Life In Multiple Sclerosis Research Articles

Effect of kinesiophobia on functional level and quality of life in multiple sclerosis

This study was planned to investigate the relationship between kinesiophobia and functional quality and quality of life in MS patients. The investigation was carried out in Samsun Ondokuz Mayıs University Research Hospital between September 30 and December 5, 2018. The participants of the study was composed of MS patients who were registered in Neurology Polyclinic and healthy voluntary people. The personal data form that developed by the researcher reviewing the literature on this subject, BBS, IPAQ, FSS, FIS, SF-36, VAS, McGill, EDSS scores and performance based 6MWT. Expert opinion was obtained for the scope validity of the data collection tool. The analysis of the data in this study wasevaluated with IBM SPSS.22 package program. The mean age of 74 patients was 37.81 ± 11.62 years, the mean age of 11 healthy individuals was 35,90 ± 12,17 years. 68.9% of the patients were female and 31.1% were male. 41.9% of the patients were primary school graduates, 17.6% were high school graduates and 40.5% were university graduates. Pain and fatigue in patients and healthy individuals were found to be related to kinesiophobia. It was found that kinesiophobia affected many parameters of quality of life and the quality of life affected the physical function of the patients. Balance and fall were found to be associated with a low level of kinesiophobia. In MS patients, functional status, especially pain and fatigue, is related to kinesiophobia. At the same time, increased kinesiophobia affects the quality of life.

Health-related quality of life in multiple sclerosis: Links to acceptance, coping strategies and disease severity

BackgroundPeople with multiple sclerosis (MS) report lower health-related quality of life (HRQoL). Improvements in quality of life can be made by identifying the factors that contribute to HRQoL in MS, which are both person specific and disease related. ObjectiveThe primary objective of this study was to examine the mutual roles of acceptance, coping, and MS severity on HRQoL. Materials and methodsThis study included 382 patients with MS who completed the 29-item Multiple Sclerosis Impact Scale, Coping Inventory for Stressful Situations, and Acceptance of Illness Scale. A standardized questionnaire was used to collect patient clinical and demographics data. General MS severity was determined using the Expanded Disability Status Scale. ResultsSix variables, acceptance of illness (β = −0.24, p < 0.001), emotional coping strategy (β = 0.40, p < 0.001), avoidance coping strategy (β = −0.19, p < 0.001), illness duration (β = −0.18, p < 0.001), age at the time of the study (β = 0.14, p = 0.009) and problem coping strategy (β = −0.09, p = 0.05), were found to be the significant correlates of HRQoL in MS. The model that included these variables explained 36% of variance in self-management in MS. ConclusionPsychological variables are more salient correlates of HRQoL in MS than the objective clinical variables, such as the severity or type of MS. Specifically, this study showed that MS patients who accept their illness and use more problem-solving and avoidance coping strategies and less emotional coping strategies assess their HRQoL highly.

The impact of cervical spinal cord atrophy on quality of life in multiple sclerosis

BackgroundSpinal cord demyelination is common in multiple sclerosis (MS) and has been linked to increased disability and progressive clinical course. Spinal cord atrophy shows an especially close relationship to MS-related physical disability, though the relationship between spinal cord lesions/atrophy and health-related quality of life (QOL) has not been explored. Methods62 patients (53 relapsing MS, 7 secondary progressive, 2 clinically isolated syndrome) from our center underwent 3 T MRI within 30 days of clinical examination and QOL assessment. Upper cervical (C1-C3) spinal cord area (UCCA) was obtained from 3D high-resolution MPRAGE sequences (1 mm isotropic voxels). Cervical spinal cord (C1-C7) lesion count, and cervical and brain T2 hyperintense lesion volumes were calculated. Brain parenchymal fraction (BPF) was obtained from an automated segmentation pipeline. Spearman correlations were assessed between MRI and clinical data. Partial Spearman correlations adjusting for age, disease duration, and BPF assessed the independent association between MRI variables and QOL domains. ResultsUCCA showed an inverse relationship with age (r = −0.330, p = .009), disease duration, (r = −0.444, p < .001), and nine-hole peg test (r = −0.353, p = .005). The Upper Extremity Function QOL domain showed the strongest relationship to UCCA (r = 0.333, p = .008), with Lower Extremity Function QOL (r = 0.234, p = .067) and Satisfaction with Social Roles and Activities (r = 0.245, p = .055) correlations bordering significance. The association between UCCA and Upper Extremity QOL remained significant after adjustment for BPF, age, and disease duration. QOL domains reflective of psychological health (Depression, Anxiety, Emotional and Behavioral Dyscontrol, Positive Affect and Wellbeing) showed no relationship to UCCA. Cervical and brain lesion volume related to impairment in Stigma while cervical lesion count was unrelated to NeuroQOL impairment. Brain atrophy correlated with conventional markers of disability and cognition but did not have a significant relationship to QOL. ConclusionCervical spinal cord volume is independently associated with impaired upper extremity-related QOL in patients with MS. These findings suggest specific clinical relevance of MS-related spinal cord atrophy as compared to brain or cervical spinal cord lesions, or whole brain atrophy.

