Cited by 1,025Multiple Sclerosis Research StudiesCancer survivorship and careFibromyalgia and Chronic Fatigue Syndrome Research

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The Impact of Fatigue on Patients with Multiple Sclerosis

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Fisk, John D., Pontefract, Amanda, Ritvo, Paul G., Archibald, Catherine J., Murray, T.J.·1994·Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques

DOI 10.1017/s0317167100048691

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Abstract

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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Andreeva, M. T., & Караваева, Т. А. (2020) · V M BEKHTEREV REVIEW OF PSYCHIATRY AND MEDICAL PSYCHOLOGY · doi:10.31363/2313-7053-2019-4-2-19-28 · Cited by 11
Testing non-inferiority of blended versus face-to-face cognitive behavioural therapy for severe fatigue in patients with multiple sclerosis and the effectiveness of blended booster sessions aimed at improving long-term outcome following both therapies: study protocol for two observer-blinded randomized clinical trials
de Gier, M., Beckerman, H., van Vliet, K., Knoop, H., & de Groot, V. (2020) · Trials · doi:10.1186/s13063-019-3825-2 · Cited by 10
A Rapid Tapping Task on Commodity Smartphones to Assess Motor Fatigability
Barrios, L., Oldrati, P., Lindlbauer, D., Hilty, M., Hayward-Koennecke, H. K., Holz, C., & Lutterotti, A. (2020) · CHI Conference on Human Factors in Computing Systems · doi:10.1145/3313831.3376588 · Cited by 11
A network-based cognitive training induces cognitive improvements and neuroplastic changes in patients with relapsing-remitting multiple sclerosis: an exploratory case-control study
Venneri, A., Manca, R., Mitolo, M., Wilkinson, I., Paling, D., & Sharrack, B. (2020) · Neural Regeneration Research · doi:10.4103/1673-5374.300450 · Cited by 10
“…Trail Making Test (Armitage, 1946); Stroop test (Wakefield et al., 2014); Digit Symbol Coding Test (Wechsler, 2008); Modified Fatigue Impact Scale (Fisk et al., 1994); Patient Health Questionnaire (Spitzer et al., 1999); Generalized Anxiety Disorder scale (Spitzer et al., 2006); and Multiple…”
Confirmed disability progression provides limited predictive information regarding future disease progression in multiple sclerosis
Healy, B. C., Glanz, B. I., Swallow, E., Signorovitch, J., Hagan, K. A., Silva, D. A. S., Pelletier, C. L., Chitnis, T., & Weiner, H. L. (2021) · Multiple Sclerosis Journal - Experimental Translational and Clinical · doi:10.1177/2055217321999070 · Cited by 10
“The measure of fatigue was the modified fatigue impact scale (MFIS), which is a commonly used measure in MS that includes 21 questions to measure the physical, mental, and psychological components of fatigue.(9) The brief cognitive screening test was the symbol digit modalities test (SDMT), which is a 90second speed o…”
Method
Multimodal emotion perception in young and elderly patients with multiple sclerosis
Montembeault, M., Brando, E., Charest, K., Tremblay, A., Roger, É., Duquette, P., & Rouleau, I. (2022) · Multiple Sclerosis and Related Disorders · doi:10.1016/j.msard.2021.103478 · Cited by 10
Therapie der Tagesmudigkeit bei Patienten mit multipler Sklerose
Zifko, U. (2003) · Wiener Medizinische Wochenschrift · doi:10.1046/j.1563-258x.2003.02014.x · Cited by 10
Environmental temperature and exercise modality independently impact central and muscle fatigue among people with multiple sclerosis
Grover, G., Ploughman, M., Philpott, D. T. G., Kelly, L. P., Devasahayam, A. J., Wadden, K. P., Power, K. E., & Button, D. C. (2017) · Multiple Sclerosis Journal - Experimental Translational and Clinical · doi:10.1177/2055217317747625 · Cited by 10
“Experimental design During the first session, demographic and MS-related data were collected (age, years since diagnosis, Fatigue Impact Scale (FIS)).(17) PwMS self-reported their degree of heat sensitivity using a”
Method
Caregiver burden in multiple sclerosis
Arnett, P. A. (2007) · Journal of Neurology Neurosurgery & Psychiatry · doi:10.1136/jnnp.2007.115659 · Cited by 10
Signal Detection Theory as a Novel Tool to Understand Cognitive Fatigue in Individuals With Multiple Sclerosis
Román, C. A. F., DeLuca, J., Yao, B., Genova, H. M., & Wylie, G. R. (2022) · Frontiers in Behavioral Neuroscience · doi:10.3389/fnbeh.2022.828566 · Cited by 12
“Fatigue, including cognitive fatigue, is one of the most common and debilitating symptoms reported by persons with MS (pwMS; Freal et al., 1984; Fisk et al., 1994), impacting employment, quality of life, psychological state, and daily functioning (Nagaraj et al., 2013; Coyne et al., 2015; Tabrizi…”
