Fatigue in Multiple Sclerosis – A Current Perspective

Fatigue constitutes a vital element of "invisible disability", accumulating throughout the course of multiple sclerosis (MS). Despite recent and ongoing progress in our understanding of the background of MS-related CNS damage, as well as in the field of therapeutic options, fatigue remains one of the major and most debilitating complaints of people with MS. It has a significant impact upon their quality of life, with a special regard to vocational status and other aspects of social participation. It may also affect the patients' adherence and compliance to disease-modifying treatment, influencing its effectiveness. Thus, there is a need for better recognition of risk factors and mechanisms of fatigue in people with MS, as well as its monitoring and management throughout the course of the disease.

This Research Topic aims to highlight the current view and recent findings of the processes underlying fatigue in MS, its assessment and management, and its physical and cognitive aspects. Investigations of fatigue in the context of other elements of "invisible disability" (such as cognitive impairment, sleep problems, anxiety, and depression) will provide us with a better insight into its background and nature. Potential markers and measures of fatigue should be identified to enable its reliable assessment and follow-up in particular stages of the disease. A review of clinical trials and real-world data, considering fatigue as one of the treatment outcomes, would provide evidence of disease-modifying therapies effectiveness in this field. Finally, examples of pharmacological and non-pharmacological interventions, targeted specifically at fatigue in MS, will be discussed. 

Submissions of Original Research, Brief Reports, and Reviews are welcome, covering the following themes:  

• Putative neuropathologic substrates for fatigue in MS - autopsy/biopsy and neuroimaging findings;

• Pathophysiological background of fatigue - evidence from electrophysiological, biochemical and immunological studies; 

• Fatigue in the context of other MS-related signs of neurological deficit;

• Relationships between fatigue and cognition, anxiety, depression and other aspects of mental health in people with MS;

• Assessment of fatigue at various stages of MS (RIS, CIS, relapsing-remitting or progressive phase);

• Fatigue as one of the treatment outcomes in clinical trials with DMT in MS;

• Interventions which relieve or reduce fatigue in MS.