Abstract
Multiple sclerosis (MS) patients suffer very often from MS fatigue and sleep problems. Despite the detrimental impact on the activities of daily living, a short and objective quantification of fatigue and sleep problems is currently lacking. The objective of the study was to systematically investigate tonic, intrinsic, and phasic alertness and the relationship of these performance-based measures with self-report measures of fatigue and quality of sleep. Thirty-three MS patients without (MS-) and 26 with selected comorbid disorders (MS+) and 43 healthy controls (HCs) performed the pupillographic sleepiness test (measuring tonic alertness) and the alertness subtest of the Test of Attentional Performance (measuring intrinsic and phasic alertness). Self-reported and performance-based measures revealed poorer performance for both MS groups compared to HC. MS+ patients presented higher rates of MS fatigue, sleep problems and depressive symptoms but similar alertness scores compared to MS- patients. However, tonic alertness was only higher in MS- patients compared to HC. Intrinsic and phasic alertness correlated moderately with fatigue ratings. In the diagnostic process of MS fatigue and quality of sleep comorbid disorders (depression, anemia, thyroid dysfunction) and performance-based measures such as alertness should be considered in daily clinical practice.
Highlights
Multiple sclerosis (MS) is an inflammatory disease of the central nervous system with a widespread demyelination and axonal loss [1]
MS+ patients differed from MS− patients with regard to clinical parameters years since diagnosis and years with fatigue were comparable
MS− patients had almost similar MSFC scores compared to healthy control (HC) (p = 0.056) whereas MS + patients presented lower scores compared to HC (p < 0.001)
Summary
Multiple sclerosis (MS) is an inflammatory disease of the central nervous system with a widespread demyelination and axonal loss [1]. Fatigue and Sleep in Multiple Sclerosis Patients symptom that includes three clinical different entities: asthenia (fatigue at rest), fatigability (fatigue with exercise), and worsening of symptoms with effort [5]. Despite these entities, the pathophysiology underlying MS-related fatigue is still under investigation: Proinflammatory cytokines, overactivity of neural circuits, HPA axis involvement, and axonal injury are discussed [for an overview see Ref. For the assessment of subjective perceived Fatigue, self-report measures are often used, because they are cheap and easy to administer These measurements are vulnerable to a series of problems such as self-perception, social desirability, malingering, motives, memory processes, and overestimation (e.g., because of depression) or underestimation (e.g., because of anosognosia). Despite the detrimental impact on the activities of daily living, a short and objective quantification of fatigue and sleep problems is currently lacking
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