07 July 2026 : Clinical Research
Presence and Impact of Fatigue in Patients With Multiple Sclerosis
Meheroz H. Rabadi
ADEF 1,2*, Kimberly A. Russell B 1, Chao Xu CD 3
DOI: 10.12659/MSM.953344
Med Sci Monit 2026; 32:e953344
Table 1 Variables between patient groups based on the absence or presence of fatigue (mean ± SD or median [Q1, Q3]).
| Grouping variable | Total population (n = 203) | Nonfatigue (n = 69) | Fatigue (n = 134) | P value |
|---|---|---|---|---|
| Age in years | 48.1 (± 11.4) | 48.9 (± 12.2) | 47.6 (± 11.0) | 0.462 |
| Age of onset in years | 36.0 [28.0, 43.0] | 36.0 [27.0, 42.0] | 35.0 [28.0, 43.0] | 0.637** |
| Duration of disease in years | 8.00 [2.00, 16.0] | 9.00 [2.00, 17.3] | 8.00 [3.00, 16.0] | 0.626** |
| Sex, men | 146 (71.9%) | 50 (72.5%) | 96 (71.6%) | > 0.999 |
| Sex, women | 56 (27.6%) | 19 (27.5%) | 37 (27.6%) | |
| Race | ||||
| White | 150 (73.9%) | 49 (71.0%) | 101 (75.4%) | 0.836* |
| Black | 42 (20.7%) | 17 (24.6%) | 25 (18.7%) | |
| Hispanic | 7 (3.4%) | 2 (2.9%) | 5 (3.7%) | |
| Other | 3 (1.5%) | 1 (1.4%) | 2 (1.5%) | |
| Missing | 1 (0.5%) | 0 (0%) | 1 (0.7%) | |
| Clinically isolated syndrome | 10 (4.9%) | 5 (7.2%) | 5 (3.7%) | 0.756* |
| Primary progressive | 40 (19.7%) | 12 (17.4%) | 28 (20.9%) | |
| Radiologically isolated syndrome | 10 (4.9%) | 2 (2.9%) | 8 (6.0%) | |
| Relapsing progressive | 9 (4.4%) | 4 (5.8%) | 5 (3.7%) | |
| Relapsing-remitting | 112 (55.2%) | 37 (53.6%) | 75 (56.0%) | |
| Secondary progressive | 16 (7.9%) | 6 (8.7%) | 10 (7.5%) | |
| Normal | 2 (1.0%) | 1 (1.4%) | 1 (0.7%) | |
| Brainstem | 16 (7.9%) | 10 (14.5%) | 6 (4.5%) | 0.096* |
| Cerebral hemisphere (CH)/cortical | 95 (46.8%) | 30 (43.5%) | 65 (48.5%) | |
| Combined (CH and spinal cord) | 33 (16.3%) | 11 (15.9%) | 22 (16.4%) | |
| Optic Nerve | 1 (0.5%) | 1 (1.4%) | 0 (0%) | |
| Spinal cord (cervical, thoracic) | 3 (1.5%) | 1 (1.4%) | 2 (1.5%) | |
| Normal | 2 (1.0%) | 0 (0%) | 2 (1.5%) | |
| Missing | 53 (26.1%) | 16 (23.2%) | 37 (27.6%) | |
| Hypertension | 86 (42.4%) | 25 (36.2%) | 61 (45.5%) | 0.164 |
| Hyperlipidemia | 97 (47.8%) | 25 (36.2%) | 72 (53.7%) | 0.010 |
| Diabetes mellitus | 25 (12.3%) | 3 (4.3%) | 22 (16.4%) | 0.012* |
| Body mass index | 29.2 (±5.38) | 27.5 (±4.66) | 30.1 (±5.53) | < 0.001 |
| Smoking | 50 (24.6%) | 14 (20.3%) | 36 (26.9%) | 0.327 |
| Alcohol | 9 (4.4%) | 4 (5.8%) | 5 (3.7%) | 0.722* |
| Recreational drug use | 621 (10.3%) | 6 (8.7%) | 15 (11.2%) | 0.662 |
| Mini-Mental State Examination | 28.0 [27.0, 29.0] | 28.0 [27.0, 29.0] | 28.0 [27.0, 29.0] | 0.426** |
| Motor upper extremity | 5.00 [5.00, 5.00] | 5.00 [5.00, 5.00] | 5.00 [5.00, 5.00] | 0.599** |
| Motor lower extremity | 5.00 [4.00, 5.00] | 5.00 [4.00, 5.00] | 5.00 [4.00, 5.00] | 0.244** |
| Initial ambulation distance (feet/min) | 390 [260, 390] | 390 [260, 410] | 390 [260, 390] | 0.446** |
| Initial pain score (0–10 scale) | 0 [0, 5.00] | 0 [0, 4.00] | 0 [0, 5.00] | 0.279** |
| Initial spasticity score (MAS 0–5) | 0 [0, 0] | 0 [0, 1.00] | 0 [0, 0] | 0.319** |
| Depression | 88 (43.3%) | 38 (55.1%) | 50 (37.3%) | 0.026 |
| Sleep disorder | 91 (44.8%) | 35 (50.7%) | 56 (41.8%) | 0.002 |
| Initial Expanded Disability Scale Score (EDSS) | 2.00 [1.00, 6.00] | 2.00 [1.00, 6.00] | 2.00 [1.00, 6.00] | 0.530** |
| Initial Fatigue Severity Scale (FSS) | 44.0 [30.5, 55.0] | 33.5 [14.0, 44.3] | 46.0 [35.5, 56.5] | < 0.001** |
| Initial Modified Fatigue Impact Scale (MFIS) | 42.9 (± 18.3) | 30.9 (± 16.5) | 47.4 (± 16.9) | < 0.001 |
| Cognitive subscore | 18.0 [10.0, 25.0] | 12.0 [3.00, 19.0] | 21.0 [13.0, 27.0] | < 0.001** |
| Physical subscore | 21.0 [14.0, 27.0] | 16.0 [10.0, 22.0] | 23.5 [16.0, 29.0] | < 0.001** |
| Psychosocial subscore | 4.00 [3.00, 6.00] | 3.00 [1.00, 4.00] | 4.00 [3.00, 6.00] | 0.001** |
| Initial Epworth Sleep Scale (ESS) | 9.00 [5.00, 15.0] | 6.00 [3.50, 9.50] | 10.0 [5.00, 16.0] | 0.002** |
| Initial Beck Depression Inventory | 3.00 [0, 6.00] | 1.00 [0, 3.00] | 4.00 [1.00, 7.00] | < 0.001** |
| Initial EuroQol 5 Domain (EQ-5D) | 9.00 [7.00, 10.0] | 7.00 [6.00, 9.00] | 9.00 [8.00, 10.0] | < 0.001** |
| Initial EuroQol visual analog scale (EQ-VAS) | 72.0 [60.0, 85.0] | 81.5 [65.0, 90.0] | 70.0 [55.0, 84.0] | 0.002** |
| Initial Total Functional Independence Measure score | 120 [113, 124] | 120 [112, 124] | 120 [113, 124] | 0.766** |
| * Fisher exact test due to small cell counts. ** Wilcoxon rank test due to non-normally distributed data, according to the Shapiro normality test. | ||||