fatigue

Since the onset of my MS, I have been acutely aware that stress and anxiety can wreak havoc on my body. Being anxious is not a comfortable feeling, whether you have a chronic illness or not. This past weekend was my husband’s celebration of life service. With his…

The TV was on as background noise the other day, but the words of the commercial cut right through my noise filter. With a little drum beat in the background, a woman’s voice was saying, “The doctor called me and she was, like, ‘You have multiple sclerosis.'” “Another drug…

Removing obstructions in large neck veins reduced multiple sclerosis patients’ headaches for several years, British and Italian researchers have demonstrated. The magnitude and duration of the effect differed among patients with different types of MS, however. Researchers also found that the treatment reduced fatigue, particularly in relapsing-remitting (RR) MS patients.

One single session of non-invasive brain stimulation can reduce cognitive fatigue in patients with multiple sclerosis (MS), say researchers at Germany’s Otto-von-Guericke University Magdeburg. Their study, “Electrophysiological and behavioral effects of frontal transcranial direct current stimulation on cognitive fatigue in multiple sclerosis,” appeared in the…

I could be in a fancy restaurant in central London rather than sitting at home writing this. Don’t feel sorry for me, I chose to stay in. The Christmas month of December is very hard. Extreme partying is allied with extreme levels of work. In my game, they are as…

I am tired, like beyond tired. I make tired look scintillating, and as funny as that sounds, it is anything but when trying to live your life. My spoons are numbered, and by midday, I am usually through all of them. Before you deem me crazy, I am referencing…

A diet rich in vegetables, fruits and whole grains may decrease symptoms and lessen disease progression in patients with multiple sclerosis (MS), a study suggests. The report, “Diet quality is associated with disability and symptom severity in multiple sclerosis,” appeared in the journal Neurology. “People with MS…

By the grace of God, I am a naturally positive individual who lends optimism and hope to even the bleakest of situations. Because of this, it is difficult to find me in a situation when my auspicious nature tires; after all, we find out the most…

Some days are easier than others, and some days are just not easy at all. Today I find myself in the latter of the two. It’s Monday morning, and my Sunday was insane: insanely busy, insanely fun, and insanely difficult. While…

Pain, walking problems and fatigue are factors that most strongly lower self-perceived health in multiple sclerosis (MS), researchers at the New York University Langone Medical Center have found. This challenges current treatment approaches focus mainly on physical disability. It suggests that “invisible disability” may be more important to how patients…

I’ve had a cold for two weeks. So, I’ve been more tired than usual. Too tired, in fact, to write the column that was supposed to post last Tuesday. (I apologize to all of you who wait, with bated breath, for the appearance of the MS Wire each…

Non-invasive brain stimulation reduces fatigue in multiple sclerosis patients, concludes a study by researchers at New York University. Fatigue is one the most disabling symptoms of MS, affecting roughly 75 percent of people with the disease. Doctors often prescribe drugs to treat narcolepsy, as well as behavior-based treatments and exercise programs, but their benefits have not been consistent. This led scientists to study a technique of brain stimulation called transcranial direct current stimulation (tDCS), which had shown positive results in earlier neurology studies, including improvements of cognitive symptoms in MS. In tDCS, doctors place electrodes on the scalp via a headset to apply a low-amplitude electrical current at the dorsolateral prefrontal cortex — a brain region believed to play a role in fatigue and cognitive symptoms. The technique has been proven safe and tolerable. The NYU study randomly assigned 27 MS patients to receive either tDCS or placebo. Patients got treatment while playing a cognitive game directed at the brain’s processing speed and working memory. Sessions lasted 20 minutes each and took place five days a week, at patients’ homes. Participants reported their level of fatigue after 20 sessions, using a scale known as the Patient-Reported Outcomes Measurement Information System (PROMIS) that grades fatigue on a score of up to 32. A higher score correlates with more fatigue. The results showed a significant 5.6-point drop with tDCS, compared to a 0.9 point increase in the placebo group. Furthermore, patients may benefit from more sessions, since those who underwent 20 sessions reduced fatigue more than those who did only 10. The study also showed that patients with the most fatigue at baseline saw the biggest improvements. Remarkably, many participants reduced their fatigue to near-normal levels, researchers observed. Further studies are needed to ascertain the precise mechanism behind tDCS. Scientists believe it changes the brain’s excitability, which improves connections and facilitates learning. Meanwhile, the study's authors strongly advise MS patients not to try over-the-counter stimulation technologies outside of a reliable research setting. The research team plans to test tDCS in larger clinical trials for MS-related fatigue, motor and cognitive symptoms. Currently, the Multiple Sclerosis Comprehensive Care Center at NYU Langone Health is the only one in the United States to offer tDCS to MS patients.

