Evidence map›Paper›PMID 27134583›Full record

ArticleInternational journal of MS care

Fatigue and Comorbidities in Multiple Sclerosis.

Kirsten M Fiest, John D Fisk, Scott B Patten, Helen Tremlett, Christina Wolfson, Sharon Warren, Kyla A McKay, Lindsay I Berrigan, Ruth Ann Marrie, CIHR Team in the Epidemiology and Impact of Comorbidity on Multiple Sclerosis (ECoMS)

Open access · bronzeAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in International journal of MS care. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
19citing papers in PubMed, 4 pooled it
3.7field-weighted citation impact, top 7% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

19 citing papers in PubMed, 4 syntheses or guidelines pooled it, 57 citations in OpenAlex.

  1. Pooled it
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  5. Article
  6. Article
  7. Review
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  11. Heart rate variability and fatigue in MS: two parallel pathways representing disseminated inflammatory processes?Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2023
    Review
  12. Article
  13. Review
  14. Multiple sclerosis-related fatigue lacks a unified definition: A narrative review.Journal of research in medical sciences : the official journal of Isfahan University of Medical Sciences · 2022
    Review
  15. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 5 institutions in 1 country.

Kirsten M FiestDepartment of Internal Medicine, College of Medicine, Faculty of Health Sciences (KMF, RAM), and Department of Community Health Sciences, College of Medicine (RAM), University of Manitoba, Winnipeg, MB, Canada; Departments of Psychiatry, Medicine, Psychology, and Neuroscience, Dalhousie University, Halifax, NS, Canada (JDF); Departments of Psychiatry and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada (SBP); Division of Neurology, Faculty of Medicine (HT), and Department of Experimental Medicine (KAM), University of British Columbia, Vancouver, BC, Canada; Departments of Epidemiology and Biostatistics, Occupational Health, and Medicine, McGill University, Montreal, QC, Canada (CW); Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada (SW); and Department of Psychology, St. Francis Xavier University, Antigonish, NS, Canada (LIB).
John D FiskDepartment of Internal Medicine, College of Medicine, Faculty of Health Sciences (KMF, RAM), and Department of Community Health Sciences, College of Medicine (RAM), University of Manitoba, Winnipeg, MB, Canada; Departments of Psychiatry, Medicine, Psychology, and Neuroscience, Dalhousie University, Halifax, NS, Canada (JDF); Departments of Psychiatry and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada (SBP); Division of Neurology, Faculty of Medicine (HT), and Department of Experimental Medicine (KAM), University of British Columbia, Vancouver, BC, Canada; Departments of Epidemiology and Biostatistics, Occupational Health, and Medicine, McGill University, Montreal, QC, Canada (CW); Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada (SW); and Department of Psychology, St. Francis Xavier University, Antigonish, NS, Canada (LIB).
Scott B PattenDepartment of Internal Medicine, College of Medicine, Faculty of Health Sciences (KMF, RAM), and Department of Community Health Sciences, College of Medicine (RAM), University of Manitoba, Winnipeg, MB, Canada; Departments of Psychiatry, Medicine, Psychology, and Neuroscience, Dalhousie University, Halifax, NS, Canada (JDF); Departments of Psychiatry and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada (SBP); Division of Neurology, Faculty of Medicine (HT), and Department of Experimental Medicine (KAM), University of British Columbia, Vancouver, BC, Canada; Departments of Epidemiology and Biostatistics, Occupational Health, and Medicine, McGill University, Montreal, QC, Canada (CW); Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada (SW); and Department of Psychology, St. Francis Xavier University, Antigonish, NS, Canada (LIB).
Helen TremlettDepartment of Internal Medicine, College of Medicine, Faculty of Health Sciences (KMF, RAM), and Department of Community Health Sciences, College of Medicine (RAM), University of Manitoba, Winnipeg, MB, Canada; Departments of Psychiatry, Medicine, Psychology, and Neuroscience, Dalhousie University, Halifax, NS, Canada (JDF); Departments of Psychiatry and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada (SBP); Division of Neurology, Faculty of Medicine (HT), and Department of Experimental Medicine (KAM), University of British Columbia, Vancouver, BC, Canada; Departments of Epidemiology and Biostatistics, Occupational Health, and Medicine, McGill University, Montreal, QC, Canada (CW); Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada (SW); and Department of Psychology, St. Francis Xavier University, Antigonish, NS, Canada (LIB).
Christina WolfsonDepartment of Internal Medicine, College of Medicine, Faculty of Health Sciences (KMF, RAM), and Department of Community Health Sciences, College of Medicine (RAM), University of Manitoba, Winnipeg, MB, Canada; Departments of Psychiatry, Medicine, Psychology, and Neuroscience, Dalhousie University, Halifax, NS, Canada (JDF); Departments of Psychiatry and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada (SBP); Division of Neurology, Faculty of Medicine (HT), and Department of Experimental Medicine (KAM), University of British Columbia, Vancouver, BC, Canada; Departments of Epidemiology and Biostatistics, Occupational Health, and Medicine, McGill University, Montreal, QC, Canada (CW); Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada (SW); and Department of Psychology, St. Francis Xavier University, Antigonish, NS, Canada (LIB).
Sharon WarrenDepartment of Internal Medicine, College of Medicine, Faculty of Health Sciences (KMF, RAM), and Department of Community Health Sciences, College of Medicine (RAM), University of Manitoba, Winnipeg, MB, Canada; Departments of Psychiatry, Medicine, Psychology, and Neuroscience, Dalhousie University, Halifax, NS, Canada (JDF); Departments of Psychiatry and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada (SBP); Division of Neurology, Faculty of Medicine (HT), and Department of Experimental Medicine (KAM), University of British Columbia, Vancouver, BC, Canada; Departments of Epidemiology and Biostatistics, Occupational Health, and Medicine, McGill University, Montreal, QC, Canada (CW); Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada (SW); and Department of Psychology, St. Francis Xavier University, Antigonish, NS, Canada (LIB).
Kyla A McKayDepartment of Internal Medicine, College of Medicine, Faculty of Health Sciences (KMF, RAM), and Department of Community Health Sciences, College of Medicine (RAM), University of Manitoba, Winnipeg, MB, Canada; Departments of Psychiatry, Medicine, Psychology, and Neuroscience, Dalhousie University, Halifax, NS, Canada (JDF); Departments of Psychiatry and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada (SBP); Division of Neurology, Faculty of Medicine (HT), and Department of Experimental Medicine (KAM), University of British Columbia, Vancouver, BC, Canada; Departments of Epidemiology and Biostatistics, Occupational Health, and Medicine, McGill University, Montreal, QC, Canada (CW); Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada (SW); and Department of Psychology, St. Francis Xavier University, Antigonish, NS, Canada (LIB).
Lindsay I BerriganDepartment of Internal Medicine, College of Medicine, Faculty of Health Sciences (KMF, RAM), and Department of Community Health Sciences, College of Medicine (RAM), University of Manitoba, Winnipeg, MB, Canada; Departments of Psychiatry, Medicine, Psychology, and Neuroscience, Dalhousie University, Halifax, NS, Canada (JDF); Departments of Psychiatry and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada (SBP); Division of Neurology, Faculty of Medicine (HT), and Department of Experimental Medicine (KAM), University of British Columbia, Vancouver, BC, Canada; Departments of Epidemiology and Biostatistics, Occupational Health, and Medicine, McGill University, Montreal, QC, Canada (CW); Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada (SW); and Department of Psychology, St. Francis Xavier University, Antigonish, NS, Canada (LIB).
Ruth Ann MarrieDepartment of Internal Medicine, College of Medicine, Faculty of Health Sciences (KMF, RAM), and Department of Community Health Sciences, College of Medicine (RAM), University of Manitoba, Winnipeg, MB, Canada; Departments of Psychiatry, Medicine, Psychology, and Neuroscience, Dalhousie University, Halifax, NS, Canada (JDF); Departments of Psychiatry and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada (SBP); Division of Neurology, Faculty of Medicine (HT), and Department of Experimental Medicine (KAM), University of British Columbia, Vancouver, BC, Canada; Departments of Epidemiology and Biostatistics, Occupational Health, and Medicine, McGill University, Montreal, QC, Canada (CW); Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada (SW); and Department of Psychology, St. Francis Xavier University, Antigonish, NS, Canada (LIB).
CIHR Team in the Epidemiology and Impact of Comorbidity on Multiple Sclerosis (ECoMS)
University of Calgary · CASt. Francis Xavier University · CAUniversity of British Columbia · CAMcGill University · CAUniversity of Manitoba · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundFatigue is commonly reported by people with multiple sclerosis (MS). Comorbidity is also common in MS, but its association with the presence of fatigue or fatigue changes over time is poorly understood.

