09/21/2001
A DGReview of :"Fatigue
is not associated with raised inflammatory markers in multiple sclerosis"
There is no apparent direct relationship
between markers of inflammatory disease activity and the pathogenesis of
fatigue in multiple sclerosis, according to British researchers. It was
noted, however, that patients with primary progressive multiple sclerosis
suffered less fatigue than their counterparts with the relapsing-remitting
form of the disorder.
The poorly understood pathogenesis
of fatigue in multiple sclerosis (MS) prompted neurologists in the departments
of neurochemistry, neurology and neurorehabilitation in London's Institute
of Neurology, Queen Square to test the relationship between fatigue and
inflammatory disease activity.
Fatigue, assessed by the Fatigue
Questionnaire Scale (FQS) and Krupp's Fatigue Severity Scale (KFSS) was
correlated with several inflammatory markers in 38 patients with MS. Sixteen
had 16 relapsing-remitting (RR) of which seven had benign MS. Nine had
secondary progressive (SP) and 13 had the primary progressive form of the
disorder.
Markers nominated by researchers
included daily urinary neopterin excretion, a marker of interferon-b- activated
macrophage activity, serum C-reactive protein (CRP) and soluble intercellular
adhesion molecule-1 (sICAM-1) levels. Urinary neopterin excretion was measured
daily for two weeks.
Researchers "found no correlation
between either urinary neopterin excretion (CRP) or slCAM-I and the fatigue
score." There did find patients whose serum C-reactive protein level was
raised had a higher KFSS, but not FQS, than those with normal CRP levels
(KFSS, 50± 8 vs 41 ± 14, FQS 13 ± 4 vs 11±5,
p =NS).
Patients with the relapsing-remitting
and secondary-progressive MS were found to be more liable to suffer fatigue
than their counterparts with the primary progressive form of the disorder
when assessed with the FQR (RR=12.5 [4 to 23] vs SP= 13 [8 to 18] vs PP
=9 [7 to 14].
Patients with benign and non-benign
multiple sclerosis both became equally fatigued.
Neurology 2001 Vol 57 pp 676-681
"Fatigue
is not associated with raised inflammatory markers in multiple sclerosis"
All contents Copyright (c) 1995-2001
Doctor's Guide Publishing Limited
By Veronica Rose
Neurology