Background
Modifying Diet and Exercise in MS (MoDEMS): Study design and protocol for a telehealth weight loss intervention for adults with obesity & Multiple Sclerosis
Bruce, J. M., Cozart, J. S., Shook, R. P., Ruppen, S., Siengsukon, C. F., Simon, S. D., Befort, C. A., LYNCH, S. G., Mahmoud, R., Drees, B. M., et al. (2021) · Contemporary Clinical Trials · doi:10.1016/j.cct.2021.106495 · Cited by 9
Interpreting the clinical importance of the relationship between subjective fatigue and cognitive impairment in multiple sclerosis (MS): How BICAMS performance is affected by MS-related fatigue
Bellew, D., Davenport, L., Monaghan, R., Cogley, C., Gaughan, M., Yap, S. M., Tubridy, N. J., Bramham, J., McGuigan, C., & O’Keeffe, F. M. (2022) · Multiple Sclerosis and Related Disorders · doi:10.1016/j.msard.2022.104161 · Cited by 10
Fatigue bei Multipler Sklerose
Flachenecker, P. (2015) · Nervenheilkunde · doi:10.1055/s-0038-1627622 · Cited by 9
Measurement properties of the Chinese version of the Mental Fatigue Scale for patients with traumatic brain injury
Chiu, H.-Y., Li, W., Lin, J.-H., Su, Y.-K., Lin, E.-Y., & Tsai, P.-S. (2018) · Brain Injury · doi:10.1080/02699052.2018.1432893 · Cited by 9
“A review (9) reported that various self-report fatigue measurements, such as the Fatigue Severity Scale (10), the Visual Analog Scale for fatigue (11), the Fatigue Impact Scale (12,13), and the Barrow Neurological Institute Fatigue Scale (14), have been used to assess the fatigue in the TBI population.”
Background
A pilot study of the impact of an exercise intervention on brain structure, cognition, and psychosocial symptoms in individuals with relapsing-remitting multiple sclerosis
Mayo, C. D., Harrison, L., Attwell-Pope, K., Stuart-Hill, L. A., & Gawryluk, J. R. (2021) · Pilot and Feasibility Studies · doi:10.1186/s40814-021-00806-2 · Cited by 9
“Participants also completed pre- and post-intervention self-report measures to assess perceived cognitive impairment (attention/concentration, retrospective memory, prospective memory, and planning/organization; Perceived Deficit Questionnaire; PDQ) [24] fatigue (Modified Fatigue Impact Scale; MFIS) [24, 25], and mood…”
Method
Natalizumab wearing-off symptoms: effect of extend interval dosing during Sars-CoV-2 pandemic
Magro, G., Barone, S., Tosto, F., Martino, A., lo, D. S., Manzo, L., Pascarella, A., Bruno, P., Pasquale, M., Gambardella, A., et al. (2022) · Journal of Neurology · doi:10.1007/s00415-022-11408-0 · Cited by 10
Multi-Disease Validation of the RUDAS for Cognitive Screening in Alzheimer’s Disease, Parkinson’s Disease, and Multiple Sclerosis
Delgado‐Álvarez, A., Díez‐Cirarda, M., Delgado‐Alonso, C., Hernández‐Lorenzo, L., Cuevas, C., Valles‐Salgado, M., Montero‐Escribano, P., Gil‐Moreno, M. J., Matías‐Guiu, J., García-Ramos, R., et al. (2022) · Journal of Alzheimer s Disease · doi:10.3233/jad-220907 · Cited by 10
“…people with AD; Hoehn and Yahr scale [52] for PD-MCI; and Expanded Disability Status Scale [53], Fatigue Severity Scale [54], Modiﬁed Fatigue Impact Scale [55], and Beck’s Depression Inventory [56] for MS. HC group was evaluated with MMSE, and also with CDR and FAQ to ensure the inclusion criteria.”
Patients experience of cognitive fatigue post-stroke: an exploratory study
Askari, S., Harvey, K., & Sam-Odutola, M. (2023) · Disability and Rehabilitation · doi:10.1080/09638288.2023.2280065 · Cited by 9
“The screening involved completing a 9-item cognitive fatigue subscale from the Modified Fatigue Impact Scale [15], the Patient Health Questionnaire 9 [17], and the Short Blessed Test for cognitive abilities [18].”
Examining the effects of stressors and resources on multiple sclerosis among African Americans and Whites
Johnson, S. K., Terrell, D. F., Sargent, C., & Kaufman, M. (2007) · Stress and Health · doi:10.1002/smi.1138 · Cited by 9
A randomized study to evaluate the effect of exercise on fatigue in people with relapsing–remitting multiple sclerosis treated with fingolimod
Mäurer, M., Schuh, K., Seibert, S. M., Baier, M. L., Hentschke, C., Streber, R., Tallner, A., & Pfeifer, K. (2018) · Multiple Sclerosis Journal - Experimental Translational and Clinical · doi:10.1177/2055217318756688 · Cited by 9
[Current possibilities of assessment of quality of life in multiple sclerosis].
Opara, J. A., Jaracz, K., & Brola, W. (2006) · PubMed · Cited by 9
Quality of life following prolonged critical illness: A mixed methods study
Ramsay, P. (2010) · ERA · Cited by 9