Which treatments improve fatigue and quality of life in Multiple Sclerosis? Evidence appraisal and development of visual interactive evidence maps (P5.2-088)

Which treatments improve fatigue and quality of life in Multiple Sclerosis? Evidence appraisal and development of visual interactive evidence maps (P5.2-088)

Cognitive and physical fatigue are associated with distinct problems in daily functioning, role fulfilment, and quality of life in multiple sclerosis

ObjectiveTo examine whether cognitive and physical fatigue are differentially associated with problems in self-care, mobility, relationships, participation, psychological well-being, and quality of life in people with multiple sclerosis. MethodsA cross-sectional study involving seventy-four community-dwelling people with MS was undertaken. Between-groups analysis was used to compare ratings on the Perceived Impact of Problem Profile (PIPP) in a range of functional domains and the SF-36 quality of life measure, across median-split groups based on level of both physical and cognitive fatigue using the Modified Fatigue Impact Scale. ResultsThe impact of poor psychological well-being (p = .005), and associated distress (p = .008) on PIPP was greater in the ‘high-level’ cognitive fatigue group than the ‘low-level’ cognitive fatigue group. By contrast, the ‘high-level’ and ‘low-level’ physical fatigue groups differed significantly in their self-reported impact of problems in the areas of mobility (p = .002), relationships (p = .014), participation (p = .001), and psychological well-being (p = .004). Overall mental quality of life was significantly lower (p < .001) in those high in cognitive fatigue comparative to the low-level group, and overall physical quality of life was significantly lower (p = .002) in people with multiple sclerosis high in physical fatigue as opposed to low. ConclusionCognitive and physical fatigue were associated with distinct problems in daily functioning, which impact differentially on role fulfilment and quality of life in multiple sclerosis. Therefore, these two types of fatigue should be considered distinct domains of the fatigue experience in MS.

The relationship between psychopathology, psychosocial adjustment, social support and quality of life in multiple sclerosis

Objectives: Multiple Sclerosis (MS) is a chronic disease which affects physical,psychological and social functioning of patients. In this study we aim to indicate psychiatric comorbidity, some psychosocial factors and their associations with quality of life in patients with MS. Methods: A total of 227 patients underwent psychiatric examination and the following scales were applied: Socio-demographic data form, Hospital Anxiety and Depression Scale (HADS), Multiple Sclerosis Quality of Life-54 (MSQOL-54), Psychosocial Adjustment to Illness Scale-Self report (PAIS-SR) and Multidimensional Scale of Perceived Social Support (MSPSS). Results: Among 227 patients with MS, 67.8% (n = 154) had psychiatric diagnosis; 24.2% (n = 55) had depression,19.8% (n = 45) had adjustment disorder, 14.9% (n = 34) had anxiety disorder, 7.1% (n=16) had dysthymic disorder and 1.8% (n = 4) had bipolar disorder. Patients with a psychiatric diagnosis had lower scores in role limitations due to emotional problems, emotional well-being, health perceptions, social function, cognitive function, health distress and mental health composite of MSQOL-54. PAIS-SR and MSPSS scores were significantly lower in MS patients with a psychiatric diagnosis. PAIS-SR scores were negatively correlated with role limitations-emotional, emotional well-being, social function, sexual function, satisfaction with sexual function, physical health composite and mental health composite scores of MSQOL-54. MSPSS total score was positively correlated with emotional well-being score of MSQOL-54. Conclusions: In MS patients, there is a high prevalence of psychopathology and it is associated with quality of life, perceived social support and psychosocial adjustment of the patients. Quality of life is reduced especially in emotional and mental aspects in patients with a psychiatric diagnosis. Diagnosis and treatment of psychopathology in MS patients seems crucial to decrease disease burden.

