Multidimensional Fatigue Inventory Research Articles

Efficacy of aquatic vs land-based therapy for pain management in women with fibromyalgia: a randomised controlled trial

ObjectiveTo determine the efficacy of two physiotherapeutic interventions – aquatic therapy (AT) and land-based therapy (LBT) – for reducing pain in women with fibromyalgia. DesignSingle-blind, randomised controlled, equivalence trial. SettingFibromyalgia, Chronic Fatigue Syndrome and Multiple Chemical Sensitivity Association in A Coruña, Spain. ParticipantsForty women with fibromyalgia were assigned at random in a 1:1 manner to two groups: AT (n = 20) and LBT (n = 20). InterventionsTwo therapeutic exercise programmes, with 60-min sessions, were undertaken three times per week for 12 weeks. Sessions were carried out in groups by a trained physiotherapist. OutcomeThe primary outcome was pain intensity (visual analogue scale). The secondary outcomes were pressure pain threshold (algometer), quality of life (Revised Fibromyalgia Impact Questionnaire), sleep quality (Pittsburgh Sleep Quality Index), fatigue (Multidimensional Fatigue Inventory) and physical ability (6-Minute Walk Test). Patients were evaluated at baseline, 12 weeks (post-treatment) and 18 weeks (follow-up). The statistical analysis was per-protocol. P < 0.05 was considered to indicate significance. Effect size was calculated. ResultsThe mean age was 50 [standard deviation (SD) 9] years, with median body mass index of 27 [interquartile range (IQR) 25–30] kg/m2 and median symptom duration of 11 (IQR 6–15) years. No differences were observed between the groups post-treatment, but differences in favour of AT were found in pain intensity [2.7 (IQR 1.5-4.9) vs 5.5 (IQR 3.3-7.6); p= 0.023; large effect, Cohen's d= 0.8; 95% confidence interval (CI) 0.1-1.5] and sleep quality [12.0 (IQR 7.3-15.3) vs 15.0 (IQR 13.0-17.0); p= 0.030; large effect, Cohen's d= 0.8; 95% CI 0.1-1.5] at follow-up. ConclusionsThe results suggest that AT is better than LBT for reducing pain intensity and improving sleep quality after 6 weeks of follow-up. AT may be a good treatment option for women with fibromyalgia. Clinical Trials Registration NumberClinicalTrials.gov NCT02695875 Contribution of the paper•This paper provides evidence that aquatic therapy is an effective intervention for reducing pain and improving sleep quality of women with fibromyalgia.•The matched protocols designed for this study highlighted the influence of the environment on symptom management in women with fibromyalgia.

Comparing Self-Report Fatigue Assessment Tools for Adults with Cerebral Palsy in a Danish Context

ABSTRACT Purpose: Many youth and adults with Cerebral Palsy (CP) experience high levels of fatigue. This study aimed to compare three fatigue self-report questionnaires to guide clinicians. Method: Thirty youth and adults (age range 17–64) with CP were assessed with Danish versions of the Fatigue Impact and Severity Self-Assessment questionnaire, the Modified Mental Fatigue Scale, and the Multidimensional Fatigue Inventory. Psychometric properties were investigated. Rank order and classification models were compared across questionnaires. Results: The Reduced Motivation and Physical Fatigue subscales of the Multidimensional Fatigue Inventory showed inadequate internal consistency. Participants were frequently ranked differently with the questionnaires. There were issues related to the conceptualization of physical fatigue. Conclusion: The choice of assessment tool should be based on assessment purpose as the questionnaires assess different aspects of fatigue severity, impact, and management. Also, test selection can have important implications on the conclusions that are made about fatigue type and severity.

Evaluation of the Relationship between Static Balance and Mental Fatigue in Healthy Adults: Preliminary Study

Mental fatigue (MF) occurs when a demanding cognitive-task is performed over a long period of time, making it difficult to continue daily tasks and maintain balance. The aim of this investigation was to determine whether the Stroop test induces mental fatigue and to examine its effects on static balance. The study is a quasi-experimental design with pre-post testing. Twenty participants (19-44) were included. Static posturography was used to evaluate balance at baseline following a 25-min relaxation period of rest and in the MFC (mental-fatigue condition) following the induction of MF with the Stroop test. The other measurements were the Multidimensional Fatigue Inventory (MFI), Fatigue Severity Scale (FSS), and Visual Analogue Scale (VAS). The study found that mental fatigue significantly increased at MFC compared to baseline, as indicated by MFI (p=.031) and FSS (p=.007) results with moderate effect sizes (d = 0.52, d = 0.67, respectively). Similarly, the study found a statistically significant increase in mental fatigue as measured by VAS results (p=.000, d = 0.95). However, the study did not find any statistically significant impairment in static balance due to mental fatigue in healthy young subjects. The results suggest that the Stroop test can induce mental fatigue, but it does not impair static balance.

