Fatigue in multiple sclerosis (MS) is a common disabling symptom that may have a major impact on quality of life (QoL) of MS patients, however it frequently is overlooked in daily clinical practice. Moreover, the studies exploring the QoL and fatigue have mostly been limited to the MS patients. Currently, we are unaware of any data exploring the QoL and fatigue in the clinical subtypes of MS and other demyelinating diseases. This study aims at bridging this gap.
Our objective is to evaluate the quality of life and fatigue in the clinical subtypes of MS patients as well as in patients with other demyelinating diseases.
The clinical types, quality of life (Multiple Sclerosis Quality of Life-54 - MSQoL-54) and fatigue levels (Fatigue Severity Scale - FSS) of the patients were analyzed retrospectively. Patients were divided into two groups in terms of disability as those with EDSS scores ≥3 and <3. The quality of life of the patients was evaluated according to clinical types and disabilities. The cut‐off score for fatigue was set to be ≥4 in FSS.
The mean age of the patients was 39.59 ± 9.85, and the mean disease duration was 6.30 years. Of all enrolled patients, 1.5% had Radiological Isolated Syndrome (RIS) (n = 1), 10.6% had Clinical Isolated Syndrome (KIS) (n = 7), 68.2% had Relapsing-Remitting MS (RRMS) (n = 45), 9.1% had Secondary Progressive MS (SPMS) (n = 6), 3% had Primary Progressive MS (PPMS) (n = 2), 4.5% had Neuromyelitis Optica Spectrum Disease (NMOSD) (n = 3), and 3% had other demyelinating disease (n = 2). Mean overall MSQoL-54 score was 86.79 ± 8.57, and mean Beck Depression Inventory score was 10.39 in all patients. MSQoL-54 score was 88.36 ± 8.54 in RRMS patients; 81.25 ± 5.78 in SPMS patients; 84.57 ± 10.84 in CIS patients; 82.75 ± 6.71 in PPMS patients; 83.50 ± 7.05 in NMOSD patients; 75.50 in RIS patient; and 90.50 ± 2.12 in patients followed up with the diagnosis of demyelinating disease. Although the QoL scores of the progressive forms were lower; no statistically significant difference between clinical types was found (p = 0.281). The mean MSQoL-54 score was 82.61 ± 5.70 in patients with EDSS scores ≥3 (n = 13) whereas it was 87.82 ± 8.89 in patients with EDSS scores <3 (n = 53) (p = 0.014). The prevalence of fatigue in our cohort was 65.2%. 57.8% of patients with RRMS; 83.3% in SPMS patients; 85.7% in CIS patients; 100% in RIS patients; 50% in PPMS patients; 66.7% in NMOSD patients; and 100% in patients who were followed up with the demyelinating disease reported fatigue (FSS ≥4).
Despite the several limitations including the small number of the patients in subgroups, our results show the higher fatigue levels regardless of clinical types and the association of increased disability and reduced quality of life in MS patients. In addition to medical treatments, periodic evaluation of patients' quality of life with appropriate support programs and taking necessary measures may contribute positively to the course of the disease.