Electrophysiological correlates of cognitive symptoms in multiple sclerosis through neuromagnetic resting-state functional connectivity

Electrophysiological correlates of cognitive symptoms in multiple sclerosis through neuromagnetic resting-state functional connectivity

The association of psychological gender characteristics with quality of life and clinical aspects in patients with multiple sclerosis

To study the association between psychological gender characteristics and illness duration, severity of disability, asthenia, depression, anxiety and quality of life in multiple sclerosis (MS). One hundred patients (62 females and 38 males) with multiple sclerosis were studied. The following methods were used: The Mini-Mental State Examination, The Bem Sex Role Inventory adapted in Russia, The Expanded Disability Status Scale, The Multidimensional Fatigue Inventory-20, The Beck Depression Inventory, The Spilberger State-Trait Anxiety Inventory, The Short Form-36 (The Life Quality Questionnaire). The majority of patients had an androgynous type of psychological gender, some of patients were feminine. It was shown that there was an association between the number of feminine and masculine traits and MS duration, worsening of disability characteristics and life quality, increase in asthenia, depression and anxiety.

Short Report: Impact of Sleep Disorders on Depression and Patient-Perceived Health-Related Quality of Life in Multiple Sclerosis.

Sleep disorders in multiple sclerosis (MS) are associated with reduced health-related quality of life (HRQOL) and depression. However, research investigating and comparing how the two most common sleep disorders-insomnia and obstructive sleep apnea (OSA)-affect depression and HRQOL in MS is limited. The goal of this study is to examine the impact of diagnosed sleep disorders on patient-reported 1) HRQOL and 2) depressive symptoms in patients with MS. We performed a retrospective medical record review of 531 adult patients with MS: 287 (54%) with a comorbid sleep disorder (insomnia or OSA) and 244 (46%) without a diagnosed sleep disorder. Neither 1) average ratings of depression or HRQOL nor 2) the proportion of moderate depression or moderately impaired HRQOL differed between individuals with MS and insomnia and those with MS and OSA. Neither sleep disorder predicted increased depression or poorer HRQOL. However, individuals with MS and a comorbid sleep disorder (insomnia or OSA) had poorer HRQOL compared with those without a diagnosed sleep disorder (MS only). Presence of a diagnosed sleep disorder may negatively affect HRQOL in MS. Providers should continue to screen for sleep disorders given their negative impact on patients with MS and the availability of effective treatments for insomnia and OSA.

Botulinum Toxin A and physiotherapy in multiple sclerosis spasticity: Patient-tailored goal setting and the measurement of its achievement

Botulinum toxin type A (BT-A) is known to be effective in improving focal spasticity; a few data are available on BT-A efficacy in improving function and quality of life in Multiple Sclerosis (MS). To evaluate in MS patients presenting with focal spasticity the grade of achievement of the predefined goals through the treatment with BT-A and physiotherapy a longitudinal prospective study was drawn in 11 patients; for each patient it was fixed an individualized rehabilitative program and BT-A was administered depending on spasticity pattern. The evaluation of the adequate achievement of the target was done at week 4 using the Goal Attainment Scale (GAS). Specific scales were applied depending on the function or disability domain involved. All of them had a progressive form of MS; EDSS was 6.5 mean (4–8). 8 patients had as target gait improvement, 2 postural changes and 1 posture improving. 9 out of 11 reached the fixed target, 6 of them with gait improvement as target. Our data suggest that an integrated, multidisciplinary approach in treating focal spasticity is effective for reaching the individualized objective targeted on actual needs of single patient. This is the first step for a subsequent evaluation of a real impact of our intervention in reducing global disability of MS patients.

Evaluation of respiratory functions and quality of life in multiple sclerosis patients.

