Research Article
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Relationship Between Fatigue, Cognitive Functions, Depression, and Disability in Multiple Sclerosis Patients

Year 2023, Volume: 7 Issue: 2, 184 - 189, 29.10.2023

Gökçe Zeytin Demiral

https://doi.org/10.30565/medalanya.1350671
Cited By: 1

Abstract

Aim : Multiple Sclerosis (MS) is a chronic, progressive, and neurodegenerative disorder of the central nervous system. It frequently leads to symptoms such as disability, cognitive impairment, fatigue, and depression. This study aims to examine the relationship between fatigue, cognitive functions, depression, and disability among individuals with MS.

Methods: Seventy-four MS patients were evaluated by using the Cognitive Failure Questionnaire (CFQ) battery. The Expanded Disability Status Scale (EDSS) was used in determining the level of disability, whereas the Fatigue Severity Scale (FSS) and the Beck Depression Inventory (BDI) were utilized in measuring the levels of fatigue and depression, respectively.

Results :Moderate positive correlations were found between EDSS and BDI (r1=0.342; p<0.001), between EDSS and FSS (r1=0.392; p<0.001), between CFQ and BDI (r1=0.451; p<0.001), between CFQ and FSS (r1=0.425; p<0.001), and between FSS and BDI (r1=0.424; p<0.001).

Conclusion :The results achieved in this study indicate that fatigue and depression increase as disability increases among Multiple Sclerosis patients and cognitive impairment is associated with both depression and fatigue.

