Unraveling the Complexity of Fatigue in Multiple Sclerosis: John DeLuca, PhD

WATCH TIME: 5 minutes

“Fatigue is the most significant symptom that patients with MS talk about that affects their lives, and [fatigue] affects them in a variety of different ways. Do we understand what fatigue is by what the patients are telling us? We have fatigue instruments that we use, but part of the issue is that these fatigue instruments don't measure fatigue alone.”

A prevalent symptom experienced among patients with multiple sclerosis (MS) is fatigue, which has become a focal point of discussion and research in the field of MS. In research and in clinical practice, clinicians have explored various approaches to understand fatigue better in patients. Through recent research studies, the interaction between the striatum and prefrontal cortex, which relies on dopamine, has become a prominent, emerging theory.¹ Also, studies on neuroimaging suggest further that fatigue stems from the disrupted communication between these brain regions, further supporting the hypothesis of the dopamine imbalance.

John DeLuca, PhD, senior vice president for Research and Training at Kessler Foundation, recently chaired a session at the 2023 Consortium of Multiple Sclerosis Centers (CMSC) Annual Meeting, held May 31 to June 3, in Aurora, Colorado, on hot topics in MS rehabilitation. In each topic of the session, speakers spoke about understanding the complexity of fatigue and how to help patients manage the symptom in the clinical practice. During DeLuca’s presentation in the session, he discussed how to define fatigue and also how to measure it among these patients with the currently available instruments.²

DeLuca sat down in an interview with NeurologyLive® at the meeting to give an overview of the presentation and how clinicians are currently treating fatigue in their clinical practice. He talked about the existing instruments for measuring fatigue and if they accurately capture the experiences and impact of the symptoms reported in patients with MS. He also explained how primary fatigue, caused by MS in the brain, can be effectively measured and understood. In addition, DeLuca spoke about the treatment approaches that might show promise for managing fatigue in MS.

Click here for more coverage of CMSC 2023.

REFERENCES
1. Dobryakova E, Genova HM, DeLuca J, Wylie GR. The dopamine imbalance hypothesis of fatigue in multiple sclerosis and other neurological disorders. Front Neurol. 2015;6:52. Published 2015 Mar 12. doi:10.3389/fneur.2015.00052
2. DeLuca, J. What is Fatigue and Can We Measure It?. Part 1: Understanding Fatigue and its Clinical Management. Presented at: 2023 CMSC Annual Meeting; May 31 to June 3; Aurora, CO.