Clinical and Laboratory Characteristics of Fatigue-Dominant Long-COVID Subjects: A Cross-Sectional Study

BackgroundLong COVID is defined by persistent symptoms following COVID-19 infection. Approximately 71% of individuals with long COVID experience ongoing fatigue, postexertional malaise, and cognitive impairments, which share pathological similarities with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). This similarity has prompted studies to explore the characteristics of long COVID to gain a better understanding of ME/CFS. To gain insights, we investigated the clinical and laboratory characteristics of individuals with fatigue-dominant long COVID. MethodsWe enrolled 100 subjects (36 males, 64 females) with long COVID who had a higher score than 60 in the modified Korean version of the Chalder Fatigue Scale (mKCFQ11) and higher than 5 in a fatigue-focused visual analogue scale. To investigate fatigue symptoms, the mKCFQ11, the Multidimensional Fatigue Inventory, a visual analogue scale for fatigue and brain fog, along with the Short-Form survey, were employed. We also measured 3 cytokines and cortisol levels for immunological and endocrinological indicators. As a cross-sectional observational study, the data were collected at a single point in time. ResultsThe mean scores on the measurements showed severe fatigue, and these scores were significantly correlated, with no differences based on sex, the post-COVID period, or age. Among the laboratory tests, plasma cortisol levels had a significant negative correlation with fatigue scores and a positive correlation with living quality. The negative correlation between cortisol levels and mKCFQ11 scores appeared to be more specific to mental fatigue than physical, which conflicted with other measurements. ConclusionOur findings provide the first insights into the characteristics of fatigue in individuals with long COVID, particularly in terms of fatigue severity and cortisol levels. These results serve as valuable reference data for clinicians dealing with fatigue symptoms in long-COVID patients and for researchers exploring postviral fatigue symptoms, including ME/CFS, in the future.

The relationship between self-perceived fatigue, muscle endurance, and circulating markers of inflammation in participants of the Copenhagen aging and Midlife Biobank (CAMB)

BackgroundFatigue, low muscle endurance, muscle weakness and low-grade inflammation are strongly related to frailty at higher age. When signs of self-perceived fatigue and low muscle endurance are interrelated with low-grade inflammation at midlife, they might be used as early markers for frailty. This study investigated whether the interrelationships among self-perceived fatigue, muscle endurance and inflammation can be observed at midlife.MethodsA total of 965 participants of the Copenhagen Aging and Midlife Biobank (aged 52 ± 4 years, 536 males, 426 females) were assessed for self-perceived fatigue (20-item multidimensional fatigue inventory), muscle endurance (grip work), circulating markers of inflammation (hsCRP, IL-6, IL-10, TNF-alpha and IFN-γ), daily physical activity (PAS-2), body composition (%body fat assessed by bio-impedance) and self-reported health status. Participants were categorised (correcting for age and gender) according to high fatigue and/or low muscle endurance, differences in inflammatory profile between fatigue categories were assessed by ANCOVA (corrected for PAS-2, %body fat and presence of inflammatory conditions).ResultsOverall, muscle endurance, fatigue and inflammatory markers were significantly interrelated. Higher levels of hsCRP (p < 0.001), IL-6 (p < 0.001), IL-10 (p = 0.035) and TNF-alpha (p = 0.028) were observed in participants presenting both low muscle endurance and high fatigue. IFN-γ was highest in those with high fatigue but normal muscle endurance (p = 0.015).ConclusionsMiddle-aged participants with higher fatigue in combination with low muscle endurance show higher levels of inflammation, independently from physical activity, body fat and inflammatory pathology. The underlying mechanisms should be identified and future studies should also investigate whether these individuals show early signs of reduced physiological reserve capacity, which in later life come to full expression by means of frailty.

