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ORIGINAL ARTICLE
Year : 2016  |  Volume : 53  |  Issue : 2  |  Page : 74-78

Primary fatigue contributes to cognitive dysfunction in patients with multiple sclerosis


1 Department of Neurology, Faculty of Medicine, Cairo University, Cairo, Egypt
2 Department of Physical Therapy for Neuromuscular Disorders and its Surgery, Cairo University, Cairo, Egypt

Correspondence Address:
Sandra M Ahmed
MD, Department of Neurology, Faculty of Medicine, Cairo University, Cairo, 11562
Egypt
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/1110-1083.183406

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Background A rising concern about quality of life of multiple sclerosis (MS) patients has emerged. Cognitive dysfunction and primary fatigue have been largely related to each other. Objective The aim of the present study was to examine the relationship between primary fatigue, cognitive dysfunction, and inflammatory biomarkers for patients with MS. Patients and methods A total of 40 Egyptian MS patients (Expanded Disability Status Scale<5) were divided into two groups according to the Fatigue Severity Scale (FSS), into patients with fatigue (G1; FSS>36) and those without fatigue (G2; FSS<36). Patients with depression and sleep problems were excluded from the study. Cognitive functions were assessed for both groups using the computer-based 'RehaCom' software, using which the following tests were carried out: (a) attention/concentration tests and (b) reaction behavior tests. The serum levels of tumor necrosis factor-α (TNF-α) and interferon-γ (IFN-γ) were analyzed for all MS patients. Results A statistically significant decrease in cognitive functions was found in G1 compared with G2 (P < 0.001), as well as a statistically significant higher level of TNF-α and IFN-γ in G1 compared with G2. FSS was positively correlated with the attention/concentration test. Correlative study also indicated a strong relation between the level of cytokines and FSS but not cognitive dysfunction. Conclusion Primary fatigue contributes to cognitive dysfunction in patients with MS and is associated with elevated serum level of TNF-α and IFN-γ


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