Keywords

Multiple Sclerosis depression fatigue cognitive failure

References

  • 1. Lewis P. Rowland, Timothy A. Pedley. Merritt’s neurology. 12th edition. Philadelphia, PA: Lippincott Williams & Wilkins; 2010. p. 93-94.
  • 2. Bölük C, Börü, ÜT, Taşdemir M, Gezer T. Epidemiology of multiple sclerosis in Turkey; a ten-year trend in rural cities. Turk J Neurol, 2021;27(1),41-5. doi: 10.4274/tnd.2020.36418  
  • 3. Kutzelnigg A, Lucchinetti CF, Stadelmann C, Brück W, Rauschka H, Bergmann M, et al. Cortical demyelination and diffuse white matter injury in multiple sclerosis. Brain 2005;128(Pt 11):2705–12. doi: 10.1093/brain/awh641.
  • 4. Chiaravalloti ND, DeLuca J. Cognitive impairment in multiple sclerosis. Lancet Neurol 2008;7(12):1139–51. doi: 10.1016/S1474-4422(08)70259-X.
  • 5. Wallin MT, Wilken JA, Kane R. Cognitive dysfunction in multiple sclerosis: Assessment, imaging, and risk factors. J Rehabil Res Dev. 2006;43(1):63-72. doi: 10.1682/jrrd.2004.09.0120. 
  • 6. Feinstein A. The Neuropsychiatry of Multiple Sclerosis. Can J Psychiatry. 2004;49(3):157-63. doi: 10.1177/070674370404900302. 
  • 7. Flachenecker P, Kümpfel T, Kallmann B, Gottschalk M, Grauer O, Rieckmann P, et al. Fatigue in multiple sclerosis: a comparison of different rating scales and correlation to clinical parameters. Mult Scler. 2002;8(6):523-6. doi: 10.1191/1352458502ms839oa.
  • 8. Wallace, J. Craig, and Stephen J. Vodanovich. Can accidents and industrial mishaps be predicted? Further investigation into the relationship between cognitive failure and reports of accidents. Journal of Business and psychology. 2003;17(4):503-14. doi: 10.1023/A:1023452218225
  • 9. Broadbent DE, Cooper PF, FitzGerald P, Parkes KR. The cognitive failures questionnaire (CFQ) and its correlates. Br J Clin Psychol. 1982;21(1):1-16. doi: 10.1111/j.2044-8260.1982.tb01421.x. 
  • 10. Attree EA, Arroll MA, Dancey CP, Griffith C, Bansal AS. Psychosocial factors involved in memory and cognitive failures in people with myalgic encephalomyelitis/chronic fatigue syndrome. Psychol Res Behav Manag. 2014;7:67-76. doi: 10.2147/PRBM.S50645. 
  • 11. Bridger RS, Johnsen SÅ, Brasher K. Psychometric properties of the Cognitive Failures Questionnaire. Ergonomics 2013;56(10):1515–24. doi: 10.1080/00140139.2013.821172. 
  • 12. Yapıcı Eser H, Yalçınay İnan M, Kucuker MU, Kılçıksız CM, Yılmaz S, Dinçer N, et al. Development, Validity, and Reliability of the 4-point Likert Turkish version of Cognitive Failures Questionnaire. Ann Med Res 2020;27(6):1650-6. 10.5455/annalsmedres.2020.04.308
  • 13. Kurtzke JF. Rating neurologic impairment in multiple sclerosis: An expanded disability status scale (EDSS). Neurology 1983;33(11):1444–52. doi: 10.1212/wnl.33.11.1444.
  • 14. Armutlu K, Korkmaz NC, Keser I, Sumbuloglu V, Akbiyik DI, Guney Z, et al. The validity and reliability of the Fatigue Severity Scale in Turkish multiple sclerosis patients. Int J Rehabil Res. 2007;30(1):81-5. doi: 10.1097/MRR.0b013e3280146ec4.
  • 15. Krupp LB, LaRocca NG, Muir-Nash J, Steinberg AD. The fatigue severity scale. Application to patients with multiple sclerosis and systemic lupus erythematosus. Arch Neurol. 1989;46(10):1121-3. doi: 10.1001/archneur.1989.00520460115022.
  • 16. Beck AT, Epstein N, Brown G, Steer RA. An inventory for measuring clinical anxiety: Psychometric properties. J Consult Clin Psychol 1988;56(6):893–7. doi: 10.1037//0022-006x.56.6.893.
  • 17. Özdamar K. Statistical Data Analysis with Package Programs-1. Eskişehir: Kaan Publishing House; 2004. p.419-426.
  • 18. Manjaly ZM, Harrison NA, Critchley HD, Do CT, Stefanics G, Wenderoth N, et al. Pathophysiological and cognitive mechanisms of fatigue in multiple sclerosis. J Neurol Neurosurg Psychiatry 2019;90(6):642–51. doi: 10.1136/jnnp-2018-320050. 
  • 19. Enoka RM, Almuklass AM, Alenazy M, Alvarez E, Duchateau J. Distinguishing between Fatigue and Fatigability in Multiple Sclerosis. Neurorehabil Neural Repair 2021;35(11):960–73. doi: 10.1177/15459683211046257.
  • 20. Giazkoulidou A, Messinis L, Nasios G. Cognitive functions and social cognition in multiple sclerosis: An overview. Hell J Nucl Med 2019;22 Suppl:102–10. PMID: 30877728
  • 21. De Meo E, Portaccio E, Giorgio A, Ruano L, Goretti B, Niccolai C, et al. Identifying the Distinct Cognitive Phenotypes in Multiple Sclerosis. JAMA Neurol 2021;78(4):4125. doi: 10.1001/jamaneurol.2020.4920.
  • 22. Caneda MA, Vecino MC. The correlation between EDSS and cognitive impairment in MS patients. Assessment of a Brazilian population using a BICAMS version. Arq Neuropsiquiatr. 2016;74(12):974-81. doi: 10.1590/0004-282X20160151.
  • 23. Wang H. MicroRNAs, Multiple Sclerosis, and Depression. Int J Mol Sci 2021;22(15):7802. doi: 10.3390/ijms22157802.
  • 24. Nauta IM, Bertens D, van Dam M, Huiskamp M, Driessen S, Geurts J, et al. Performance validity in outpatients with multiple sclerosis and cognitive complaints. Mult Scler 2022;28(4):642–53. doi: 10.1177/13524585211025780.
  • 25. Diamond BJ, Johnson SK, Kaufman M, Graves L. Relationships between information processing, depression, Fatigue, and cognition in multiple sclerosis. Arch Clin Neuropsychol 2008;23(2):189–99. doi: 10.1016/j.acn.2007.10.002.

Multipl Sklerozlu Hastalarda; Yorgunluk, Kognitif Fonksiyonlar, Depresyon ve Özürlülük İlişkisi

Year 2023, Volume: 7 Issue: 2, 184 - 189, 29.10.2023

Gökçe Zeytin Demiral

https://doi.org/10.30565/medalanya.1350671
Cited By: 1

Abstract

Amaç: Multipl skleroz (MS); kronik, ilerleyici ve nörodejeneratif bir merkezi sinir sistemi bozukluğudur. Multipl Skleroz; genellikle özürlülük, bilişsel yetersizlik, yorgunluk ve depresyon semptomlarına neden olur. Bu çalışmada amaç Multipl skleroz hastalarında bilişsel işlev, yorgunluk ve depresyonun özürlülük ile ilişkisini değerlendirmektir.

Yöntem: 74 Multipl sklerozlu hastayı değerlendirmek için Bilişsel Başarısızlıklar Ölçeği (CFQ) bataryasını uyguladık. Özürlülük düzeylerini değerlendirmek için Genişletilmiş Özürlülük Durum Ölçeği (EDSS) kullanıldı. Yorgunluk ve depresyon düzeyleri için sırasıyla Yorgunluk Şiddet Ölçeği (FSS) ve Beck Depresyon Envanteri (BDI) kullanıldı.