Prevalence and risk factors of fatigue and its association with quality of life among patients with chronic pancreatitis: A cross-sectional study

BackgroundFatigue is a debilitating symptom found in various chronic diseases and is associated with more severe symptoms and worse quality of life (QoL). However, this symptom has not been adequately addressed in chronic pancreatitis (CP), and there have been no studies on fatigue in patients with CP. MethodsThis cross-sectional study was conducted at the Changhai Hospital in Shanghai, China. Data on the patients’ sociodemographic, disease, and therapeutic characteristics were collected. Fatigue was assessed using the Multidimensional Fatigue Inventory-20. QoL was assessed utilizing the European Organization for the Research and Treatment of Cancer of QoL questionnaire (EORTC-QLQ-C30). Sleep quality, anxiety and depression, and pain was assessed using Pittsburgh Sleep Quality Index, the Hospital Anxiety and Depression Scale, and the Brief Pain Inventory, respectively. ResultsThe prevalence of fatigue among Chinese patients with CP was 35.51 % (87/245). Multivariate analysis showed that steatorrhea (OR = 2.638, 95 % CI: 1.117–6.234), history of smoking (OR = 4.627, 95 % CI: 1.202–17.802), history of endoscopic treatment (OR = 0.419, 95 % CI: 0.185–0.950), depression (OR = 5.924, 95 % CI: 2.462–14.255), and sleep disorder (OR = 6.184, 95 % CI: 2.543–15.034) were influencing factors for the presence of fatigue. The scores for global health and all functional dimensions in the EORTC-QLQ-C30 significantly decreased, whereas the scores for all symptom dimensions significantly increased in patients with fatigue. ConclusionsThis study indicated that Fatigue is a common symptom and has a negative impact on the QoL of patients with CP. Steatorrhea, smoking history, endoscopic treatment, depression, and sleep disorders were associated with fatigue.

Maternal Fatigue after Postpartum Anemia Treatment with Intravenous Ferric Carboxymaltose vs. Intravenous Ferric Derisomaltose vs. Oral Ferrous Sulphate: A Randomized Controlled Trial

(1) Background: Postpartum anemia is a common maternal complication and is recognized as a cause of impaired quality of life, reduced cognitive abilities, and fatigue. Efficient iron supplementation for the treatment of postpartum anemia is an essential component of high-quality maternal care. The optimal mode of iron supplementation has not been determined yet, whether oral or intravenous. The objective of this study was to compare postpartum anemia treatment with intravenous ferric carboxymaltose, intravenous ferric derisomaltose, and oral ferrous sulfate. (2) Methods: A single-center, open-label, randomized controlled trial. Women with hemoglobin &lt; 100 g/L within 48 h postpartum were randomly allocated to receive intravenous ferric carboxymaltose, intravenous ferric derisomaltose, or oral ferrous sulfate. Intravenous iron was given in one or two doses, while ferrous sulfate was given as two 80 mg tablets once daily. The primary outcome was maternal fatigue measured by the Multidimensional Fatigue Inventory (MFI) six weeks postpartum. Hemoglobin, ferritin, and transferrin saturation levels were analyzed as secondary outcomes. A Kruskal–Wallis test was used for group comparison (p &lt; 0.05 significant). (3) Results: Three hundred women were included. The MFI score at six weeks postpartum did not differ between groups (median 38 (inter-quartile range (IQR) 29–47) in the ferric carboxymaltose group, median 34 (IQR 26–42) in the ferric derisomaltose group, and median 36 (IQR 25–47) in the ferrous sulfate group; p = 0.26). Participants receiving oral iron had lower levels of hemoglobin (135 (131–139) vs. 134 (129–139) vs. 131 (125–137) g/L; p = 0.008), ferritin (273 (198–377) vs. 187 (155–246) vs. 24 (17–37) µg/L; p &lt; 0.001) and transferrin saturation (34 (28–38) vs. 30 (23–37) vs. 24 (17–37) %; p &lt; 0.001) than those receiving ferric carboxymaltose or ferric derisomaltose. (4) Conclusions: Intravenous ferric carboxymaltose, intravenous ferric derisomaltose, and oral ferrous sulfate had similar impacts on maternal fatigue at six weeks postpartum despite improved laboratory parameters in the intravenous groups.

