Understanding fatigue in multiple sclerosis

Abstract

Fatigue is a commonly reported symptom of multiple sclerosis (MS) which may impair function. It is thought that fatigue may be of either a central or peripheral origin. Physical and psychosocial mechanisms have been suggested as causing fatigue. Many physical causes have been investigated including type of MS, lesion site, inflammation, abnormal heat response, autonomic dysfunction, ventilatory dysfunction, disturbed sleep, cortical dysfunction, altered central activation ratio and conduction time, and changes in skeletal muscle morphology. Potential psychosocial causes include abnormal health beliefs and behaviours, personality changes and depression. The objective of this review was to assist health professionals to gain a better understanding of MS fatigue and its causes in order to assist them in management choices. It is suggested that fatigue may be multifactorial in origin as the evidence does not strongly support any one causal mechanism. Understanding the various mechanisms contributing to MS fatigue may assist physiotherapists and their patients to develop more effective management strategies.

Keywords:

• FATIGUE
• CAUSE
• IMPACT
• MULTIPLE SCLEROSIS