa · Cited by 71
Development and validation of a tourism fatigue scale
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Contribution of symptom clusters to multiple sclerosis consequences
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“A separate group [15] found that fatigue, quantified using a French version of the Fatigue Impact Scale (FIS) [16], correlated strongly with sleep disturbances as measured by the Pittsburgh Sleep Quality Index among individuals with MS [17].”
MethodO’Hara, L., Cadbury, H., Souza, L. H. D., & Ide, L. (2002) · Clinical Rehabilitation · doi:10.1191/0269215502cr478oa · Cited by 68
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“For example, fatigue, which affects 75 to 90% of patients with MS [54-57] was not included in the EQ-5D or the HUI measures.”
BackgroundDepression and fatigue in patients with multiple sclerosis
Greeke, E. E., Chua, A. S., Healy, B. C., Rintell, D. J., Chitnis, T., & Glanz, B. I. (2017) · Journal of the Neurological Sciences · doi:10.1016/j.jns.2017.07.047 · Cited by 67
Ziemssen, T., Hoffman, J., Apfel, R., & Kern, S. (2008) · Health and Quality of Life Outcomes · doi:10.1186/1477-7525-6-67 · Cited by 67
“Introduction Fatigue is a common symptom of multiple sclerosis [1-5], reported by around three-quarters of affected patients [3], and considered one of the most distressing symptoms of disease by over half [2].”
Summary of comprehensive systematic review: Rehabilitation in multiple sclerosis [RETIRED]
Haselkorn, J. K., Hughes, C., Rae-Grant, A., Henson, L. J., Bever, C. T., Lo, A. C., Brown, T. R., Kraft, G. H., Getchius, T., Gronseth, G., et al. (2015) · Neurology · doi:10.1212/wnl.0000000000002146 · Cited by 68
Impairment of social cognition in multiple sclerosis: Amygdala atrophy is the main predictor
Batista, S., d’Almeida, O. C., Afonso, A., Freitas, S., Macário, C., Sousa, L., Castelo-Branco, M. S., Santana, I. J., & Cunha, L. (2016) · Multiple Sclerosis Journal · doi:10.1177/1352458516680750 · Cited by 66
Prevalence of fatigue in patients with multiple sclerosis and its effect on the quality of life
Nagaraj, K., Taly, A. B., Gupta, A., Prasad, C., & Christopher, R. (2013) · Journal of Neurosciences in Rural Practice · doi:10.4103/0976-3147.118774 · Cited by 64
“[3] Certain factors such as neurological impairment, spasticity, motor weakness, nocturia, pain, depression, sleep disturbances, and heat sensitivity correlate consistently with fatigue and considered secondary causes of fatigue in MS.[1,2] Quality‑of‑life (QoL) is defined as individual perception of their position in…”
BackgroundInfluentialFatigue in multiple sclerosis patients
Mollaoğlu, M., & Üstün, E. (2009) · Journal of Clinical Nursing · doi:10.1111/j.1365-2702.2008.02733.x · Cited by 66
Impact of fatigue in multiple sclerosis: the Fatigue Impact Scale for Daily Use (D-FIS)
Benito‐León, J., Martínez‐Martín, P., Frades, B., Martínez-Ginés, M. L., de Andrés, C., Meca-Lallana, J. E., Antigüedad, A. R., Antón, B. H., Rodríguez-García, E., & Ruiz‐Martínez, J. (2007) · Multiple Sclerosis Journal · doi:10.1177/1352458506073528 · Cited by 66
Treatment of fatigue in multiple sclerosis: A systematic review of the literature
Lee, D., Newell, R., Ziegler, L. E., & Topping, A. E. (2008) · International Journal of Nursing Practice · doi:10.1111/j.1440-172x.2008.00670.x · Cited by 66
Kentson, M. U., Tödt, K., Skargren, E. I., Jakobsson, P., Ernerudh, J., Unosson, M., & Theander, K. (2016) · Therapeutic Advances in Respiratory Disease · doi:10.1177/1753465816661930 · Cited by 66
“Patients with more pronounced dyspnoea (mMRC ⩾ 2) had greater limitation on physical and psychosocial dimension of FIS than those with less dyspnoea (mMRC ⩽ 1).”
