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Query: UMLS:C0015672 (fatigue)
 51,768 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Fatigue is a complaint often made by multiple sclerosis patients. Description of the symptom varies from patient to patient. This paper proposes a descriptive and quantitative scale for assessing fatigue in these patients. Eighty patients classified as having Poser's type I multiple sclerosis were asked to respond to a questionnaire on the characteristics and variations in fatigue (character, intensity, frequency, periodicity, consequences, mitigating and aggravating factors). Based on the questionnaire, a scale was designed to assess the symptom's spontaneity, nature, severity, frequency of occurrence and existence of Uhthoff's phenomenon. A formula is given for arriving at a global score in the range of 0-17. The scale was then validated by asking two different examiners to apply it prospectively to 32 patients and then calculating the correlation with another quantitative scale of fatigue (Krupp's FSS). The proposed scale had a significant reproducibility (kappa > 0.53) as well as evident correlation with the other scale applied (p < 0.01). The proposed scale is a clear improvement toward a standardized description of fatigue. It is easy to apply, validated and offers advantages over exclusively quantitative scales.
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PMID:[Proposal of a new scale for assessing fatigue in patients with multiple sclerosis]. 820 66

We studied 100 multiple sclerosis outpatients in order to assess the frequency of fatigue and to detect its relationships with other clinical findings. Fatigue was quantified by fatigue severity scale (FSS; range 1-7); current clinical neurological status and disability level were respectively scored by Kurtzke's functional systems and expanded disability status scale (EDSS). FSS mean score was 4.12; fatigue was totally absent in 3% of the patients. Fatigue started before onset of the disease in 7 patients, at onset in 12 and within the first year in 7. Fatigue intensity and frequency were related to each other. FSS mean scores were significantly higher in the patients with fatigue worsened by heat (p < 0.01), with chronic progressive disease (p < 0.0001), with motor symptoms (p < 0.0001) and with EDSS > or = 3.5 (p < 0.0001). Multiple regression analysis showed a significant effect of EDSS on fatigue (p < 0.0001), not attributable to differences in duration of the disease.
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PMID:Clinical aspects of fatigue in multiple sclerosis. 943 42

The effects of a short-term (3-week) integrated body weight reduction (BWR) program on fatigue perception and on lower limb anaerobic power output were evaluated in 200 severely obese in-patients (40 males and 160 females, age: 18-83 yr, BMI: 35.0-65.3 kg/m2). Fatigue was assessed by a 7-point Likert-type scale questionnaire (Fatigue Severity Scale, FSS), while average lower limb power output (W) during a maximal effort was determined with a modification of the Margaria test for stair climbing. In both genders, total FSS score was influenced by both age and obesity level, resulting significantly (p < 0.001) lower in younger subjects (< 45 yr) than in older (> 45 yr) and in patients with lower BMI (< 40 kg/m2) than in those with a higher one (> 40 kg/m2). An opposite trend was observed in W. The 3-week BWR integrated program with moderate aerobic exercise and free standing and ground gymnastic routines induced a significant reduction in body weight (p < 0.001), in total FSS score (p < 0.001) and a significant increase in W, both in absolute terms (p < 0.05) and relative to body mass (p < 0.001). Total FSS score and absolute or relative power output were positively correlated both before and after the BWR program (p < 0.001, Wilcoxon rank test). It is concluded that: a) subjective fatigue perception, assessed by a FSS questionnaire, can be considered an indirect indicator of effective lower limb power output in severely obese patients and, b) in spite of a relatively small, although significant, decline of BMI, the full-time participation in a hospital-based, integrated BWR program with moderate exercise activity is associated with significant short-term improvements of both fatigue sensation and power output. Dia
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PMID:Short-term changes of fatigability and muscle performance in severe obese patients after an integrated body mass reduction program. 1284 47

