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Aldughmi M1, Alghwiri A1, Abu-Sa'da R2, Jamali F2, Alshorman A3, Khalil H3, Abbadi A2
1University of Jordan, Department of Physiotherapy, Amman, Jordan, 2University of Jordan, Cell Therapy Center, Amman, Jordan, 3Jordan University of Science and Technology, Department of Rehabilitation Sciences, Irbid, Jordan
Background: Cognitive deficits may affect up to 70% of people with multiple sclerosis (PwMS), with memory being one of the most affected cognitive domains in this population. Fatigue and depression are both prevalent issues among PwMS and may play a role in affecting cognitive function. Previous studies often failed to find an association between fatigue and cognitive deficits, and inconsistent results on the association between depression and cognitive function in PwMS. Cognitive deficits, fatigue, and depression negatively affects the quality of life of these individuals.
Purpose: The purpose of this study was to explore whether verbal memory is affected by fatigue and its association with depression in PwMS.
Methods: Forty-eight MS individuals with mild-moderate disease severity (EDSS= 4.3 ± 1.9, 36.9 ± 9.8 years of age) participated in this study. Participants completed the Modified Fatigue Impact Scale (MFIS) to assess fatigue in the past month and completed the Beck Depression Inventory (BDI) that assess depression. Using a validated cut-off score of 38 on the MFIS, the sample was divided into two groups: Fatigued (N= 28) and non-Fatigued (N=20). Verbal memory specifically Immediate Memory (IM) and Delayed Recall (DR) was measured using the Rey Auditory-Verbal Learning Test (RAVLT): participants are instructed to repeat a list of 15 unrelated words over five trials (IM is first Trial), and repeat the same list again after 20 minutes' delay (DR). Independent t-tests were utilized to explore the differences between the two groups. Spearman's correlations were utilized to examine the associations between BDI and verbal memory among the two groups.
Results: The Fatigued group was significantly more depressed than the non-Fatigued group (p= .024), and there was a significant difference in DR between the two groups (p= .033) but not in IM (p= .495). Depression was significantly and negatively associated with IM in the fatigued group (r= -.434, p= .021) but not with DR (r= -.266, p= .171). No significant association was found between depression and verbal memory in the non-Fatigued group.
Conclusion(s): The results of this study demonstrate that those who are fatigued memorize significantly less words after a 20 minutes' delay compared to those who are not. Also, depression in those who are fatigued seems to affect immediate memory not delayed recall in this study sample. Large scale future studies are needed to confirm these conclusions.
Implications: Therapists may need to consider a multidimensional approach in MS rehabilitation. Emphasis should be put on managing symptoms such as fatigue and depression that may affect cognition in PwMS. Having memory impairments may affect rehabilitation outcomes as individuals would have difficulty learning new information, remembering instructions and tasks from therapists, keeping up with appointments, and therefore participation in therapy is affected.
Keywords: Multiple Sclerosis, Cognition, Fatigue
Funding acknowledgements: This study was funded by the University of Jordan Deanship of Academic Research.
Purpose: The purpose of this study was to explore whether verbal memory is affected by fatigue and its association with depression in PwMS.
Methods: Forty-eight MS individuals with mild-moderate disease severity (EDSS= 4.3 ± 1.9, 36.9 ± 9.8 years of age) participated in this study. Participants completed the Modified Fatigue Impact Scale (MFIS) to assess fatigue in the past month and completed the Beck Depression Inventory (BDI) that assess depression. Using a validated cut-off score of 38 on the MFIS, the sample was divided into two groups: Fatigued (N= 28) and non-Fatigued (N=20). Verbal memory specifically Immediate Memory (IM) and Delayed Recall (DR) was measured using the Rey Auditory-Verbal Learning Test (RAVLT): participants are instructed to repeat a list of 15 unrelated words over five trials (IM is first Trial), and repeat the same list again after 20 minutes' delay (DR). Independent t-tests were utilized to explore the differences between the two groups. Spearman's correlations were utilized to examine the associations between BDI and verbal memory among the two groups.
Results: The Fatigued group was significantly more depressed than the non-Fatigued group (p= .024), and there was a significant difference in DR between the two groups (p= .033) but not in IM (p= .495). Depression was significantly and negatively associated with IM in the fatigued group (r= -.434, p= .021) but not with DR (r= -.266, p= .171). No significant association was found between depression and verbal memory in the non-Fatigued group.
Conclusion(s): The results of this study demonstrate that those who are fatigued memorize significantly less words after a 20 minutes' delay compared to those who are not. Also, depression in those who are fatigued seems to affect immediate memory not delayed recall in this study sample. Large scale future studies are needed to confirm these conclusions.
Implications: Therapists may need to consider a multidimensional approach in MS rehabilitation. Emphasis should be put on managing symptoms such as fatigue and depression that may affect cognition in PwMS. Having memory impairments may affect rehabilitation outcomes as individuals would have difficulty learning new information, remembering instructions and tasks from therapists, keeping up with appointments, and therefore participation in therapy is affected.
Keywords: Multiple Sclerosis, Cognition, Fatigue
Funding acknowledgements: This study was funded by the University of Jordan Deanship of Academic Research.
Topic: Neurology; Mental health
Ethics approval required: Yes
Institution: University of Jordan
Ethics committee: Deanship of Academic Research
Ethics number: NCT03326505
All authors, affiliations and abstracts have been published as submitted.