DEPRESSION MAY BE A STRONGER UNIQUE PREDICTOR OF FATIGUE THAN SELF-REPORTED IBD DISEASE ACTIVITY

Abstract Fatigue is a frequent and debilitating symptom of inflammatory bowel disease (IBD) and can include mental and physical exhaustion, tiredness, or weakness. Modifiable psychosocial factors, such as depression and anxiety, are associated with fatigue in IBD, and provide insight into potential treatment targets. However, little is known about distinct ways in which psychosocial factors relate to subtypes of fatigue. The current study examined associations between psychosocial factors and 5 fatigue subtypes: general, physical, mental, reduced motivation, and reduced activity. Patients 18 and above from Dartmouth-Hitchcock’s IBD Center with Crohn’s disease or ulcerative colitis were invited to participate in a survey via an electronic medical record system message. Measures included the Patient Reported Outcomes-3, Multidimensional Fatigue Inventory, Pain Catastrophizing Scale, Generalized Anxiety Disorder-7, Patient Health Questionnaire-9, Insomnia Severity Index, and Brief Pain Inventory. Five forward linear regressions were performed with step 1 including disease activity, step 2 including covariates (age, gender, IBD diagnosis) and step 3 allowing for the inclusion of insomnia, pain severity, depression, anxiety, and pain catastrophizing. Participants were 312 individuals above the age of 18 (M=48.62, SD=16.10). Participants were 66.3% women and 96.5% White. 60.9% were diagnosed with Crohn’s disease and 39.1% with ulcerative colitis. 54.8% were categorized as having active disease based on self-reported symptoms. For all five subtypes of fatigue, depression emerged as the most influential psychosocial predictor. Depression accounted for 21% of the variance in general fatigue, 14% in physical fatigue, 18% in activity avoidance, 19% in reduced motivation, and 29% in mental fatigue. Regarding differences among subtypes, insomnia was only significant in the model predicting general fatigue, accounting for an additional 2% of the variance, and anxiety was only significant in the model predicting activity avoidance, accounting for an additional 3% of the variance. In comparison, self-reported disease activity accounted for 23% of the variance in general fatigue, 7% in physical fatigue, 8% in activity avoidance, 12% in reduced motivation, and 10% in mental fatigue. Depression is a notable factor associated with all subtypes of fatigue in IBD, especially mental fatigue. There are differences in how psychosocial factors relate to fatigue subtypes such that anxiety is uniquely associated with activity avoidance and severity of insomnia is uniquely associated with general fatigue. Results suggest that assessment of fatigue in IBD should also include assessment of depression as standard of care. Additionally, helping patients engage in behavioral interventions to reduce depression, anxiety, and insomnia may be critical for managing fatigue. Results of forward regressions predicting fatigue subtypes

P813 A questionnaire-based study on fatigue and associated factors in Inflammatory Bowel Disease

Abstract Background Although fatigue is common in patients with inflammatory bowel disease (IBD), it often goes unrecognized and untreated. We investigated the degree of fatigue, and associated factors, in patients with IBD. Methods A multicenter study involving 147 IBD patients was conducted at five academic hospitals from August 2019 to December 2021. Demographic, clinical, and laboratory data were collected. Disease activity was assessed by the Mayo score or Crohn’s Disease Activity Index, as appropriate. Fatigue was evaluated using the validated Korean version of the Multidimensional Fatigue Inventory (MFI-K). Anxiety and depression were measured using the Hospital Anxiety and Depression Scale Results Among 97 ulcerative colitis and 50 Crohn’s disease patients, the mean total MFI-K score was 59.0 ± 5.5. Age, sex, body mass index, disease duration, anemia, hypoalbuminemia, and use of steroids did not affect the total MFI-K score. The anxiety and depression scores did not correlate with the fatigue score. Moderate and high disease activity significantly increased the MFI-K general and physical fatigue subscale scores compared to remission and mild disease activity (17.6 ± 1.7 vs. 16.7 ± 2.0, P = 0.009), while the use of biologics significantly decreased the total MFI-K score (57.3 ± 5.0 vs. 59.5 ± 5.5, P = 0.031). Multiple linear regression showed that fatigue was significantly increased by a history of surgery for IBD and decreased by the use of biologics. Conclusion The degree of fatigue in patients with IBD is high, and disease activity is the most important contributing factor.

Fatigue, sleep and physical activity in postoperative patients with pituitary adenomas: A survey.

The condition and correlation of fatigue, sleep and physical activity in postoperative patients with pituitary adenomas remain unclear. This survey aimed to evaluate the current status and influencing factors of fatigue, sleep and physical activity in postoperative patients with pituitary adenomas. Patients undergoing pituitary adenoma resection in two tertiary hospitals from November 2019 to November 2021 were included. The general data questionnaire, Multidimensional Fatigue Inventory (MFI-20), Pittsburgh Sleep Quality Index (PSQI) and international physical activity questionnaire were used for data analysis. In total, 184 patients with pituitary adenomas were included. The postoperative patients with pituitary adenomas had a high level of fatigue. In total, 34 (18.5%) patients had low level of physical activity, 76(41.3%) patients had medium level of physical activity and 74 (40.2%) had high level of physical activity. Postoperative time, PSQI, physical activity level and gender were the influencing factors of fatigue in patients with pituitary adenomas (all P < 0.05). Postoperative patients with pituitary adenomas have a higher level of fatigue, and it is related to reduced sleep quality and activity. Relevant nursing measures should be taken according to the influencing factors of fatigue to reduce the fatigue of postoperative patients with pituitary adenomas.