In mammals, separate muscles are typically specialized as a whole to provide distinct functional roles leading to well-recognized adaptations. This is exemplified in the lower limb by the slow, fatigue-resistant soleus, which provides a postural role vs. the fast, fatiguable tibialis anterior (TA), which provides rapid movements. A unique characteristic of extraocular muscles (EOMs) is their compartmentalization into two distinct layers, the orbital layer (OL) and global layer (GL), presumably to subserve diverse functions within the same muscle. However, molecular evidence of this diversity has been limited. We used laser-capture microscopy coupled with microarray-based expression profiling to identify molecular differences between the OL and GL of rat EOMs. We found that 210 genes were differentially regulated between these layers at a twofold expression cutoff. Differences in genes related to metabolic pathways and related to structural elements of muscle and nerve formed the largest functional clusters. Layer-specific differential expression was validated at both mRNA and protein level for MYH3, MYH6, and ACTN3. The expected layer-specific differences among genes encoding vascular elements were not evident by profiling; morphometric analysis demonstrated that the differences exist, but at a magnitude below the cutoff level established by our statistical methods. Comparison of these results with previous results comparing whole EOMs and TA suggest evolutionary mechanisms may play a role in achieving functional distinctions between OL and GL.
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PMID:Layer-specific differences of gene expression in extraocular muscles identified by laser-capture microscopy. 1546 12

The aim of this study is to find out if lamotrigine gives symptomatic relief and enhances quality of life in patients with post-polio syndrome. Thirty patients were randomly assigned to receive or not to receive lamotrigine treatment. Lamotrigine at a daily dose of 50-100 mg was given to the fifteen patients, and fifteen patients were used as the control group. Interventional advice and home exercises were given to all of the patients. Clinical assessments were made at baseline and repeated at the second and fourth weeks by the physician who was unaware of medication. The severity of pain, fatigue and muscle cramps were rated on a visual analogue scale. Health-related quality of life was measured using the Nottingham Health Profile. The patient's perceived level of fatigue was assessed using Fatigue Severity Scale. Comparing to the baseline values, statistically significant improvements were obtained in the mean scores of VAS, NHP and FSS at two weeks and four weeks in the patients on lamotrigine. No significant improvements were reported in the control group. These preliminary results indicate that lamotrigine relieves the symptoms and improves the life qualities of patients with post polio syndrome.
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PMID:Effects of lamotrigine on the symptoms and life qualities of patients with post polio syndrome: a randomized, controlled study. 1640 93

The present study aimed to investigate the relationship between subjective fatigue and selective attention deficits following traumatic brain injury (TBI). Forty-six participants with mild-severe TBI and 46 healthy controls completed fatigue scales (Visual Analogue Scale--Fatigue, Fatigue Severity Scale [FSS] and Causes of Fatigue Questionnaire [COF]), and attentional measures including subtests from the Test of Everyday Attention, and the Complex Selective Attention Task (C-SAT). TBI participants reported greater fatigue on the FSS and COF, performed more slowly on attentional measures, and made more errors on the C-SAT. After controlling for anxiety and depression, fatigue was significantly correlated with performance only on the C-SAT. Findings suggest a relationship between subjective fatigue and impairment on tasks requiring higher order attentional processes.
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PMID:Selective attention deficits and subjective fatigue following traumatic brain injury. 1671 31

An Auditory Vigilance Task (AVT) as a validation criterion for monitoring mental fatigue was proposed in this study. The biological basis of this task design is on the understanding that mental fatigue is a cortical deactivation. This AVT is simple to perform, free of learning curve and independent on acquired skills (aptitude, knowledge). The validity and sensitivity of this task was verified by a scientifically controlled 25-hour fatigue experiment recorded by Electroencephalogram (EEG). Results showed that this AVT is highly sensitive to changes during fatigue process. The effectiveness of this AVT was compared to one subjective rating scale (FSS). The 5-level fatigue EEG datasets (labeled by AVT and FSS respectively) were fed into Support Vector Machines (SVM). SVM test accuracy indicated that AVT is more effective than subject's own estimation. The results demonstrate conclusively that this AVT is suitable for fatigue detection study as a reliable validation criterion.
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PMID:An auditory vigilance task for mental fatigue detection. 1728 42

