Anna L Kratz1, Susan L Murphy2, Tiffany J Braley3. 1. Department of Physical Medicine & Rehabilitation, University of Michigan, Ann Arbor, MI. Electronic address: alkratz@med.umich.edu. 2. Department of Physical Medicine & Rehabilitation, University of Michigan, Ann Arbor, MI; Veterans Affairs Ann Arbor Health Care System, Geriatric Research, Education, and Clinical Center, Ann Arbor, MI. 3. Department of Neurology, University of Michigan, Ann Arbor, MI.
Abstract
OBJECTIVE: To examine the temporal associations, within day and day to day, between pain, fatigue, depressed mood, and cognitive function in multiple sclerosis (MS). DESIGN: Repeated-measures study involving 7 days of ecological momentary assessment (EMA) of symptoms 5 times a day; multilevel mixed models were used to analyze data. SETTING: Community. PARTICIPANTS: Ambulatory adults (N=107) with MS. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURE: EMA of pain, fatigue, depressed mood, and cognitive function rated on a 0 to 10 scale. RESULTS: Fatigue and pain were linked within day such that higher pain was associated with higher subsequent fatigue (B=.09, P=.04); likewise, higher fatigue was associated with higher pain in the following time frame (B=.05, P=.04). Poorer perceived cognitive function preceded increased subsequent pain (B=.08, P=.007) and fatigue (B=.10, P=.01) within day. Depressed mood was not temporally linked with other symptoms. In terms of day-to-day effects, a day of higher fatigue related to decreased next day fatigue (B=-.16, P=.01), and a day of higher depressed mood related to increased depressed mood the next day (B=.17, P=.01). There were no cross-symptom associations from one day to the next. CONCLUSIONS: Findings provide new insights on how common symptoms in MS relate to each other and vary within and over days. Pain and fatigue show evidence of a dynamic bidirectional relation over the course of a day, and worsening of perceived cognitive function preceded worsening of both pain and fatigue. Most temporal associations between symptoms occur within the course of a day, with relatively little carryover from one day to the next.
OBJECTIVE: To examine the temporal associations, within day and day to day, between pain, fatigue, depressed mood, and cognitive function in multiple sclerosis (MS). DESIGN: Repeated-measures study involving 7 days of ecological momentary assessment (EMA) of symptoms 5 times a day; multilevel mixed models were used to analyze data. SETTING: Community. PARTICIPANTS: Ambulatory adults (N=107) with MS. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURE: EMA of pain, fatigue, depressed mood, and cognitive function rated on a 0 to 10 scale. RESULTS:Fatigue and pain were linked within day such that higher pain was associated with higher subsequent fatigue (B=.09, P=.04); likewise, higher fatigue was associated with higher pain in the following time frame (B=.05, P=.04). Poorer perceived cognitive function preceded increased subsequent pain (B=.08, P=.007) and fatigue (B=.10, P=.01) within day. Depressed mood was not temporally linked with other symptoms. In terms of day-to-day effects, a day of higher fatigue related to decreased next day fatigue (B=-.16, P=.01), and a day of higher depressed mood related to increased depressed mood the next day (B=.17, P=.01). There were no cross-symptom associations from one day to the next. CONCLUSIONS: Findings provide new insights on how common symptoms in MS relate to each other and vary within and over days. Pain and fatigue show evidence of a dynamic bidirectional relation over the course of a day, and worsening of perceived cognitive function preceded worsening of both pain and fatigue. Most temporal associations between symptoms occur within the course of a day, with relatively little carryover from one day to the next.
Authors: Robert W Motl; Edward McAuley; Daniel Wynn; Yoojin Suh; Madeline Weikert; Deirdre Dlugonski Journal: J Nerv Ment Dis Date: 2010-03 Impact factor: 2.254
Authors: R H C Lazeron; J B Boringa; M Schouten; B M J Uitdehaag; E Bergers; J Lindeboom; M I Eikelenboom; P H Scheltens; F Barkhof; C H Polman Journal: Mult Scler Date: 2005-10 Impact factor: 6.312
Authors: Varsha D Badal; Ellen E Lee; Rebecca Daly; Emma M Parrish; Ho-Cheol Kim; Dilip V Jeste; Colin A Depp Journal: Front Digit Health Date: 2022-02-07