Effectiveness of Warm Water Foot Submerged Technique on the Level of Fatigue, Quality of Sleep, and Quality of Life among Patients with Cancer in Selected Hospital at Mangaluru

Abstract Introduction Cancer is the most leading cause of death globally. Fatigue and poor quality of sleep are the common side effects of cancer treatment that lead to poor quality of life. There is a need of complementary therapy, which can help to minimize the side effects of cancer treatment and boosting relaxation. Warm water foot submerged technique helps to relieve fatigue and improve the quality of sleep; hence, quality of life can be improved. This study was conducted to assess effectiveness of warm water foot submerged technique on the level of fatigue, quality of sleep, and quality of life among patients with cancer. Materials and Methods A quasi-experimental pretest and post-test control group research design was adopted to conduct the study in oncology ward of selected hospital. Sixty-eight participants were recruited using a nonprobability purposive sampling technique and allocated to intervention and control groups. Data was collected using multidimensional fatigue inventory, Groningen sleep quality scale, EORTC QLQ-C30. The control group received normal routine care and the intervention group received warm water foot submerged technique that was given for 15 minutes two times per day for 5 consecutive days. Results Warm water foot submerged technique showed a significant difference in level of fatigue (p &lt; 0.05), quality of sleep (p &lt; 0.001), and quality of life (p &lt; 0.001) in the intervention group. There was no significant difference in control group. Conclusion This study showed that the warm water foot submerged technique is effective in reducing the fatigue and improving the quality of sleep and quality of life among patients with cancer. Thus, this study was found to be effective.

Experience of pyridoxin and glutamic acid use in effective correction of the main asthenia manifestations

Introduction. Asthenia manifestation treatment is an urgent problem due to its high frequency in outpatients.Аim. To evaluate in a controlled randomized clinical trial the efficacy and tolerability of the course use of a combination of pyridoxine and glutamic acid in patients with asthenic complaints.Materials and methods. 50 outpatients with main asthenia manifestations were included in the study if they complied inclusion criteria and signed the informed consent. After randomization, in group 1 a combined supplement with 2.5 mg of pyridoxin and 100 mg of glutamic acid (Metabovit® Life Energy, MNPK “BIOTIKI”) was added to therapy 1 tablet a day sublingually, in group 2 patients received basic therapy for chronic diseases only. The duration of observation was 21 days. Before and after the end of the study all patients underwent neuropsychological examination, which included the questionnaires: Multidimensional Fatigue Inventory (MFI-20), a Reader stress test (adopted by O.Kopina), a questionnaire on the level of life exhaustion (The Maastricht Questionnaire), a “Schulte tables” test with working efficiency evaluation.Results. In the group of patients receiving Metabovit® Life Energy 1 tablet a day, in comparison with the control group (p &lt; 0.001) the overall score on the MFI-20 self-questionnaire decreased and amounted to 29 [26; 30]; Δ MFI-20 was equal to -22 [-27; -16]; the results reached normative values for most participants; improved time the performance of the “Schulte tables” test decreased by more than 9 seconds; stress levels decreased by almost 30% in men and 20% in women; the indicator of life exhaustion decreased by 60%. In patients in the control group, no significant changes in the studied indicators were detected by the end of the follow-up.Conclusion. In the group of patients who received the biologically active food supplement Metabovit® Life Energy, there was a significant positive dynamics and regression of most of the symptoms of asthenia, in comparison with the control group.

Association between cytokines and fatigue in patients with type 1 narcolepsy

BackgroundFatigue is a frequent complaint among patients with narcolepsy. Studies have shown that inflammatory cytokines are associated with fatigue in neurological disorders; however, this association has not been identified in patients with type 1 narcolepsy. The purpose of this study was to investigate the potential relationship between cytokines and fatigue in patients with type 1 narcolepsy. MethodsWe investigated the association between 12 inflammatory cytokines and fatigue in 49 patients with type 1 narcolepsy. The Multidimensional Fatigue Inventory-20 was used to assess the fatigue severity. The associations of fatigue were identified using Spearman and Pearson correlation analyses. A linear regression analysis model was used to adjust the confounding factors and evaluate the associations of fatigue. ResultsCorrelation analysis showed that the plasma interleukin (IL)-2 level (r = 0.409, p = 0.004) was positively correlated with fatigue in patients with narcolepsy type 1. After adjusting for confounding factors, the linear regression model revealed a positive association between the IL-2 level (β = 1.148, p = 0.04) and fatigue in individuals diagnosed with type 1 narcolepsy. ConclusionIL-2 levels show a positive correlation with fatigue in type 1 narcolepsy, suggesting its potential role in the pathophysiology of fatigue.