Bulgular :EDSS ile BDI arasında orta düzeyde pozitif korelasyon bulundu (r1=0,342; p<0,001). EDSS ile yorgunluk arasında orta düzeyde pozitif korelasyon bulundu (r1=0,392; p<0,001). CFQ ile BDI arasında orta düzeyde pozitif korelasyon bulundu (r1=0,451; p<0,001). CFQ ile yorgunluk arasında orta düzeyde pozitif korelasyon bulundu (r1=0,425; p<0,001). Yorgunluk ile BDI arasında orta düzeyde pozitif bir korelasyon bulundu (r1=0,424; p<0,001).

Sonuç Multipl skleroz hastalarında özürlülük arttıkça yorgunluk, depresyon artmaktadır ve bilişsel işlevlerdeki bozulmada depresyon ve yorgunluk rol almaktadır.

Keywords

Multipl Skleroz; depresyon yorgunluk bilişsel yetersizlik

Thanks

Çalışmanın verilerinin toplanmasında yardımcı olan Afyonkarahisar Tıp Fakültesi dönem 3 öğrencilerinden Emine Tuğba Yeşil, Feraya Yalçınkaya, Elif Yalçın, Mukaddes Taştan, Vakkas Enes Gündoğan ve Merve Acar’a katkılarından dolayı teşekkür ederim./I would like to express my gratitude to the 3rd-year medical students of Afyonkarahisar Medical Faculty, Emine Tuğba Yeşil, Feraya Yalçınkaya, Elif Yalçın, Mukaddes Taştan, Vakkas Enes Gündoğan, and Merve Acar, for their contributions in collecting the data for this study.

