Skip to main content

Cognitive Fatigue

  • Chapter
  • First Online:
Fatigue in Multiple Sclerosis

Abstract

Contrary to earlier assumptions that MS fatigue is a unidimensional construct that can be captured by scales quantifying severity (e.g., Krupp et al. 1989; Schwartz et al. 1993), there is at least agreement at the symptom level that fatigue may manifest physically and/or cognitively. Chalder et al. (1993) were among the first to attempt to map this distinctiveness in a fatigue scale that captures both components. Most commonly, patients can be observed complaining of both physical and cognitive fatigue, albeit to varying degrees. The previous chapter dealt exclusively with motor fatigue and fatigability. The following chapter will focus on the cognitive manifestation of the symptom.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Subscribe and save

Springer+ Basic
$34.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or eBook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 39.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 54.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 84.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Similar content being viewed by others

References

  • Alexander GE, Crutcher MD. Functional architecture of basal ganglia circuits: neural substrates of parallel processing. Trends in Neuroscience. 1990;13:266–71.

    Article  CAS  Google Scholar 

  • Bailey A, Channon S, Beaumont JG. The relationship between subjective fatigue and cognitive fatigue in advanced multiple sclerosis. Multiple Sclerosis. 2007;13:73–80.

    Article  CAS  Google Scholar 

  • Chalder T, Berelowitz G, Pawlikowska T, Watts L, Wessely S, Wright D, Wallace EP. Development of a fatigue scale. J Psychosom Res. 1993;37:147–53.

    Article  CAS  Google Scholar 

  • Chaudhuri A, Behan PO. Fatigue and basal ganglia. J Neurol Sci. 2000;179:34–42.

    Article  CAS  Google Scholar 

  • Claros-Salinas D, Bratzke D, Greitemann G, Nickisch N, Ochs L, Schröter H. Fatigue-related diurnal variations of cognitive performance in multiple sclerosis and stroke patients. J Neurol Sci. 2010;295(1–2):75–81.

    Article  Google Scholar 

  • Claros-Salinas D, Cundelik VC, Greitemann G. Back to work - subjective and objective perspectives of occupation-oriented neurorehabilitation. Neurol Rehabil. 2012;18:275–90.

    Google Scholar 

  • Claros-Salinas D, Dittmer N, Neumann M, Sehle A, Spiteri S, Willmes K, et al. Induction of cognitive fatigue in MS patients through cognitive and physical load. Neuropsychol Rehabil. 2013;23(2):182–201.

    Article  Google Scholar 

  • Comi G, Leocani L, Rossi P, Colombo B. Physiopathology and treatment of fatigue in multiple sclerosis. J Neurol. 2001;248:174–9.

    Article  CAS  Google Scholar 

  • DeLong M, Georgopoulos AP. Motor functions of the basal ganglia. In: Brookhart JM, Mountcastle VB, Brooks VB, editors. Handbook of physiology, vol. (Vol. 2. Bethesda: American; 1981. p. 1017–61.

    Google Scholar 

  • DeLuca J. Fatigue as a window to the brain. Cambridge (MA): MIT Press; 2005.

    Book  Google Scholar 

  • DeLuca J, Genova HM, Hillary FG, Wylie G. Neural correlates of cognitive fatigue in multiple sclerosis using fMRI. J Neurol Sci. 2008;270:28–39.

    Article  Google Scholar 

  • Denny-Brown D. The basal ganglia and their relation to disorders of movement. Oxford: Oxford University Press; 1962.

    Google Scholar 

  • Filippi M, Rocca MA, Colombo B, Falini A, Codella M, Scotti G, Comi G. Functional magnetic resonance imaging correlates of fatigue in multiple sclerosis. NeuroImage. 2002;15:559–67.

    Article  CAS  Google Scholar 

  • Fuster JM. The prefrontal cortex: anatomy, physiology, and neuropsychology of the frontal lobe. New York: Raven Press; 1989.

    Google Scholar 

  • Hanken K, Eling P, Hildebrandt H. Is there a cognitive signature for MS-related fatigue? Multiple Sclerosis. 2015;21(4):376–81.

    Article  Google Scholar 

  • Jaeger S, Paul F, Scheel M, Brandt A, Heine J, Pach D, et al. Multiple sclerosis-related fatigue: Altered resting-state functional connectivity of the ventral striatum and dorsolateral prefrontal cortex. Multiple Sclerosis. 2019;25(4):554–64.

    Article  Google Scholar 

  • Kluger BM, Krupp LB, Enoka RM. Fatigue and fatigability in neurologic illnesses: proposal for a unified taxonomy. Neurology. 2013;80(4):409–16.

    Article  Google Scholar 

  • Krupp LB, Alvarez LA, LaRocca NG, Scheinberg L. Clinical characteristics of fatigue. Arch Neurol. 1988;45:435–7.