BackgroundMethodInfluentialSauter, C., Zebenholzer, K., Hisakawa, J., Zeitlhofer, J., & Vass, K. (2008) · Multiple Sclerosis Journal · doi:10.1177/1352458507084649 · Cited by 65
“[2,32] as an outcome measure in a prepost comparison after teaching the Packer program and found significant improvements in the physical, cognitive and psychosocial subscales [18,30,31].”
BackgroundMethodFrith, J., & Newton, J. L. (2010) · Occupational Medicine · doi:10.1093/occmed/kqp180 · Cited by 64
Güner, S., & İnanıcı, F. (2014) · Journal of Bodywork and Movement Therapies · doi:10.1016/j.jbmt.2014.04.004 · Cited by 64
“Seventy-five to ninety percent of patients with MS report fatigue and 55% describe it as one of their worst symptoms, and 85% of patients report gait disturbance as their main complaint (Flachenecker et al., 2002; Fisk et al., 1994; Lerdal et al., 2007; Scheinberg et al., 1980).”
BackgroundFatigue after brain injury: initial reliability study of the BNI Fatigue Scale
Borgaro, S. R., Gierok, S. D., Caples, H., & Kwasnica, C. M. (2004) · Brain Injury · doi:10.1080/02699050310001646080 · Cited by 64
“In post-concussional syndrome (PCS), it is one of a constellation of symptoms that defines the condition and has been reported as the third most prevalent symptom of PCS following headaches and dizziness [1].”
BackgroundClinical trial of a formal group fatigue program in multiple sclerosis
Hugos, C., Copperman, L., Fuller, B., Yadav, V., Lovera, J. F., & BOURDETTE, D. N. (2010) · Multiple Sclerosis Journal · doi:10.1177/1352458510364536 · Cited by 62
“81.(25,26) The MFIS provides a total score and scores for each of three subscales (physical, cognitive, and psychosocial) and lower scores on the MFIS and its subscales indicate less fatigue.”
BackgroundHancock, L. M., Bruce, J. M., Bruce, A. S., & LYNCH, S. G. (2015) · Journal of Clinical and Experimental Neuropsychology · doi:10.1080/13803395.2014.989818 · Cited by 62
Use of cognitive aids and other assistive technology by individuals with multiple sclerosis
Johnson, K., Bamer, A. M., Yorkston, K. M., & Amtmann, D. (2009) · Disability and Rehabilitation Assistive Technology · doi:10.1080/17483100802239648 · Cited by 63
Sjonnesen, K., Berzins, S., Fiest, K. M., Bulloch, A. G. M., Metz, L. M., Thombs, B. D., & Patten, S. B. (2012) · Postgraduate Medicine · doi:10.3810/pgm.2012.09.2595 · Cited by 68
“Cognitive impairment occurs in 43% to 60% of patients with MS, 21,22 while 69% of patients with MS report fatigue as their worst or among their worst symptoms.(23) Therefore, symptom contamination is a concern when assessing depression in patients with MS using the PHQ-9 and other scales.”
BackgroundLam, K., Meijer, K. A., Loonstra, F. C., Coerver, E. M. E., Twose, J., Redeman, E. G. M., Moraal, B., Barkhof, F., de Groot, V., Uitdehaag, B. M. J., et al. (2020) · Multiple Sclerosis Journal · doi:10.1177/1352458520968797 · Cited by 64
“Our objective is to investigate (1) the feasibility and reliability of real-world keystroke dynamics collected by smartphone technology and (2) its validity to assess fatigue, MRI disease activity and clinical disability in MS.”