The aim of this study was to evaluate respiratory muscle strength, respiratory functions and quality of life in multiple sclerosis (MS) patients and compare the results with the healthy volunteers. The study included a group of 24 patients diagnosed with MS (16 women, 8 men) with an EDSS score of ≤ 5, who were without clinical respiratory impairment. MS patients were compared with the healthy volunteer group (16 women, 8 men). Respiratory muscle strength and respiratory functions were evaluated with specific devices. Maximal inspiratory pressure (MIP) and maximal expiratory pressure (MEP) parameters were measured for the muscle strength. Forced vital capacity (FVC), forced expiratory volume (FEV1), FEV1/FVC, peak expiratory flow, and forced expiratory flow (FEF25-75) parameters were measured for the respiratory functions. Questionnaire SF-36 was applied to evaluate health-related quality of life. A total of 24 MS patients' respiratory function test results were compared with healthy volunteers and significant changes were found at MIP, MEP, and FEV1 parameters. Quality of life was compared between the groups and there was a significant difference in parameters related with physical performance and physical-health-related role limitations. There is an early involvement of the respiratory muscles in patients with MS, yet clinical symptoms appear in later stages. Respiratory functions should be evaluated at the earlier stage of the disease so that rehabilitation can be planned in order to reduce respiratory complications and improve the quality of life in patients.

Health-related quality of life in multiple sclerosis: temperament outweighs EDSS

BackgroundThe influence of personality on health-related quality of life in patients with multiple sclerosis has been the focus of previous studies showing that introversion and neuroticism were related with reduced health related quality of life. However, no data exist on the impact of temperament on quality of life in this patient group.MethodsBetween April 2014 and March 2016 139 multiple sclerosis patients were recruited from a specialized outpatient clinic of the general hospital of Vienna. Health-related quality of life was measured by “The Multiple Sclerosis International Quality of Life Questionnaire (MusiQol)”, temperament by “Temperament Evaluation of Memphis, Pisa, Paris, and San Diego Questionnaire – Münster version” (briefTEMPS-M), and disability by the “Expanded disability status scale”. All patients underwent a diagnostic psychiatric semi-structured interview (MINI).ResultsKnown predictors (like disease duration, EDSS, psychiatric co-morbidities, immunomodulatory treatments) explain the proportion of variation in the outcome of MusiQol global index score in 30.9% in multi-variable linear regression analysis. It increased respectively to 40.3, 42.5, and 45.8% if adding the depressive, cyclothymic, or hyperthymic temperament to the list of variables. An increase of depressive and cyclothymic temperament scores significantly reduced global index score of MusiQol (p = 0.005, p = 0.002, respectively), while the hyperthymic temperament significantly raised it (p < 0.001).ConclusionIn MS patients, the depressive and cyclothymic temperament predict a lower and hyperthymic temperament an increased health-related quality of life, independent of current disability status, immunomodulatory treatments, and affective co-morbidities.

The Impact of Cervical Spinal Cord Atrophy on Quality of Life in Multiple Sclerosis (P1.422)

The Impact of Cervical Spinal Cord Atrophy on Quality of Life in Multiple Sclerosis (P1.422)

Social-Emotional Aspects of Quality of Life in Multiple Sclerosis (P4.417)

Social-Emotional Aspects of Quality of Life in Multiple Sclerosis (P4.417)

Sensory processing, cognitive fatigue, and quality of life in multiple sclerosis: Traitement de l'information sensorielle, fatigue cognitive et qualité de vie des personnes atteintes de sclérose en plaques.

Quality of life for persons living with multiple sclerosis (MS) is significantly lower than population norms. Fatigue, both physical and cognitive, is one of the most prevalent and debilitating symptoms of MS that decrease quality of life. Cognitive fatigue presents similarly to sensory overresponsiveness, but the connection has not been explored. This study aims to describe how sensory-processing preferences and cognitive fatigue relate to variances in quality of life for people with MS. A cross-sectional design was used with 30 people living with MS to complete the Adolescent/Adult Sensory Profile (AASP), Modified Fatigue Impact Scale, and RAND-36. Spearman's coefficient measured nonparametric correlations between variables. People with MS who have high scores in low registration, sensory sensitivity, and sensation avoidant quadrants of the AASP also have higher levels of cognitive fatigue and poorer quality of life. Those with high scores in sensory seeking experience greater quality of life and less cognitive fatigue. The findings shape clinical practice by supporting the assessment of sensory processing alongside fatigue, offering individualized intervention planning to shape fatigue management, and fostering hope and quality of life for persons living with MS.

