Contributions
Abstract: P363
Type: Poster
Abstract Category: Clinical aspects of MS - Clinical assessment tools
Background: People with Multiple Sclerosis (PwMS) frequently report fatigue that can be disabling and impact quality of life (QoL) and employment. PwMS-fatigue is related to: physical disability, medication, sleep disorders, and depression. Effective PwMS-fatigue treatment is problematic. The role/degree cognitive fatigue plays in PwMS patient reported outcome (PRO) fatigue is unknown.
Objective: Explore the relationship PRO-fatigue and depression in PwMS and Visual Evoked Potential latency (VEP-L), one objective neurophysiological measure of central demyelination.
Methods: Retrospective review of PwMS who underwent VEP and completed PRO Modified Fatigue Impact Scale (MFIS), Fatigue Severity Scale (FSS), and Beck´s Depression Inventory (BDI) during routine clinical care. PRO-MFIS sub-score scales reportedly identify and differentiate between physical, cognitive, and psychosocial subtypes of fatigue, whereas PRO-FSS does not allow such differentiation.
Results: 60 PwMS (average age 45 +/-10.4 years, 72% female) were identified. VEP-L correlated with PRO-sub-scale cognitive fatigue scores in PwMS: both right (r=0.27, p=0.03) and left (r=0.31, p=0.02) eyes, MFIS-global, MFIS-physical, and MFIS-psychosocial fatigue sub-scale scores and FSS-global score did not significantly correlate with VEP-L in either eye. VEP-L also correlated with PwMS PRO-MFIS-cognitive fatigue Rasch-corrected analysis scores for both right (r=0.26, p=0.04) and left (r=0.27 p=0.04) eyes, whereas scores of MFIS-global and MFIS-physical PRO-sub-scale and global-FSS did not correlate with VEP-L in either eye. BDI scores did not significantly correlate with any latency outcomes.
Conclusion: VEP-Latency, an objective neurophysiological proxy marker reflecting CNS demyelination along the visual pathway, correlates with PwMS PRO-MFIS-cognitive fatigue. PwMS PRO-Fatigue is not unidimensional, and fatigue subtypes should be measured independently to produce a better understanding of individual PwMS PRO-fatigue. PRO-fatigue subtypes in PwMS may have different physiologic underpinnings, as indicated by the specific correlation between PRO-MFIS-cognitive fatigue and VEP-L independent of other PRO-fatigue subtypes. Future studies of PRO-fatigue in PwMS should investigate which aspects PRO-fatigue and PRO-cognitive fatigue may be reflective of the degree of demyelination as measured independently by objective measures.
Disclosure: Glen Doniger is an employee of NeuroTrax Corporation
Abstract: P363
Type: Poster
Abstract Category: Clinical aspects of MS - Clinical assessment tools
Background: People with Multiple Sclerosis (PwMS) frequently report fatigue that can be disabling and impact quality of life (QoL) and employment. PwMS-fatigue is related to: physical disability, medication, sleep disorders, and depression. Effective PwMS-fatigue treatment is problematic. The role/degree cognitive fatigue plays in PwMS patient reported outcome (PRO) fatigue is unknown.
Objective: Explore the relationship PRO-fatigue and depression in PwMS and Visual Evoked Potential latency (VEP-L), one objective neurophysiological measure of central demyelination.
Methods: Retrospective review of PwMS who underwent VEP and completed PRO Modified Fatigue Impact Scale (MFIS), Fatigue Severity Scale (FSS), and Beck´s Depression Inventory (BDI) during routine clinical care. PRO-MFIS sub-score scales reportedly identify and differentiate between physical, cognitive, and psychosocial subtypes of fatigue, whereas PRO-FSS does not allow such differentiation.
Results: 60 PwMS (average age 45 +/-10.4 years, 72% female) were identified. VEP-L correlated with PRO-sub-scale cognitive fatigue scores in PwMS: both right (r=0.27, p=0.03) and left (r=0.31, p=0.02) eyes, MFIS-global, MFIS-physical, and MFIS-psychosocial fatigue sub-scale scores and FSS-global score did not significantly correlate with VEP-L in either eye. VEP-L also correlated with PwMS PRO-MFIS-cognitive fatigue Rasch-corrected analysis scores for both right (r=0.26, p=0.04) and left (r=0.27 p=0.04) eyes, whereas scores of MFIS-global and MFIS-physical PRO-sub-scale and global-FSS did not correlate with VEP-L in either eye. BDI scores did not significantly correlate with any latency outcomes.
Conclusion: VEP-Latency, an objective neurophysiological proxy marker reflecting CNS demyelination along the visual pathway, correlates with PwMS PRO-MFIS-cognitive fatigue. PwMS PRO-Fatigue is not unidimensional, and fatigue subtypes should be measured independently to produce a better understanding of individual PwMS PRO-fatigue. PRO-fatigue subtypes in PwMS may have different physiologic underpinnings, as indicated by the specific correlation between PRO-MFIS-cognitive fatigue and VEP-L independent of other PRO-fatigue subtypes. Future studies of PRO-fatigue in PwMS should investigate which aspects PRO-fatigue and PRO-cognitive fatigue may be reflective of the degree of demyelination as measured independently by objective measures.
Disclosure: Glen Doniger is an employee of NeuroTrax Corporation