BackgroundBarakou, I., Sakalidis, K. E., Abonie, U. S., Finch, T. L., Hackett, K. L., & Hettinga, F. J. (2023) · Scientific Reports · doi:10.1038/s41598-023-41075-8 · Cited by 72
O’Connell, K., Langdon, D. W., Tubridy, N. J., Hutchinson, M., & McGuigan, C. (2015) · Multiple Sclerosis and Related Disorders · doi:10.1016/j.msard.2015.07.012 · Cited by 62
“Depression and anxiety was assessed with the Hospital Anxiety and Depression Score (HADS) (Zigmond and Snaith, 1983) and the Modified Fatigue Impact Scale (MFIS) (Fisk et al., 1994) was used to measure fatigue.”
MethodIMPACT OF POST-POLIO-RELATED FATIGUE ON QUALITY OF LIFE
On, A. Y., Öncü, J., Atamaz, F. C., & Durmaz, B. (2006) · Journal of Rehabilitation Medicine · doi:10.1080/16501970600722395 · Cited by 62
“The FIS was originally developed for patients with multiple sclerosis (16), and has been used in several disorders (17, 18).”
MethodFeys, P., Gijbels, D., Romberg, A., Santoyo-Medina, C., Gebara, B., de Noordhout, B. M., Knuts, K., Béthoux, F., de Groot, V., Vaney, C., et al. (2011) · Multiple Sclerosis Journal · doi:10.1177/1352458511419881 · Cited by 62
Fatigue in Multiple Sclerosis: Misconceptions and Future Research Directions
Rudroff, T., Kindred, J. H., & Ketelhut, N. B. (2016) · Frontiers in Neurology · doi:10.3389/fneur.2016.00122 · Cited by 68
“They found that MS related fatigue, assessed by the MFIS, FSS, and MRI, is at least partially associated with disruption of frontal and parietal pathways and cortical areas involved in cognitive/ attentional processing.”
BackgroundInfluentialInduction of cognitive fatigue in MS patients through cognitive and physical load
Claros-Salinas, D., Dittmer, N., Neumann, M., Sehle, A., Spiteri, S., Willmes, K., Schoenfeld, M. A., & Dettmers, C. (2012) · Neuropsychological Rehabilitation · doi:10.1080/09602011.2012.726925 · Cited by 61
Cognitive and neurobehavioral features in multiple sclerosis
Arnett, P. A., & Strober, L. B. (2011) · Expert Review of Neurotherapeutics · doi:10.1586/ern.11.12 · Cited by 59
Stern, M. A., Sorkin, L. Y., Milton, K., & Sperber, K. (2010) · Physical Medicine and Rehabilitation Clinics of North America · doi:10.1016/j.pmr.2009.12.008 · Cited by 61
Fatigue and Comorbidities in Multiple Sclerosis
Fiest, K. M., Fisk, J. D., Patten, S. B., Tremlett, H. L., Wolfson, C. M., Warren, S., McKay, K. A., Berrigan, L. I., Marrie, R. A., & for the CIHR Team in the Epidemiology and Impact of Comorbidity on Multiple Sclerosis (ECoMS) (2016) · International Journal of MS Care · doi:10.7224/1537-2073.2015-070 · Cited by 63
Self-citationPsychometric Properties of the HIV-Related Fatigue Scale
Barroso, J. V., & Lynn, M. R. (2002) · Journal of the Association of Nurses in AIDS Care · doi:10.1016/s1055-3290(06)60242-2 · Cited by 59
Fatigue and multiple sclerosis
Béthoux, F. (2006) · Annales de Réadaptation et de Médecine Physique · doi:10.1016/j.annrmp.2006.04.022 · Cited by 60
Invisible and Visible Symptoms of Multiple Sclerosis
White, C. P., White, M. B., & Russell, C. S. (2008) · Journal of Neuroscience Nursing · doi:10.1097/01376517-200804000-00007 · Cited by 60
“Given that fatigue is a common complaint of persons with MS (Fisk et al., 1994; Freal et al., 1984; Krupp, 2003), it is surprising that it was not one of the significant individual variables for the entire sample.”