The effect of virtual interactive nurse-led support group intervention on fatigue, shock anxiety, and acceptance of implantable cardioverter defibrillator patients: a randomized trial

BackgroundImplantable cardioverter defibrillators (ICD), as a gold and standard treatment for fatal cardiac arrhythmia, may lead to some physical and psychological problems for the patients. Therefore, performing some interventions to reduce or eliminate these issues is crucial. This study aimed to determine the effect of virtual interactive nurse-led support group intervention on fatigue, shock anxiety, and acceptance of ICD patients.MethodsThis is a clinical trial study on 72 patients with ICD. They were randomly allocated to the intervention (n = 36) and control (n = 36) groups. A virtual interactive nurse-led support group intervention through WhasApp was performed for one month. Multidimensional fatigue inventory, Florida Shock Anxiety Scale, and Florida Patient Acceptance Scale were used. Data were analyzed to perform the analysis of data through SPSS, using independent and paired-t test, Mann-Whitney U test, Wilcoxon test, and ANCOVA.ResultsBefore the intervention, no significant difference was observed between the two groups with regard to fatigue, shock anxiety, and ICD acceptance. However, after the intervention, a significant difference was found between the two groups with regard to fatigue, shock anxiety, and ICD acceptance (P < 0.05).ConclusionThis study showed that virtual interactive nurse-led support group intervention reduced fatigue and shock anxiety and improved the ICD acceptance.Practice implicationsThis flexible, accessible, and interactive nurse-led support group intervention is suggested to be used for ICD patients.Trial registrationThis trial was registered and approved by Iranian Registry of Clinical Trials (Trial Id: 60,738, date: (24/02/2022). (https://www.irct.ir/trial/60738).

Disentangling the effects of PTSD from Gulf War Illness in male veterans via a systems-wide analysis of immune cell, cytokine, and symptom measures

BackgroundOne-third of veterans returning from the 1990–1991 Gulf War reported a myriad of symptoms including cognitive dysfunction, skin rashes, musculoskeletal discomfort, and fatigue. This symptom cluster is now referred to as Gulf War Illness (GWI). As the underlying mechanisms of GWI have yet to be fully elucidated, diagnosis and treatment are based on symptomatic presentation. One confounding factor tied to the illness is the high presence of post-traumatic stress disorder (PTSD). Previous research efforts have demonstrated that both GWI and PTSD are associated with immunological dysfunction. As such, this research endeavor aimed to provide insight into the complex relationship between GWI symptoms, cytokine presence, and immune cell populations to pinpoint the impact of PTSD on these measures in GWI.MethodsSymptom measures were gathered through the Multidimensional fatigue inventory (MFI) and 36-item short form health survey (SF-36) scales and biological measures were obtained through cytokine & cytometry analysis. Subgrouping was conducted using Davidson Trauma Scale scores and the Structured Clinical Interview for Diagnostic and statistical manual of mental disorders (DSM)-5, into GWI with high probability of PTSD symptoms (GWIH) and GWI with low probability of PTSD symptoms (GWIL). Data was analyzed using Analysis of variance (ANOVA) statistical analysis along with correlation graph analysis. We mapped correlations between immune cells and cytokine signaling measures, hormones and GWI symptom measures to identify patterns in regulation between the GWIH, GWIL, and healthy control groups.ResultsGWI with comorbid PTSD symptoms resulted in poorer health outcomes compared with both Healthy control (HC) and the GWIL subgroup. Significant differences were found in basophil levels of GWI compared with HC at peak exercise regardless of PTSD symptom comorbidity (ANOVA F = 4.7, P = 0.01,) indicating its potential usage as a biomarker for general GWI from control. While the unique identification of GWI with PTSD symptoms was less clear, the GWIL subgroup was found to be delineated from both GWIH and HC on measures of IL-15 across an exercise challenge (ANOVA F > 3.75, P < 0.03). Additional differences in natural killer (NK) cell numbers and function highlight IL-15 as a potential biomarker of GWI in the absence of PTSD symptoms.ConclusionWe conclude that disentangling GWI and PTSD by defining trauma-based subgroups may aid in the identification of unique GWI biosignatures that can help to improve diagnosis and target treatment of GWI more effectively.