methodsNine hundred forty-nine people with definite MS were recruited from four Canadian centers. The Fatigue Impact Scale for Daily Use and a validated comorbidity questionnaire were completed at three visits over 2 years. Participants were classified into groups with no fatigue versus any fatigue. Logistic regression was used to determine the relationship between fatigue and each comorbidity at baseline, year 1, year 2, and overall.

resultsThe incidence of fatigue during the study was 38.8%. The prevalence of fatigue was greater in those who were older (P = .0004), had a longer time since symptom onset (P = .005), and had greater disability (P < .0001). After adjustment, depression (odds ratio [OR], 2.58; 95% confidence interval [CI], 2.03-3.27), irritable bowel syndrome (OR, 1.71; 95% CI, 1.18-2.48), migraine (OR, 1.69; 95% CI, 1.27-2.27), and anxiety (OR, 1.57; 95% CI, 1.15-2.16) were independently associated with fatigue that persisted during the study. There was also an individual-level effect of depression on worsening fatigue (OR, 1.49; 95% CI, 1.08-2.07).

conclusionsComorbidity is associated with fatigue in MS. Depression is associated with fatigue and with increased risk of worsening fatigue over 2 years. However, other comorbid conditions commonly associated with MS are also associated with persistent fatigue, even after accounting for depression. Further investigation is required to understand the mechanisms by which comorbidities influence fatigue.

Identifiers

PMID27134583
PMCPMC4849402
OpenAlexW2344555179

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.