The unique nature of fatigue in multiple sclerosis: prevalence, pathophysiology, contributing factors and subjective experience

Smith, Cath; Hale, Leigh

Fatigue is a multidimensional and multifactorial symptom experienced in many neurological and non-neurological conditions. Fatigue in these conditions may be affected by pathophysiological, psychological and pharmacological factors which, in turn, may impact upon physical, cognitive and psychosocial domains leading to activity restriction and disability. This narrative review compares and contrasts prevalence, pathophysiology, contributing factors and the subjective experience of fatigue in four chronic health conditions; multiple sclerosis (MS), Parkinson's disease, cancer and human immunovirus/autoimmune deficiency syndrome. Whilst all conditions share certain factors, some aspects of fatigue may be unique to each condition. In addition, the mechanisms of fatigue may be particularly complex in multiple sclerosis. It is recommended that the nature of MS-related fatigue is explored in depth through qualitative methodology in order to inform future quantitative investigation and to refine current measurement scales which may fail to capture all aspects of this phenomenon.

Physical Therapy Reviews, 2007, 12(1),  43-51.

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