Behavioral therapy focusing on goal attainment might reduce cognitive fatigue in multiple sclerosis patients, finds a study that used brain imaging to examine goal-oriented tasks involving rewards. Since fatigue is one of the most common MS symptoms, affecting up to 90 percent of patients, researchers at the Kessler Foundation in East Hanover, New Jersey, say their findings could open the door to new non-medication approaches to treating MS-related fatigue. Scientists believe that a part of the brain, called the fronto-striatal network, causes fatigue. But studies also show that the network is active during goal attainment tasks, and that such tasks can reduce fatigue in healthy people. Equipped with this knowledge, Kessler researchers recruited 19 MS patients and 14 healthy controls, and exposed them to one of two conditions. In the first, they had the chance to win money while gambling. Researchers called this the outcome condition. The second condition did not include the prospect of a reward, or outcome. The tasks were performed in a brain scanner. Using functional magnetic resonance imaging of the brain — a method that tracks brain activity by monitoring blood flow — researchers could study how different tasks activated the fronto-striatal network. It turned out that the prospect of a reward activated parts of the network in deep brain structures, while parts of the prefrontal cortex were more active during the task without a potential reward. Importantly, the activation seen during the reward condition was linked to significantly lower levels of fatigue, which researchers measured outside the scanner. While researchers used a gambling task to study the process, similar exercises like achieving a good score on a test, might work equally well, researchers said. In fact, goal attainment is already incorporated in many neuropsychological rehabilitation efforts, including in MS.

People with multiple sclerosis (MS) often face geographic barriers that end up limiting their treatment options. That has led a Case Western Reserve University researcher to test online- and teleconference-based methods of reducing fatigue and improving patients’ quality of life. Matthew Plow, assistant professor at the university’s Frances Payne Bolton…

The Patient-Centered Outcomes Research Institute has awarded $38 million in grants for five projects that compare the effectiveness of different multiple sclerosis treatment strategies. A key aim of the research is to improve knowledge about the therapies to help doctors and patients choose the healthcare option that best meets patients’ needs. The…

Beth Kantor, 42, now knows what it really means to get down in the dirt. For the past four years, she’s volunteered as a first-aid assistant at the annual Twin Cities MuckFest, a fundraising event that the National Multiple Sclerosis Society organized in suburban Minneapolis. But this year, Kantor decided it…

Therapeutic horseback riding, also known as hippotherapy, when combined with standard care regimens significantly reduces fatigue and spasticity in multiple sclerosis. It also improves balance and quality of life, according to a German study. Hippotherapy takes advantage of a horse's natural movements to develop a patient's muscle tone and improve breathing, while strengthening the torso muscles. Horseback riding also improves balance control, coordination and gait, while boosting a patient's social communication skills, which can benefit self-esteem. “Hippotherapy as a complementary treatment can be defined as one-patient-one-horse physiotherapy treatment with and on the horse,” researchers wrote. Team leaders Vanessa Vermöhlen and Petra Schiller of the University of Cologne evaluated the benefits of half-hour weekly sessions of hippotherapy in combination with standard care. They randomly assigned 70 MS patients with lower limb spasticity to either an intervention group that did 12 weeks of hippotherapy, or a control group that received only standard therapy. The team evaluated the impact therapeutic horseback riding had on balance, measured by the Berg Balance Scale (BBS). They also measured its effect on other multiple sclerosis symptoms and signs, including fatigue, quality of life, pain, and spasticity. Overall, the team found that those who received hippotherapy plus standard care improved their BBS scores by 4.8 points after six weeks of therapy, and 6.4 by the trial's end. These increases were significantly higher than those achieved by the control group (2.9 points at six weeks and 3.1 points at 12 weeks). Although this represents a difference of only 3.3 points after 12 weeks, it still reflects a relevant change in patients' balance control capabilities, the authors said. In addition, the researchers also recognized significant improvements in fatigue, spasticity and quality of life of those undergoing hippotherapy plus standard care compared to those on the control group. The observed beneficial effects of hippotherapy validate previous reports that showing that activities with horses could help adults and children improve their balance, gait and psychomotor abilities.

