The correlation between Cognitive Impairment and seveirty of pathologic Fatigue in MS patients

Abstract

Multiple sclerosis (MS) is a demyelinating disease of the central nervous system. The disease destroys myelin around the axon and disrupts nerve conduction, leading to a wide range of symptoms and signs, including mobility problems, Abnormal sensations, vision problems, ataxia, sphincter problems, depression, and muscle spasms. Fatigue and cognitive impairment are common and debilitating symptoms of MS that affect the patient's quality of life considerably. Due to the limited data about the relationship between pathological fatigue and cognitive impairment in multiple sclerosis patients, this study aimed to determine the relationship. Methods and Materials: In this cross-sectional study, patients with a definitive diagnosis of multiple sclerosis of RRMS type based on the MacDonald 2017 criteria were included. The exclusion criteria were severe depression, other neurological disorders, and progressive type of MS. Cognitive impairment is assisted with the Symbol Digit Modality Test (SDMT) and the Paced Auditory Serial Addition test (PASAT). In this study, Beck's Depression Inventory (BDI) and the Comprehensive Fatigue Assessment Battrey for Multiple Sclerosis (CFAB-MS) are used to evaluate the Psychological status of patients and pathological fatigue and related factors respectively. SPSS software version 27 was used for statistical evaluation. Results: In this study, 123 MS patients are included. The average age of the patients was 34.12±8.61. Of the total number of patients, 92 (74.8%) were women and 31 (25.2%) were men. In this investigation, the differences between patients with (impaired SDMT: 7 persons, impaired PASAT: 18 persons) or without (normal SDMT: 84 persons, normal PASAT: 73 persons) cognitive impairments in terms of age, gender, duration of illness, disability status based on EDSS, and pathological fatigue were not statistically significant (p-values<0.05). However, the pain index had a significant relationship with impaired SDMT(p=0.02), unlike impaired PASAT(p=0/21).