Kessler Foundation research scientist John DeLuca, PhD, has recently published a crucial clinical article in the Journal of Neurology. The article sheds light on the elusive nature of fatigue in multiple sclerosis (MS) and its implications for treatment. The study provides a comprehensive review of current challenges in defining, measuring, and treating MS-related fatigue, offering new insights and directions for future research.
It sheds light on the complex nature of fatigue in multiple sclerosis, underscoring the challenges in accurately defining and effectively measuring it. Dr. DeLuca found more than 250 scales used to assess fatigue but noticed significant content validity issues, which raised concerns about their reliability.
“Ou” ability to define, measure, and treat fatigue in MS has only marginally improved despite over a century of research,”” said Dr. DeLuca, senior vice president for research and training at the Foundation. “The study underscores the need for innovative approaches to understand better and address this complex symptom. It also highlights distinguishing fatigue from other related symptoms and developing more precise measurement tools. Addressing these challenges is crucial for improving the quality of life for individuals with MS.”
F”tigue affects up to 90 per cent of individuals with MS, significantly impacting their daily lives. Despite its prevalence, defining fatigue remains challenging due to its subjective and multifaceted nature. The article reviews historical and contemporary definitions of fatigue, critiques existing measurement tools for their lack of clarity and consistency, and explores the subjective nature of fatigue and its correlation with other symptoms such as depression, pain, and cognitive complaints.
Furthermore, Dr. DeLuca examines the brabrain’sle in fatigue, proposing that disruptions in the cortico-striato-thalamo-cortical loop contribute to central fatigue. “Ad”anced MRI imaging techniques have shown that central fatigue correlates with disruptions in this brain network. Recent research indicates that motivational incentives can reduce fatigue by stimulating the frontostriatal network, suggesting new potential treatment approaches,” h” emphasized.
How Can We Treat Fatigue?
The study discusses pharmacological and non-pharmacological treatments for fatigue in MS. Pharmacological treatments, such as amantadine, modafinil, and methylphenidate, have shown limited effectiveness. In contrast, the article also explores non-pharmacological treatments for fatigue, such as cognitive-behavioral therapy and exercise, which have demonstrated moderate to significant effects in reducing fatigue symptoms. The potential of novel approaches involving the brabrain’sward system is also mentioned, suggesting that motivational incentives could play a crucial role in managing fatigue in MS patients.