Факторы риска развития психических нарушений у больных рассеянным склерозом

Up to 50% of patients with multiple sclerosis (MS) suffer from mental disorders. The purpose — to study the risk factors for mental disorders development in MS patients. Material and methods. The study group included 315 patients with MS and mental disorders. The control group consisted of 300 MS patients without mental disorders. The diagnosis of MS was established according to the 2017 McDonald criteria. The diagnosis of mental disorders was established in accordance with the ICD-10 criteria. We used Beck Depression Inventory (BDI), Multidimensional Fatigue Inventory (MFI-20), Spielberger State-Trait Anxiety Inventory (STAI), adapted by Khanin, Expanded Disability Status Scale (EDSS), and Holmes and Rahe stress scale. MS progression rate (PR) was calculated using N. A. Malkova (1988) method. Results. The research established a link between mental disorders development and the localization of demyelination foci, with MS PR of at least 0.74 EDSS points per year, and with significant stressful events before MS development. Conclusion. The data obtained can be used to predict the development of mental disorders in MS patients.

Evaluating myelophil, a 30% ethanol extract of Astragalus membranaceus and Salvia miltiorrhiza, for alleviating fatigue in long COVID: a real-world observational study.

Persistent post-infectious symptoms, predominantly fatigue, characterize Long COVID. This study investigated the efficacy of Myelophil (MYP), which contains metabolites extracted from Astragalus membranaceus and Salvia miltiorrhiza using 30% ethanol, in alleviating fatigue among subjects with Long COVID. In this prospective observational study, we enrolled subjects with significant fatigue related to Long COVID, using criteria of scores of 60 or higher on the modified Korean Chalder Fatigue scale (mKCFQ11), or five or higher on the Visual Analog Scale (VAS) for brain fog. Utilizing a single-arm design, participants were orally administered MYP (2,000mg daily) for 4weeks. Changes in fatigue severity were assessed using mKCFQ11, Multidimensional Fatigue Inventory (MFI-20), and VAS for fatigue and brain fog. In addition, changes in quality of life using the short form 12 (SF-12) were also assessed along with plasma cortisol levels. A total of 50 participants (18 males, 32 females) were enrolled; 49 were included in the intention-to-treat analysis with scores of 66.9 ± 11.7 on mKCFQ11 and 6.3 ± 1.5 on the brain fog VAS. After 4weeks of MYP administration, there were statistically significant improvements in fatigue levels: mKCFQ11 was measured at 34.8 ± 17.1 and brain fog VAS at 3.0 ± 1.9. Additionally, MFI-20 decreased from 64.8 ± 9.8 to 49.3 ± 10.8, fatigue VAS dropped from 7.4 ± 1.0 to 3.4 ± 1.7, SF-12 scores rose from 53.3 ± 14.9 to 78.6 ± 14.3, and plasma cortisol levels also elevated from 138.8 ± 50.1 to 176.9 ± 62.0/mL. No safety concerns emerged during the trial. Current findings underline MYP's potential in managing Long COVID-induced fatigue. However, comprehensive studies remain imperative. https://cris.nih.go.kr, identifier KCT0008948.

Mental Fatigue in Parkinson's Disease: Systematic Review and Evaluation of Self-Reported Fatigue Scales.