BackgroundWhite, A. T., Light, A. R., Hughen, R. W., VanHaitsma, T. A., & Light, K. C. (2011) · Psychosomatic Medicine · doi:10.1097/psy.0b013e31824152ed · Cited by 60
Efficacy of Balance and Eye-Movement Exercises for Persons With Multiple Sclerosis (BEEMS)
Hebert, J. R., Corboy, J. R., Vollmer, T. L., Forster, J. E., & Schenkman, M. L. (2018) · Neurology · doi:10.1212/wnl.0000000000005013 · Cited by 60
Gullo, H., Fleming, J., Bennett, S. H., & Shum, D. (2019) · Multiple Sclerosis and Related Disorders · doi:10.1016/j.msard.2019.03.024 · Cited by 60
“For some PwMS, fatigue may be the first manifestation of the disease (Fisk et al., 1994; Kos et al., 2008); it may be more severe during periods of disease exacerbation; aggravated by heat and physical effort; and worsen at certain times of day or during warmer months (Freal, Kraft & Coryell, 1984; Krupp et al.”
BackgroundRatings of Perceived Exertion During Aerobic Exercise in Multiple Sclerosis
Morrison, E., Cooper, D. M., White, L. J., Larson, J. K., Leu, S., Zaldivar, F. P., & Ng, A. V. (2008) · Archives of Physical Medicine and Rehabilitation · doi:10.1016/j.apmr.2007.12.036 · Cited by 60
Flensner, G., & Lindencrona, C. (2002) · Journal of Advanced Nursing · doi:10.1046/j.1365-2648.2002.02129.x · Cited by 60
Alexithymia in multiple sclerosis: Relationship with fatigue and depression
Bodini, B., Mandarelli, G., Tomassini, V., Tarsitani, L., Pestalozza, I., Gasperini, C., Lenzi, G. L., Pancheri, P., & Pozzilli, C. (2008) · Acta Neurologica Scandinavica · doi:10.1111/j.1600-0404.2007.00969.x · Cited by 59
Carroll, S., Chalder, T., Hemingway, C. A., Heyman, I., & Moss-Morris, R. E. (2015) · Developmental Medicine & Child Neurology · doi:10.1111/dmcn.12964 · Cited by 61
Finlayson, M. L. (2005) · Neurorehabilitation · doi:10.3233/nre-2005-20404 · Cited by 59
“…and the associated measurement tools for the research questions included fatigue severity (Fatigue Severity Scale – conducted during screening [11]), fatigue impact (Fatigue Impact Scale [6]), self-efficacy for fatigue management (Self-efficacy questionnaire [17]), and quality of life (SF-36 [35]).”
Kargarfard, M., Eetemadifar, M., Mehrabi, M., Maghzi, A., & Hayatbakhsh, M. R. (2011) · European Journal of Neurology · doi:10.1111/j.1468-1331.2011.03535.x · Cited by 59
“Reliability and validity of the MFIS have been established in patients with MS [34,37,38].”
BackgroundMultiple sclerosis associated fatigue during natalizumab treatment
Putzki, N., Yaldizli, Ö., Tettenborn, B., & Diener, H. (2009) · Journal of the Neurological Sciences · doi:10.1016/j.jns.2009.06.004 · Cited by 59
Self-Care, Productivity and Leisure Limitations of People with Multiple Sclerosis in Manitoba
Finlayson, M. L., Impey, M., Nicolle, C., & Edwards, J. (1998) · Canadian Journal of Occupational Therapy · doi:10.1177/000841749806500508 · Cited by 59
“Authors such as Fisk et al. (1994), in their discussions of the EDSS have also alluded to this point.”
