ArticleNeurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology2026
Fatigue and contributing factors in relapsing-remitting multiple sclerosis: a descriptive study based on the comprehensive fatigue assessment battery for multiple sclerosis (CFAB-MS).
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Abstract
introductionMultiple sclerosis (MS) is a demyelinating disease of the central nervous system. The Comprehensive Fatigue Assessment Battery for Multiple Sclerosis (CFAB-MS) is a questionnaire designed to assess fatigue and its contributing factors, including sleep, pain, mobility, stress, anxiety, mood, and fatigue management skills.
methodsIn this cross-sectional descriptive study, patients with a definitive diagnosis of relapsing-remitting MS (RRMS) and Expanded Disability Status Scale (EDSS) < 4, based on the MacDonald 2017 criteria, were included. Patients with diagnosed depression, other neurological disorders, or progressive forms of MS were excluded. CFAB-MS was used to evaluate fatigue and its related factors. SPSS software version 23 and PRISM 9 were used for statistical evaluations.
resultsA total of 123 patients with RRMS participated in this study. The average age was 34.12 ± 8.61. Of the total number of patients, 92 (74.8%) were women and 31 (25.2%) were men. The most common issues in the study population were anxiety and worry, fatigue, and stress. EDSS was correlated with fatigue (correlation r: 0.331; p-value < 0.001), pain (correlation r: 0.187; p-value: 0.040), stress (correlation r: 0.186; p-value: 0.041), anxiety (correlation r: 0.206; p-value: 0.023), and walking disability (correlation r: 0.376; p-value < 0.001) VAS. Physical, Psychological, and Social Fatigue Index was correlated to all results obtained with the VAS (p-values < 0.05).
conclusionFactors such as age, EDSS, pain, sleep problems, stress, mood, anxiety and worry, nutrition, mobility, and environment are associated with fatigue in RRMS patients with EDSS < 4, which should be considered by clinicians to achieve appropriate management of fatigue in this population.
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