Fatigue is a common and debilitating symptom affecting a significant proportion of individuals with Parkinson's disease (PD), often overshadowing even motor symptoms in its impact on quality of life. The accurate definition and assessment of mental fatigue in PD is crucial for both clinical management and research, yet it remains a challenge due to the subjective nature of the symptom and the heterogeneity of assessment scales. This systematic review examined the existing measures of self-reported mental fatigue in PD by searching through PubMed, Embase, and Scopus databases using specific keywords from 2001 to 2024. Out of the 4182 articles found, 40 met the inclusion criteria, and 14 different scales were identified to measure self-reported fatigue in PD patients. However, most of these scales lack a consistent definition of fatigue, indicating a need for validated combinations of unidimensional and multidimensional scales to accurately assess mental fatigue in PD. The review found that it is best to use Fatigue Severity Inventory (FSI) and Multidimensional Fatigue Inventory (MdFI) to screen for severity of PD mental fatigue and Neuro-QoL Item Bank v1.0 (Neuro-QoL) to evaluate its impact on patients' lives. Furthermore, multidimensional scales Parkinson's Disease Questionnaire (PDQ) and Functional Assessment of Chronic Illness Therapy-Fatigue Scale (FACIT-F) are frequently coupled with Fatigue Severity Scale (FSS), Parkinson's Fatigue Scale (PFS), and/or Modified Fatigue Impact Scale (MFIS) due to their short length and holistic coverage of variables in patients' quality of life. Combining fatigue scales can be used for screening and scoring methods. The review also recommends validating fatigue scales translation and combining them with biomarkers to improve the accuracy and effectiveness of fatigue assessment in clinical practice. Future research should analyze correlations between fatigue scales, expand language types, and explore the link between fatigue scales and the pathophysiological basis of PD. Our findings underscore the need for a standardized approach to the measurement of fatigue in PD and set the stage for future research to consolidate assessment tools that can reliably guide treatment strategies and improve patient outcomes.

Возрастные аспекты клинической картины когнитивных нарушений

AIM. To identify a combination of the most informative patterns that allow a differentiated approach to the diagnosis of agerelated cognitive impairment. MATERIAL AND METHODS. 213 patients were examined (99 patients ≤ɸ 65 years of age, 114 patients over 65 years of age) with complaints of decreased mental performance, memory and attention. A neuropsychologic testing was conducted using next scales: Montreal Cognitive Assessment (MoCA), Hospital Anxiety and Depression Scale (HADS), Multidimensional Fatigue Inventory (MFI-20) and additional cognitive impairment tests. For statistical analysis, machine learning algorithms, Python programming language, and Pandas and SciPy libraries were used. RESULTS AND DISSCUSION. For patients in the 50–65 age category, high relevance was found for executive dysfunction, decreased attention span, fatigue, anxiety, and endocrine system disorders. For patients over 65 years of age, significant features were semantic aphasia, perceptual and memory impairment, hyperlipidaemia, history of ischemic stroke, and obesity. A significant negative correlation for the age index was found with the parameters of depression and anxiety; a positive correlation was found with the index of physical asthenia, disorders of perception, memory and semantic processing of information. CONCLUSION. The results demonstrate average prevalence of cognitive dysfunctions in elderly patients. The tests assessing visual perception and semantic information processing can be of interest in early degenerative cognitive impairments diagnosis in elderly age. Discriminant analysis of a wide range of age-related variables will allow to make more effective aging trajectories prediction without any time-consuming diagnostic methods. KEYWORDS: aging, cognitive dysfunctions, discriminant analysis

Fatigue, Physical Activity, and Quality of Life in Patients with Inflammatory Bowel Disease: A Cross-Sectional Study.

The benefits of physical activity (PA) are widely recognized, but the intensity of PA in inflammatory bowel disease (IBD) patients with varying disease activity levels remains controversial. We aimed to investigate the relationship between PA levels, fatigue, and other health-related quality of life (QoL) in Chinese IBD patients. The study is a cross-sectional investigation conducted at a comprehensive IBD diagnosis and treatment facility in East China, spanning from August 2022 to February 2023. A total of 245 participants were initially enrolled, and after excluding individuals with incomplete data about crucial exposure and outcome variables, the final sample size amounted to 237. Participants were provided with a questionnaire encompassing sociodemographic factors, clinical information, the International Physical Activity Questionnaire (IPAQ), the Multidimensional Fatigue Inventory (MFI-20), and the Inflammatory Bowel Disease Questionnaire (IBDQ). Correlation analysis was employed to assess the relationship between variables. A majority of participants (144) exhibited low levels of PA. Furthermore, 40.5% of all participants reported experiencing fatigue. Individuals with low levels of PA had an average MIF-20 score of 62.9±16.0. Correlation analysis showed that PA was significantly and negatively associated with fatigue (r = -0.224, p < 0.001). Additionally, PA was also negatively correlated with anxiety (r = -0.150, p < 0.05) and depression (r = -0.242, p < 0.001). On the other hand, PA was positively correlated with quality of life (QoL) (r = 0.171, p < 0.01). Furthermore, our analysis indicated that sleep disorders were positively associated with both anxiety (r = 0.349, p < 0.01) and depression (r = 0.354, p < 0.001). The levels of PA are significantly low, and there is a high prevalence of fatigue among individuals with IBD. PA in IBD showed a strong negative correlation with fatigue and a strong positive correlation with quality of life.