Salim Chahin1, Deborah Miller2, Reiko E Sakai3, James A Wilson4, Teresa Frohman5, Clyde Markowitz6, Dina Jacobs7, Ari Green8, Peter A Calabresi9, Elliot M Frohman10, Steven L Galetta11, Laura J Balcer12. 1. Department of Neurology, University of Pennsylvania, 3400 Spruce St. 3. W. Gates, Philadelphia, PA 19104, USA. Electronic address: salim.chahin@uphs.upenn.edu. 2. Department of Neurology, Cleveland Clinic Foundation, 1950 E 89th St, Cleveland, OH 44106, USA. Electronic address: millerd@ccf.org. 3. University of Vermont College of Medicine, 89 Beaumont Ave, Burlington, VT 05405, USA. Electronic address: reiko.sakai@med.uvm.edu. 4. Department of Neurology, University of Pennsylvania, 3400 Spruce St. 3. W. Gates, Philadelphia, PA 19104, USA. Electronic address: jawilson@mail.med.upenn.edu. 5. Department of Neurology, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX 75390, USA. Electronic address: Teresa.Frohman@UTSouthwestern.edu. 6. Department of Neurology, University of Pennsylvania, 3400 Spruce St. 3. W. Gates, Philadelphia, PA 19104, USA. Electronic address: cmarkowi@mail.med.upenn.edu. 7. Department of Neurology, University of Pennsylvania, 3400 Spruce St. 3. W. Gates, Philadelphia, PA 19104, USA. Electronic address: Dina.Jacobs2@uphs.upenn.edu. 8. Department of Neurology, University of California at San Francisco, 1500 Owens St #320, San Francisco, CA 94158, USA. Electronic address: agreen@ucsf.edu. 9. Department of Neurology, Johns Hopkins School of Medicine, 600 N. Wolfe St, Baltimore, MD 21287, USA. Electronic address: pcalabr1@jhmi.edu. 10. Department of Neurology, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX 75390, USA. Electronic address: Elliot.Frohman@UTSouthwestern.edu. 11. Department of Neurology, New York University School of Medicine, 240 East 38th Street, 20th Floor, New York, NY 10016, USA. Electronic address: Steven.Galetta@nyumc.org. 12. Departments of Neurology and Population Health, New York University School of Medicine, 240 East 38th Street, 20th Floor, New York, NY 10016, USA. Electronic address: Laura.Balcer@nyumc.org.
Abstract
BACKGROUND: The relation of fatigue in multiple sclerosis (MS) to the visual system, an emerging structural and functional surrogate in MS, has not been well established. OBJECTIVE: We examined how physical and cognitive fatigue could be associated with visual dysfunction and neurologic impairment. METHODS: At a single time-point, we assessed 143 patients with: Low-contrast letter acuity (LCLA) and high-contrast visual acuity (VA) testing, the 25-Item National Eye Institute Visual Functioning Questionnaire (NEI-VFQ-25) and Neuro-Ophthalmic Supplement, the Modified Fatigue Impact Scale (MFIS), the MS Functional Composite (MSFC), and the Expanded Disability Status Scale (EDSS). RESULTS: Worse binocular LCLA scores were associated with increased levels of total and physical fatigue (p≤0.026). Greater levels of fatigue were also associated with reduced vision-specific QOL (p<0.001). Patients with more physical, but not cognitive, fatigue had greater levels of impairment by the Timed 25-Foot Walk (T25W, r=0.39, p<0.001), 9-Hole Peg Test (9HP r=0.22, p=0.011) and EDSS (r=0.45, p<0.001). CONCLUSIONS: Reduced vision in MS is highly associated with physical fatigue and could be used to capture more global, difficult to describe, symptoms. The potential differences in physical vs. cognitive fatigue and their correlates may begin to provide insight into their underlying mechanisms.
BACKGROUND: The relation of fatigue in multiple sclerosis (MS) to the visual system, an emerging structural and functional surrogate in MS, has not been well established. OBJECTIVE: We examined how physical and cognitive fatigue could be associated with visual dysfunction and neurologic impairment. METHODS: At a single time-point, we assessed 143 patients with: Low-contrast letter acuity (LCLA) and high-contrast visual acuity (VA) testing, the 25-Item National Eye Institute Visual Functioning Questionnaire (NEI-VFQ-25) and Neuro-Ophthalmic Supplement, the Modified Fatigue Impact Scale (MFIS), the MS Functional Composite (MSFC), and the Expanded Disability Status Scale (EDSS). RESULTS: Worse binocular LCLA scores were associated with increased levels of total and physical fatigue (p≤0.026). Greater levels of fatigue were also associated with reduced vision-specific QOL (p<0.001). Patients with more physical, but not cognitive, fatigue had greater levels of impairment by the Timed 25-Foot Walk (T25W, r=0.39, p<0.001), 9-Hole Peg Test (9HP r=0.22, p=0.011) and EDSS (r=0.45, p<0.001). CONCLUSIONS: Reduced vision in MS is highly associated with physical fatigue and could be used to capture more global, difficult to describe, symptoms. The potential differences in physical vs. cognitive fatigue and their correlates may begin to provide insight into their underlying mechanisms.
Authors: Wouter Schakel; Christina Bode; Hilde P A van der Aa; Carel T J Hulshof; Judith E Bosmans; Gerardus H M B van Rens; Ruth M A van Nispen Journal: BMJ Open Date: 2017-08-03 Impact factor: 2.692
Authors: Aung Zaw Zaw Phyo; Thibaut Demaneuf; Alysha M De Livera; George A Jelinek; Chelsea R Brown; Claudia H Marck; Sandra L Neate; Keryn L Taylor; Taylor Mills; Emily O'Kearney; Amalia Karahalios; Tracey J Weiland Journal: Front Neurol Date: 2018-04-04 Impact factor: 4.003
Authors: Alissa Rothman; Olwen C Murphy; Kathryn C Fitzgerald; Julia Button; Eliza Gordon-Lipkin; John N Ratchford; Scott D Newsome; Ellen M Mowry; Elias S Sotirchos; Stephanie B Syc-Mazurek; James Nguyen; Natalia Gonzalez Caldito; Laura J Balcer; Elliot M Frohman; Teresa C Frohman; Daniel S Reich; Ciprian Crainiceanu; Shiv Saidha; Peter A Calabresi Journal: Ann Clin Transl Neurol Date: 2019-01-19 Impact factor: 4.511
Authors: Jennifer S Graves; Frederike Cosima Oertel; Anneke Van der Walt; Sara Collorone; Elias S Sotirchos; Gorm Pihl-Jensen; Philipp Albrecht; E Ann Yeh; Shiv Saidha; Jette Frederiksen; Scott Douglas Newsome; Friedemann Paul Journal: Neurol Neuroimmunol Neuroinflamm Date: 2021-12-26