BackgroundResultCardiorespiratory response to walk in multiple sclerosis patients
Chetta, A. A., Rampello, A., Marangio, E., Merlini, S., Dazzi, F., Aiello, M., Ferraro, F., Foresi, A., Franceschini, M., & Olivieri, D. (2004) · Respiratory Medicine · doi:10.1016/j.rmed.2003.11.011 · Cited by 58
Freitas, S., Batista, S., Afonso, A. C., Simões, M. R., Sousa, L., Cunha, L., & Santana, I. J. (2016) · Applied Neuropsychology Adult · doi:10.1080/23279095.2016.1243108 · Cited by 60
Strober, L. B., Bruce, J. M., Arnett, P. A., Alschuler, K. N., DeLuca, J., Chiaravalloti, N. D., Lebkuecher, A. L., Benedetto, M. D., Cozart, J. S., Thelen, J., et al. (2020) · Multiple Sclerosis and Related Disorders · doi:10.1016/j.msard.2020.102576 · Cited by 57
Therapy-induced plasticity of cognitive functions in MS patients: Insights from fMRI
Penner, I., Kappos, L., Rausch, M., Opwis, K., & Radue, E. W. (2006) · Journal of Physiology-Paris · doi:10.1016/j.jphysparis.2006.03.008 · Cited by 57
Potential Benefits of Nintendo Wii Fit Among People with Multiple Sclerosis
Plow, M. A., & Finlayson, M. L. (2011) · International Journal of MS Care · doi:10.7224/1537-2073-13.1.21 · Cited by 57
Rehabilitation challenges in multiple sclerosis
BURKS, J. S., Bigley, G. K., & Hill, H. (2009) · Annals of Indian Academy of Neurology · doi:10.4103/0972-2327.58273 · Cited by 57
Sangelaji, B., Smith, C. M., Paul, L., Sampath, K. K., Treharne, G. J., & Hale, L. A. (2015) · Clinical Rehabilitation · doi:10.1177/0269215515595274 · Cited by 60
Harvey, L. A., Smith, A. D., & Jones, R. (1999) · Physiotherapy · doi:10.1016/s0031-9406(05)65699-4 · Cited by 57
Prevalence and Severity of Multiple-Sclerosis-Associated Fatigue in Treated and Untreated Patients
Putzki, N., Katsarava, Z., Vago, S., Diener, H., & Limmroth, V. (2007) · European Neurology · doi:10.1159/000111876 · Cited by 56
Fatigue Impact Scale Demonstrates Greater Fatigue in Younger Stroke Survivors
Parks, N. E., Eskes, G. A., Gubitz, G. J., Reidy, Y., Christian, C. A., & Phillips, S. J. (2012) · Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques · doi:10.1017/s0317167100015353 · Cited by 56
Bilateral differences in lower-limb performance in individuals with multiple sclerosis
Larson, R. D., McCully, K. K., Larson, D. J., Pryor, W. M., & White, L. J. (2013) · The Journal of Rehabilitation Research and Development · doi:10.1682/jrrd.2011.10.0189 · Cited by 56
“Symptoms vary widely across individuals; however, fatigue is a common complaint [2–5], with 40 percent of those surveyed identifying it as their most disabling symptom [2,4].”
BackgroundNeumann, M., Sterr, A., Claros-Salinas, D., Gütler, R., Ulrich, R., & Dettmers, C. (2014) · Journal of the Neurological Sciences · doi:10.1016/j.jns.2014.03.024 · Cited by 61
“Fatigue is a very common symptom inmultiple sclerosis (MS) that is experienced by up to 90% of patients [1,2].”
Renfrew, L. (., Paul, L., McFadyen, A. K., Rafferty, D., Moseley, O., Lord, A. C., Bowers, R. J., & Mattison, P. (2019) · Clinical Rehabilitation · doi:10.1177/0269215519842254 · Cited by 56
Ormstad, H., Simonsen, C. S., Broch, L., Maes, M. H. J., Anderson, G., & Celius, E. G. (2020) · Multiple Sclerosis and Related Disorders · doi:10.1016/j.msard.2020.102533 · Cited by 56
Ng, A., Dao, H. T., Miller, R. G., Gelinas, D. F., & Kent‐Braun, J. A. (2000) · Journal of Applied Physiology · doi:10.1152/jappl.2000.88.3.871 · Cited by 56
“Previous studies have found that symptomatic fatigue does not correlate with disability level (13, 14, 25) or with muscle fatigue (46).”