Fatigability-related oscillatory brain activity changes in people with MS
Linnhoff, S., Haghikia, A., & Zaehle, T. (2022) · Multiple Sclerosis and Related Disorders · doi:10.1016/j.msard.2022.104457 · Cited by 8
Amantadine and/or transcranial magnetic stimulation for fatigue associated with multiple sclerosis (FETEM): study protocol for a phase 3 randomised, double-blind, cross-over, controlled clinical trial
Matías‐Guiu, J. A., González-Rosa, J. J., Hernández, M. Á., Martínez‐Ginés, M. L., Portolés, A., Pérez-Macías, N., Benito‐León, J., Padrón, I., Prieto, J., & Matías‐Guiu, J. (2024) · BMJ Open · doi:10.1136/bmjopen-2023-078661 · Cited by 8
Feasibility and usability evaluation of a gamified fatigue management mobile application for persons with multiple sclerosis in everyday life
Giunti, G., Yrttiaho, T., Guardado, S., Sachinopoulou, A., Mylonopoulou, V., Fält, J., Paloniemi, B., Ryytty, M., Krüger, J., & Isomursu, M. (2025) · Multiple Sclerosis and Related Disorders · doi:10.1016/j.msard.2025.106379 · Cited by 12
“Fatigue is the most prevalent and debilitating symptom in Multiple Sclerosis (MS), impacting up to 80 % of patients (Krupp, 2006; S Pittion-Vouyovitch et al., 2006; V Janardhan and Bakshi, 2002; Fisk et al., 1994; Zwibel, 2009; Hadjimichael et al., 2008).”
Characterizing fatigue phenotypes with other symptoms and clinically relevant outcomes among people with multiple sclerosis
Plow, M. A., Gunzler, D. D., & Chang, J. H. (2022) · Quality of Life Research · doi:10.1007/s11136-022-03204-0 · Cited by 8
Cognitive Reserve Moderates the Effects of Fatigue and Depressive Symptoms in Multiple Sclerosis
Bradson, M. L., Cadden, M. H., Riegler, K. E., Thomas, G. A., Randolph, J. J., & Arnett, P. A. (2023) · Archives of Clinical Neuropsychology · doi:10.1093/arclin/acad041 · Cited by 9
Penetrating the Dark Silence
Crocker, S. H. (2009) · Advances in Nursing Science · doi:10.1097/ans.0b013e3181bd693d · Cited by 8
Fatigue evaluation in fingolimod treated patients: An observational study
Masingue, M., Debs, R., Maillart, É., Delvaux, V., Lubetzki, C., Vidal, J., & Papeix, C. (2017) · Multiple Sclerosis and Related Disorders · doi:10.1016/j.msard.2017.03.006 · Cited by 8
A multicenter randomized controlled trial of two group education programs for fatigue in multiple sclerosis: Long-term (12-month) follow-up at one site
Hugos, C. L., Cameron, M. H., Chen, Z., Chen, Y., & BOURDETTE, D. N. (2018) · Multiple Sclerosis Journal · doi:10.1177/1352458518775920 · Cited by 8
Osteopathic Manipulative Therapy and Multiple Sclerosis: A Proof-of-Concept Study
Cordano, C., Armezzani, A., Veroni, J., Pardini, M., Sassos, D., Infante, M. T., Tacchino, A., Lapucci, C., Cellerino, M., Calabrò, V., et al. (2018) · Journal of Osteopathic Medicine · doi:10.7556/jaoa.2018.121 · Cited by 8
Cryotherapy and self-reported fatigue in individuals with multiple sclerosis: A systematic review
Campbell, A., Killen, B. S., Cialone, S. J., Scruggs, M., & Lauderdale, M. (2019) · Physical Therapy Reviews · doi:10.1080/10833196.2019.1674546 · Cited by 8
Cognitive fatigability in multiple sclerosis: How does performance decline over time on the Paced Auditory Serial Addition Test?
Agyemang, C., Berard, J. A., & Walker, L. A. S. (2021) · Multiple Sclerosis and Related Disorders · doi:10.1016/j.msard.2021.103130 · Cited by 8
Making Visible the Invisible: Automatically Measured Global and Regional Brain Volume Is Associated with Cognitive Impairment and Fatigue in Multiple Sclerosis
Ziccardi, S., Pizzini, F. B., Guandalini, M., Tamanti, A., Cristofori, C., & Calabrese, M. (2022) · Bioengineering · doi:10.3390/bioengineering10010041 · Cited by 8
Longitudinal assessment of neurocognitive function in people with relapsing multiple sclerosis initiating alemtuzumab in routine clinical practice: LEM-COG study results
Wilken, J. A., Traboulsee, A. L., Nelson, F. M., Ionete, C., Kolind, S., Fratto, T., Kane, R., Gandhi, R., Rawlings, A. M., Roesch, N., et al. (2023) · Multiple Sclerosis and Related Disorders · doi:10.1016/j.msard.2023.104677 · Cited by 8
Fahreignung bei Multipler Sklerose
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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
DOI: 10.1017/s0317167100048691
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
Licence: www.cambridge.org/core/terms (unspecified, 7899 d)
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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The Impact of Fatigue on Patients with Multiple Sclerosis

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