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- Title
Fatigue predicts disease worsening in relapsing-remitting multiple sclerosis patients.
- Authors
Cavallari, Michele; Palotai, Miklos; Prieto, Juan Carlos; Guttmann, Charles R. G.; Glanz, Bonnie I.; Egorova, Svetlana; Healy, Brian C.; Chitnis, Tanuja
- Abstract
Background: It is unclear whether fatigue is a consequence or a predictive trait of disease worsening. Objective: To investigate the predictive value of fatigue toward conversion to confirmed moderate–severe disability in patients with relapsing-remitting multiple sclerosis (RRMS). Methods: We retrospectively selected from the Comprehensive Longitudinal Investigations in MS at the Brigham and Women’s Hospital (CLIMB) study cohort RRMS patients who converted to confirmed (⩾2 years) Expanded Disability Status Scale (EDSS) score ⩾3 within a follow-up period ⩾3 years. We contrasted the Modified Fatigue Impact Scale (MFIS) score of 33 converters, obtained at least 1 year before conversion to EDSS ⩾3, with that of 33 non-converter RRMS patients matched for baseline characteristics. Results: Total MFIS score was higher in converter versus non-converter MS patients (median 37 vs 13; p < 0.0001). EDSS and Center for Epidemiological Studies Depression scale (CES-D) scores were also higher in the converters (median EDSS 1.5 vs 0, p < 0.0001; median CES-D 30 vs 24, p < 0.0001) and were both associated with MFIS score (EDSS: rho = 0.42, p = 0.0005; CES-D: rho = 0.72, p < 0.0001). After adjusting for EDSS and CES-D in multivariate analysis, MFIS remained a significant predictor of subsequent conversion to confirmed EDSS ⩾3. Conclusion: Fatigue is a promising indicator of risk for conversion to confirmed moderate–severe disability in RRMS patients.
- Subjects
MULTIPLE sclerosis; MULTIPLE sclerosis research; FATIGUE (Physiology); NEUROPSYCHOLOGICAL tests; QUALITY of life; PATIENTS
- Publication
Multiple Sclerosis Journal, 2016, Vol 22, Issue 14, p1841
- ISSN
1352-4585
- Publication type
Article
- DOI
10.1177/1352458516635874