We have tested the hypothesis that restless leg syndrome (RLS) is related to quality of sleep, fatigue and clinical disability in multiple sclerosis (MS). The diagnosis of RLS used the four minimum criteria defined by the International Restless Legs Syndrome Study Group. Fatigue was assessed by the Fatigue Severity Scale (FSS >27), quality of sleep by the Pittsburgh Sleep Quality Index (PSQI >6), excessive daytime sleepiness by the Epworth Sleepiness Scale (ESS >10) and clinical disability by the Expanded Disability Status Scale (EDSS). Forty-four patients (32 women) aged 14 to 64 years (43 +/- 14) with disease from 0.4 to 23 years (6.7 +/- 5.9) were evaluated. Thirty-five were classified as relapsing-remitting, 5 as primary progressive and 4 as secondary progressive. EDSS varied from 0 to 8.0 (3.6 +/- 2.0). RLS was detected in 12 cases (27%). Patients with RLS presented greater disability (P = 0.01), poorer sleep (P = 0.02) and greater levels of fatigue (P = 0.03). Impaired sleep was present in 23 (52%) and excessive daytime sleepiness in 3 cases (6.8%). Fatigue was present in 32 subjects (73%) and was associated with clinical disability (P = 0.000) and sleep quality (P = 0.002). Age, gender, disease duration, MS pattern, excessive daytime sleepiness and the presence of upper motor neuron signs were not associated with the presence of RLS. Fatigue was best explained by clinical disability and poor sleep quality. Awareness of RLS among health care professionals may contribute to improvement in MS management.
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PMID:Restless leg syndrome, sleep quality and fatigue in multiple sclerosis patients. 1903 Jul 14

The role of axonopathy in the development of demyelinating processes in the CNS and peripheral nervous system was addressed in studies of 43 patients with multiple sclerosis (MS) and 144 patients with chronic inflammatory demyelinating polyneuropathy (CIDPN). Patients with MS were found to have foci of reduced MRI intensity in the T1 regime ("black holes," present in 28%) and regional atrophy of the cerebral cortex (in 46%), which showed a significant association with the degree of invalidity on the EDSS (Kendall tau = 0.38 and 0.43; p = 0.038 and 0.021, respectively). The mean fatigue score on the FSS was 4.9 (3.6; 5.4). A significant increase in the central conduction time on the background of fatigue (p = 0.016), along with an absence of signs of impaired reliability of neuromuscular transmission and an absence of past-activation phenomena, suggested that central mechanisms were predominant in the formation of fatigue phenomena in MS. In addition, 34.9% of patients with MS showed signs of peripheral nervous system involvement, while the clinical-electrophysiological pattern in 12.5% of patients with CIDPN showed signs of CNS involvement. These data widen existing concepts of the mechanisms of formation of axonopathy in the CNS, based on evidence for the development of axon-demyelinating processes in CIDPN, which is the most accessible model of demyelination for study using contemporary neurophysiological methods.
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PMID:The role of axonopathy in the mechanisms of development of demyelination processes in the central and peripheral nervous system. 1908 37

Fatigue is a common symptom associated with a wide range of chronic diseases. A large number of instruments have been developed to measure fatigue. An assessment regarding the reliability, validity, and utility of fatigue measures is time-consuming for the clinician and researcher, and few reviews exist on which to draw such information. The aim of this article is to present a critical review of fatigue measures, the populations in which the scales have been used, and the extent to which the psychometric properties of each instrument have been evaluated to provide clinicians and researchers with information on which to base decisions. Seven databases were searched for all articles that measured fatigue and offered an insight into the psychometric properties of the scales used over the period 1980-2007. Criteria for judging the "ideal" measure were developed to encompass scale usability, clinical/research utility, and the robustness of psychometric properties. Twenty-two fatigue measures met the inclusion criteria and were evaluated. A further 17 measures met some of the criteria, but have not been tested beyond initial development, and are reviewed briefly at the end of the article. The review did not identify any instrument that met all the criteria of an ideal instrument. However, a small number of short instruments demonstrated good psychometric properties (Fatigue Severity Scale [FSS], Fatigue Impact Scale [FIS], and Brief Fatigue Inventory [BFI]), and three comprehensive instruments demonstrated the same (Fatigue Symptom Inventory [FSI], Multidimensional Assessment of Fatigue [MAF], and Multidimensional Fatigue Symptom Inventory [MFSI]). Only four measures (BFI, FSS, FSI, and MAF) demonstrated the ability to detect change over time. The clinician and researcher also should consider the populations in which the scale has been used previously to assess its validity with their own patient group, and assess the content of a scale to ensure that the key qualitative aspects of fatigue of the population of interest are covered.
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PMID:The measurement of fatigue in chronic illness: a systematic review of unidimensional and multidimensional fatigue measures. 1911 79


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