References

  • 1. Lewis P. Rowland, Timothy A. Pedley. Merritt’s neurology. 12th edition. Philadelphia, PA: Lippincott Williams & Wilkins; 2010. p. 93-94.
  • 2. Bölük C, Börü, ÜT, Taşdemir M, Gezer T. Epidemiology of multiple sclerosis in Turkey; a ten-year trend in rural cities. Turk J Neurol, 2021;27(1),41-5. doi: 10.4274/tnd.2020.36418  
  • 3. Kutzelnigg A, Lucchinetti CF, Stadelmann C, Brück W, Rauschka H, Bergmann M, et al. Cortical demyelination and diffuse white matter injury in multiple sclerosis. Brain 2005;128(Pt 11):2705–12. doi: 10.1093/brain/awh641.
  • 4. Chiaravalloti ND, DeLuca J. Cognitive impairment in multiple sclerosis. Lancet Neurol 2008;7(12):1139–51. doi: 10.1016/S1474-4422(08)70259-X.
  • 5. Wallin MT, Wilken JA, Kane R. Cognitive dysfunction in multiple sclerosis: Assessment, imaging, and risk factors. J Rehabil Res Dev. 2006;43(1):63-72. doi: 10.1682/jrrd.2004.09.0120. 
  • 6. Feinstein A. The Neuropsychiatry of Multiple Sclerosis. Can J Psychiatry. 2004;49(3):157-63. doi: 10.1177/070674370404900302. 
  • 7. Flachenecker P, Kümpfel T, Kallmann B, Gottschalk M, Grauer O, Rieckmann P, et al. Fatigue in multiple sclerosis: a comparison of different rating scales and correlation to clinical parameters. Mult Scler. 2002;8(6):523-6. doi: 10.1191/1352458502ms839oa.
  • 8. Wallace, J. Craig, and Stephen J. Vodanovich. Can accidents and industrial mishaps be predicted? Further investigation into the relationship between cognitive failure and reports of accidents. Journal of Business and psychology. 2003;17(4):503-14. doi: 10.1023/A:1023452218225
  • 9. Broadbent DE, Cooper PF, FitzGerald P, Parkes KR. The cognitive failures questionnaire (CFQ) and its correlates. Br J Clin Psychol. 1982;21(1):1-16. doi: 10.1111/j.2044-8260.1982.tb01421.x. 
  • 10. Attree EA, Arroll MA, Dancey CP, Griffith C, Bansal AS. Psychosocial factors involved in memory and cognitive failures in people with myalgic encephalomyelitis/chronic fatigue syndrome. Psychol Res Behav Manag. 2014;7:67-76. doi: 10.2147/PRBM.S50645. 
  • 11. Bridger RS, Johnsen SÅ, Brasher K. Psychometric properties of the Cognitive Failures Questionnaire. Ergonomics 2013;56(10):1515–24. doi: 10.1080/00140139.2013.821172. 
  • 12. Yapıcı Eser H, Yalçınay İnan M, Kucuker MU, Kılçıksız CM, Yılmaz S, Dinçer N, et al. Development, Validity, and Reliability of the 4-point Likert Turkish version of Cognitive Failures Questionnaire. Ann Med Res 2020;27(6):1650-6. 10.5455/annalsmedres.2020.04.308
  • 13. Kurtzke JF. Rating neurologic impairment in multiple sclerosis: An expanded disability status scale (EDSS). Neurology 1983;33(11):1444–52. doi: 10.1212/wnl.33.11.1444.
  • 14. Armutlu K, Korkmaz NC, Keser I, Sumbuloglu V, Akbiyik DI, Guney Z, et al. The validity and reliability of the Fatigue Severity Scale in Turkish multiple sclerosis patients. Int J Rehabil Res. 2007;30(1):81-5. doi: 10.1097/MRR.0b013e3280146ec4.
  • 15. Krupp LB, LaRocca NG, Muir-Nash J, Steinberg AD. The fatigue severity scale. Application to patients with multiple sclerosis and systemic lupus erythematosus. Arch Neurol. 1989;46(10):1121-3. doi: 10.1001/archneur.1989.00520460115022.
  • 16. Beck AT, Epstein N, Brown G, Steer RA. An inventory for measuring clinical anxiety: Psychometric properties. J Consult Clin Psychol 1988;56(6):893–7. doi: 10.1037//0022-006x.56.6.893.
  • 17. Özdamar K. Statistical Data Analysis with Package Programs-1. Eskişehir: Kaan Publishing House; 2004. p.419-426.
  • 18. Manjaly ZM, Harrison NA, Critchley HD, Do CT, Stefanics G, Wenderoth N, et al. Pathophysiological and cognitive mechanisms of fatigue in multiple sclerosis. J Neurol Neurosurg Psychiatry 2019;90(6):642–51. doi: 10.1136/jnnp-2018-320050. 
  • 19. Enoka RM, Almuklass AM, Alenazy M, Alvarez E, Duchateau J. Distinguishing between Fatigue and Fatigability in Multiple Sclerosis. Neurorehabil Neural Repair 2021;35(11):960–73. doi: 10.1177/15459683211046257.
  • 20. Giazkoulidou A, Messinis L, Nasios G. Cognitive functions and social cognition in multiple sclerosis: An overview. Hell J Nucl Med 2019;22 Suppl:102–10. PMID: 30877728
  • 21. De Meo E, Portaccio E, Giorgio A, Ruano L, Goretti B, Niccolai C, et al. Identifying the Distinct Cognitive Phenotypes in Multiple Sclerosis. JAMA Neurol 2021;78(4):4125. doi: 10.1001/jamaneurol.2020.4920.
  • 22. Caneda MA, Vecino MC. The correlation between EDSS and cognitive impairment in MS patients. Assessment of a Brazilian population using a BICAMS version. Arq Neuropsiquiatr. 2016;74(12):974-81. doi: 10.1590/0004-282X20160151.
  • 23. Wang H. MicroRNAs, Multiple Sclerosis, and Depression. Int J Mol Sci 2021;22(15):7802. doi: 10.3390/ijms22157802.
  • 24. Nauta IM, Bertens D, van Dam M, Huiskamp M, Driessen S, Geurts J, et al. Performance validity in outpatients with multiple sclerosis and cognitive complaints. Mult Scler 2022;28(4):642–53. doi: 10.1177/13524585211025780.
  • 25. Diamond BJ, Johnson SK, Kaufman M, Graves L. Relationships between information processing, depression, Fatigue, and cognition in multiple sclerosis. Arch Clin Neuropsychol 2008;23(2):189–99. doi: 10.1016/j.acn.2007.10.002.
There are 25 citations in total.

Details

Primary Language English
Subjects Clinical Sciences (Other)
Journal Section Research Article
Authors

Gökçe Zeytin Demiral 0000-0002-9635-5804

Early Pub Date October 20, 2023
Publication Date October 29, 2023
Submission Date August 27, 2023
Acceptance Date September 22, 2023
Published in Issue Year 2023 Volume: 7 Issue: 2

Cite

Vancouver Zeytin Demiral G. Relationship Between Fatigue, Cognitive Functions, Depression, and Disability in Multiple Sclerosis Patients. Acta Med. Alanya. 2023;7(2):184-9.

Cited By

Üniversite Öğrencilerinin Depresyon Düzeyleri ve Sınav Kaygı Düzeyleri Arasındaki Ilişkinin İncelenmesi
Uluslararası İnsan Çalışmaları Dergisi
https://doi.org/10.35235/uicd.1310776

9705

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