    Article  CAS  Google Scholar 

  • Krupp LB, Elkins LE. Fatigue and declines in cognitive functioning in multiple sclerosis. Neurology. 2000;55:934–9.

    Article  CAS  Google Scholar 

  • Krupp LB, LaRocca NG, Muir-Nash J, Steinberg AD. The fatigue severity scale. Application to patients with multiple sclerosis and systemic lupus erythematosus. Arch Neurol. 1989;46:1121–3.

    Article  CAS  Google Scholar 

  • Lange R, Hassa T, Weiller C, Dettmers C. Imaging cognitive fatigue in encephalomyelitis disseminate: an fMRI study. Multiple Sclerosis. 2006;12:S43.

    Google Scholar 

  • Mainero C, Caramia F, Pozzilli C, Pisani A, Pestalozza I, Borriello G, et al. fMRI evidence of brain reorganization during attention and memory tasks in multiple sclerosis. NeuroImage. 2004;21:858–67.

    Article  Google Scholar 

  • Meissner H, Volkert J, König H, Alpers G, Flachenecker P. Fatigue in multiple sclerosis: subjective complaints and intensity of attention. Multiple Sclerosis. 2007;13:S228.

    Google Scholar 

  • Neumann M, Sterr A, Claros-Salinas D, Gütler R, Ulrich R, Dettmers C. Modulation of alertness by sustained cognitive demand in MS as surrogate measure of fatigue and fatigability. J Neurol Sci. 2014;340(1–2):178–82.

    Article  Google Scholar 

  • Paul RH, Beatty WW, Schneider R, Blanco CR, Hames KA. Cognitive and physical fatigue in multiple sclerosis: relations between self-report and objective performance. Appl Neuropsychol. 1998;5:143–8.

    Article  CAS  Google Scholar 

  • Penner IK, Raselli C, Stöcklin M, Opwis K, Kappos L, Calabrese P. The Fatigue Scale for Motor and Cognitive Functions (FSMC) - validation of a new instrument to assess multiple sclerosis-related fatigue. Mult Scler. 2009;15(12):1509–17.

    Article  CAS  Google Scholar 

  • Penner IK, Rausch M, Kappos L, Opwis K, Radü EW. Analysis of impairment-related functional architecture in MS patients during performance of different attention tasks. J Neurol. 2003;250:461–72.

    Article  Google Scholar 

  • Pfitzner A, Zettl UK, Flachenecker P. Effects of endurance training under normobaric hypoxia conditions on fatigue in patients with multiple sclerosis: results of a randomized prospective study. Neurol Rehabil. 2013;19:400.

    Google Scholar 

  • Roelcke U, Kappos L, Lechner-Scott J, Brunnschweiler H, Huber S, Ammann W, et al. Reduced glucose metabolism in the frontal cortex and basal ganglia of multiple sclerosis patients with fatigue: A 18F-fluorodeoxyglucose positron emission tomography study. Neurology. 1997;48(1566):71.

    Google Scholar 

  • Rypma B, Berger JS, Prabhakaran V, Bly BM, Kimberg DY, Biswall BB, et al. Neural correlates of cognitive efficiency. NeuroImage. 2006;33:969–79.

    Article  Google Scholar 

  • Schwartz JE, Jandorf L, Krupp LB. The measurement of fatigue: a new instrument. J Psychosom Res. 1993;37:753–62.

    Article  CAS  Google Scholar 

  • Schwid SR, Tyler CM, Scheid EA, Weinstein A, Goodman AD, McDermott MP. Cognitive fatigue during a test requiring sustained attention: a pilot study. Mult Scler. 2003;9:503–8.

    Article  Google Scholar 

  • Stahl SM. Basal ganglia neuropharmacology and obsessive-compulsive disorder: the obsessive compulsive disorder hypothesis of basal ganglia dysfunction. Psychopharmacol Bull. 1988;24:370–4.

    CAS  Google Scholar 

  • Sturm W, Zimmermann P. Attention deficit disorders. In: Sturm W, Herrmann M, Wallesch CW, editors. Textbook of clinical neuropsychology. Lisse: Swets & Zeitlinger; 2000. p. 345–65.

    Google Scholar 

  • Van Zomeren AH, Brouwer WH. Clinical neuropsychology of attention. New York: Oxford University Press; 1994.

    Google Scholar 

  • Weinges-Evers N, Brandt AU, Bock M, Pfueller CF, Dörr J, Bellmann-Strobl J, et al. Correlation of self-assessed fatigue and alertness in multiple sclerosis. Mult Scler. 2010;16(9):1134–40.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Iris-Katharina Penner .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2023 The Author(s), under exclusive license to Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Penner, IK., Flachenecker, P., Meißner, H. (2023). Cognitive Fatigue. In: Penner, IK. (eds) Fatigue in Multiple Sclerosis. Springer, Cham. https://doi.org/10.1007/978-3-031-13498-2_6

Download citation

Publish with us

Policies and ethics