The effect of cycling using active-passive trainers on spasticity, cardiovascular fitness, function and quality of life in Multiple Sclerosis

The effect of cycling using active-passive trainers on spasticity, cardiovascular fitness, function and quality of life in Multiple Sclerosis

Social-emotional aspects of quality of life in multiple sclerosis

Multiple sclerosis (MS) is an inflammatory auto-immune disease of the central nervous system. It leads to many impairments including physical, cognitive, psychological, and social challenges. Our study examined gender and cultural associations with quality of life (QoL), personal characteristics, and benefits from having MS among those with MS. The study was conducted in Austria and the United States. The sample included 128 participants, 64 in each country, of whom 78 were women and 50 were men aged between 20 and 57 years. We used standard statistical tests, including analyses of covariance (ANCOVA) and partial correlations for the analysis of quantitative data. For the qualitative part of the survey we used semi-structured interviews, which we transcribed and coded to identify categories in the answers for qualitative analyses. Austrian participants with MS perceived a higher social-emotional QoL in comparison to American participants. American participants expressed a higher self-esteem in comparison to Austrian participants. Men reported a lower ability to express love than women. Independent of sex/gender and nationality, participants reported benefits through the disease, especially with regard to improved compassion, mindfulness, improved family relations and lifestyle gains. The qualitative interviews revealed additional gender differences for coping with the illness; and in experiences, expectations, and challenges related to MS. These insights can be used to develop targeted psychological and social support interventions aimed toward improving social-emotional QoL for persons with MS.

Quality of life among multiple sclerosis patients in Saudi Arabia.

Objective:To assess quality of life in multiple sclerosis (MS) patients and determine the factors associated with levels of quality of life in MS patients in a public hospital in Saudi Arabia.Methods:A cross-sectional study was conducted from June 2016 to April 2017 in King Abdulaziz Medical City, Jeddah, Kingdom of Saudi Arabia. Multiple sclerosis patients attending the outpatient and inpatient services were approached and recruited to participate in the study. The Arabic version of EuroQOL-5 Dimensions instrument (EQ-5D) was utilized for the assessment of MS patients quality of life.Results:Data on quality of life were obtained from 292 patients. The reported quality of life of MS patients as measured by the EQ-5D index value score was 0.31±0.51 and the EQ-VAS score was 73.87±23.41, respectively. It was found that quality of life determined numerically in the EQ-5D index value and EQ-VAS deteriorates proportionally according to the disease duration.Conclusion:Multiple sclerosis is associated with a considerable effect on the patients quality of life. It continues to be challenging to manage both medically and psychosocially. Clinicians should consider the assessment of quality of life as routine practice along with the other important measures including symptomatic evaluation, laboratory tests, and neuroimaging to provide a holistic care of their MS patients.

Quality of life in multiple sclerosis and relationship to cognitive impairment

Quality of life in multiple sclerosis and relationship to cognitive impairment

Diagnoses of Depression and Anxiety Versus Current Symptoms and Quality of Life in Multiple Sclerosis.

Studies assessing the prevalence of depression and anxiety in multiple sclerosis (MS) have used various ascertainment methods that capture different constructs. The relationships between these methods are incompletely understood. Psychiatric comorbidity is associated with lower health-related quality of life (HRQOL) in MS, but the effects of past diagnoses of depression and anxiety on HRQOL are largely unknown. We compared the prevalence of depression and anxiety in persons with MS using administrative data, self-reported physician diagnoses, and symptom-based measures and compared characteristics of persons classified as depressed or anxious by each method. We evaluated whether HRQOL was most affected by previous diagnoses of depression or anxiety or by current symptoms. We linked clinical and administrative data for 859 participants with MS. HRQOL was measured by the Health Utilities Index Mark 3. We classified participants as depressed or anxious using administrative data, self-reported physician diagnoses, and the Hospital Anxiety and Depression Scale. Multivariable linear regression examined whether diagnosed depression or anxiety affected HRQOL after accounting for current symptoms. Lifetime prevalence estimates for depression were approximately 30% regardless of methods used, but 35.8% with current depressive symptoms were not captured by either administrative data or self-reported diagnoses. Prevalence estimates of anxiety ranged from 11% to 19%, but 65.6% with current anxiety were not captured by either administrative data or self-reported diagnoses. Previous diagnoses did not decrease HRQOL after accounting for current symptoms. Depression and, to a greater extent, anxiety remain underdiagnosed and undertreated in MS; both substantially contribute to reduced HRQOL in MS.