Fatigue. Most people with chronic illness – especially MS — experience this. My energy levels vary from one day to the next. I am tired of being tired (pun intended). There are days when getting out of bed is challenging, and times when I literally have to force…

Many of us with multiple sclerosis have heard the saying, “I go to bed wired and wake up tired.” This is quite accurate, as fatigue is one of the most prevalent aspects of living with MS. So often I hear from well-meaning individuals who,…

Editor’s note: Tamara Sellman continues her occasional series on the MS alphabet with this second of two columns about words starting with the letter F. Read the first “F” column here. When it comes to multiple sclerosis, mastering an understanding of the disease means you…

Fatigue, limited mobility, and poor self-esteem or resiliency were found to be associated with periods of serious depression among multiple sclerosis patients, according to a recent study. Previous research has suggested that MS patients are at risk of major depression, with potentially profound impact on their quality of life. But only a few studies have addressed the incidence of depression among MS patients or the risk factors that may underlie its occurrence. Researchers in Canada enrolled 188 MS patients being treated an Alberta clinic, who were interviewed to assess potential risk factors for depression: namely, socioeconomic status, disease-related factors, childhood risk factors, psychosocial factors, and health behaviors. Participants were also asked to complete the Patient Health Questionnaire every two weeks for six months to identify depressive symptoms in real-time. Over a six-month follow-up, 36 cases of depression were reported among the group of MS patients analyzed. The incidence of depression was 0.019 for women, but higher — 0.044 — for men. Importantly, several factors seemed to be associated with depression in these patients — fatigue, limited mobility, and low resiliency, self-esteem, and self-efficacy, as well as poor coping skills. Results also showed that gender and income were associated with depression. Overall, the researchers concluded that "depression in MS exhibits a risk factor profile similar to that of depression in the general population, with the additional impact of MS illness-related factors. Potentially modifiable risk factors, such as coping with stress and resiliency, present opportunities for focus of further research in depression in MS treatment and prevention efforts." Concerning treatment, the team also emphasized that "while there is evidence in the clinical context that supports the efficacy for pharmacologic and non-pharmacologic treatments for depression in the general population, there is currently insufficient evidence to support/or refute the efficacy of depression treatment for individuals with MS ... Clearly this is an area that requires additional research."

It’s summer in the U.K., and it’s hot. That’s cause for celebration for everyone but us. It’s actually the hottest June day since 1986. Heat immediately spikes my fatigue. For some of us, the cold does the same. Thankfully, not me — I get the winter off. According…

Fatigue and limited leg function are more common among older people with progressive multiple sclerosis than in those with relapsing forms of the disease, according to a study. In fact, they are a sign that the disease of a person with relapsing MS is becoming worse by reaching the progressive MS…

Fatigue is a topic I have not wanted to write about. It’s not because the subject isn’t important. As I hemmed and hawed about this week’s column topic, fading in and out of an annoying cognitive fog brought on by increased MS fatigue, the task-minded side of me…

Young multiple sclerosis (MS) patients who engage in physical activity can relieve symptoms of depression, concludes a Canadian study supported by the National Multiple Sclerosis Society. Researchers presented their study, “Longitudinal Relationships Between Moderate and Vigorous Physical Activity, Fatigue, and Depression in Pediatric Multiple Sclerosis,” at the 2017 Annual Meeting of the…

MS is sneaky. It is expert at evading detection and diagnosis, and often brings a host of invisible symptoms that may come and go at random. MS also brings invisible costs — expenses beyond the obvious medications, supplements, assistive devices, and healthcare. I am not talking about externalities,…

A significant percentage of multiple sclerosis (MS) patients struggle with improper diagnoses and ineffective treatments, a national survey of more than 5,300 patients found. The fifth annual survey, “MS in America 2017,” was conducted by Health Union between Jan. 25 and March 1, 2017. It was released through the…

Multiple sclerosis causes debilitating fatigue. The following photographs show, without censorship, what my fatigue leaves undone. The homes of everyone I know have living rooms without sweaters tossed over the back of chairs. Their floors are not an obstacle course. They do not have piles of mail, notes, drills,…

In pursuit of an answer for breathing difficulty The MRI of my cervical and thoracic spine showed no active lesions last week. That was good news. Other…

People with secondary progressive multiple sclerosis (SPMS) are more likely to feel exhausted and have limited leg function than those without progressive MS as they age, a preliminary study suggests. The findings will be presented at the American Academy of Neurology (AAN) 69th Annual Meeting, set for April 22-28 in Boston.