BackgroundThe role of melatonin in Multiple Sclerosis
Skarlis, C., & Anagnostouli, M. C. (2019) · Neurological Sciences · doi:10.1007/s10072-019-04137-2 · Cited by 56
“Sleep abnormalities are also very common among MS patients and significantly more frequent compared with the general population [136].”
BackgroundGoverover, Y., Strober, L. B., Chiaravalloti, N. D., & DeLuca, J. (2015) · American Journal of Occupational Therapy · doi:10.5014/ajot.2015.014332 · Cited by 54
“Lastly, fatigue was measured with the Modified Fatigue Impact Scale (Fisk, Pontefract, Ritvo, Archibald, & Murray, 1994).”
Evaluation of cognition and fatigue in multiple sclerosis: daily practice and future directions
Penner, I. (2016) · Acta Neurologica Scandinavica · doi:10.1111/ane.12651 · Cited by 54
Mental Health Comorbidity in MS: Depression, Anxiety, and Bipolar Disorder
Turner, A. P., Alschuler, K. N., Hughes, A. J., Beier, M. L., Haselkorn, J. K., Sloan, A. P., & Ehde, D. M. (2016) · Current Neurology and Neuroscience Reports · doi:10.1007/s11910-016-0706-x · Cited by 55
Khaw, Y. M., Cunningham, C., Tierney, A., Sivaguru, M., & Inoue, M. (2020) · Journal of Neuroinflammation · doi:10.1186/s12974-020-1730-y · Cited by 51
Walking in multiple sclerosis improves with tDCS: a randomized, double‐blind, sham‐controlled study
Pilloni, G., Choi, C. S., Shaw, M., Coghe, G., Krupp, L., Moffat, M., Cocco, E. E., Pau, M., & Charvet, L. E. (2020) · Annals of Clinical and Translational Neurology · doi:10.1002/acn3.51224 · Cited by 54
“MS-related fatigue was self-reported using the Fatigue Severity Scale (FSS) that scored the general impact of fatigue as descriptive clinical measure,(31) and using the 21item modified form of the Fatigue Impact Scale (MFIS21) to evaluate changes in the physical, cognitive, and psychosocial aspects of fatigue.(32) The…”
MethodPiatkowski, J., Kern, S., & Ziemssen, T. (2009) · The Journal of Alternative and Complementary Medicine · doi:10.1089/acm.2008.0501 · Cited by 53
“Fatigue is not closely related to physical signs of disability or with magnetic resonance imaging markers of disease activity, although it does seem to increase when the patient experiences relapses.(2,4) Fatigue is a major cause of unemployment in patients with MS.”
Marchesi, O., Vizzino, C., Meani, A., Conti, L., Riccitelli, G. C., Preziosa, P., Filippi, M., & Rocca, M. A. (2020) · European Journal of Neurology · doi:10.1111/ene.14471 · Cited by 53
Bussmann, J. B. J., Garssen, M. P. J., van Doorn, P. A., & Stam, H. (2007) · Acta Dermato Venereologica · doi:10.2340/16501977-0007 · Cited by 53
“The cognitive subscale (10 items) of the FIS was selected as a third and final outcome measure of mental functioning (14, 15).”
Effects of whole-body vibration training on physical function in patients with Multiple Sclerosis
Hilgers, C., Mündermann, A., Riehle, H. J., & Dettmers, C. (2013) · Neurorehabilitation · doi:10.3233/nre-130888 · Cited by 52
Derache, N., Grassiot, B., Mézenge, F., Dugué, A. E., Desgranges, B., Constans, J., & Defer, G. (2013) · Multiple Sclerosis and Related Disorders · doi:10.1016/j.msard.2013.03.005 · Cited by 52
“Fatigue may be experienced in the early stages of MS, before neurological system dysfunctions become apparent and Fisk et al. (1994) have shown that 50% of MS patients had fatigue as the first symptom of the disease.”
BackgroundResult
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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