Abstract Details

Title Fatigue in Multiple Sclerosis: Relation with Clinical and Neuropsychological Variables, Brain MRI Lesions and Atrophy

Topic Aging, Dementia, and Behavioral Neurology

Presentation(s) P14 - Poster Session 14 (8:00 AM-9:00 AM)

Poster/Presentation
Number 10-002

Objective To investigate the prevalence of fatigue in MS patients and its relation with clinical, neuropsychological and brain structural MRI variables.

Background Fatigue is one of the most common and disabling symptom in MS. According to patients’ reported outcomes, fatigue can affect daily-life activities.

Design/Methods The Modified Fatigue Impact Scale (MFIS) and its subdomains (cognitive/physical/psychosocial) were collected from 725 healthy controls (HC) and 366 MS patients (238 relapsing-remitting [RR] and 128 progressive [P]). For global and sub-domains of MFIS, MS patients were classified as fatigued (F-MS) or not-fatigued (nF-MS) according to cut-off values provided by logistic regression models with a specificity of 90% in correctly classifying HC. MS patients underwent neurological, neuropsychological (Montgomery-Asberg-Depression-Rating Scale and Paced-Auditory-Serial-Addition Test) and structural MRI evaluations. Clinical and MRI measures were compared between F-MS and nF-MS patients using age-, sex- and phenotype-adjusted linear models. Heterogeneities between phenotypes were tested with specific interaction terms.

Results Global fatigue affected 174 (47.5%) MS patients, being more prevalent in PMS than RRMS (PMS=64.1% vs RRMS=38.7%, p=0.014). For all dichotomizations, F-MS patients were older (p from <0.001 to 0.041) and more depressed (p<0.001) than nF-MS patients. Compared to nF-MS, cognitive F-MS patients, had lower education (p=0.035). Compared to nF-MS, patients with global and physical fatigue had higher Expanded Disability Status Scale (EDSS) score only in RRMS (p<0.001), but not in PMS. RRMS patients with physical fatigue had lower brain (p=0.050), white matter (p=0.039) and thalamic volumes (p=0.022) compared to nF MS patients.

Conclusions In MS, fatigue is associated with an older age, lower education and higher depression. Only in RRMS, fatigue was associated with EDSS score and brain atrophy. A plateau effect of disability and structural damage could explain the lack of significant associations in PMS. The impact of fatigue on cognitive and physical activities should be considered to improve patients’ care.

Authors/Disclosures
Carmen Vizzino PRESENTER	No disclosure on file
Gianna Carla Riccitelli (San Raffaele)	No disclosure on file
Alessandro Meani	Alessandro Meani has nothing to disclose.
Paolo Preziosa (Ospedale San Raffaele)	Mr. Preziosa has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Bristol Myers Squibb . Mr. Preziosa has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Sanofi Genzyme. Mr. Preziosa has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Novartis. Mr. Preziosa has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Roche. Mr. Preziosa has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Merck.
Maria A. Rocca (Neuroimaging Research Unit)	Maria Assunta Rocca has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Biogen, Bristol Myers Squibb, Eli Lilly, Janssen, Roche. Maria Assunta Rocca has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for AstraZaneca, Biogen, Bristol Myers Squibb, Bromatech, Celgene, Genzyme, Horizon Therapeutics Italy, Merck Serono SpA, Novartis, Roche, Sanofi and Teva. The institution of Maria Assunta Rocca has received research support from MS Society of Canada, the Italian Ministry of Health, the Italian Ministry of University and Research, and Fondazione Italiana Sclerosi Multipla.
Massimo Filippi, MD, F�鶹��ýӳ�� (Ospedale San Raffaele, Neuroimaging Research Unit)	Dr. Filippi has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Alexion, Almirall, Biogen, Merck, Novartis, Roche, Sanofi. Dr. Filippi has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Alexion, Biogen, Bristol-Myers Squibb, Merck, Novartis, Roche, Sanofi, Sanofi-Aventis, Sanofi-Genzyme, Takeda. Dr. Filippi has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Bayer, Biogen, Celgene, Chiesi Italia SpA, Eli Lilly, Genzyme, Janssen, Merck-Serono, Neopharmed Gentili, Novartis, Novo Nordisk, Roche, Sanofi, Takeda, and TEVA. Dr. Filippi has received personal compensation in the range of $10,000-$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Springer Nature. The institution of Dr. Filippi has received research support from Biogen Idec, Merck-Serono, Novartis, Roche, the Italian Ministry of Health, the Italian Ministry of University and Research, and Fondazione Italiana Sclerosi Multipla.

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