Background: Cognitive fatigue and autonomic abnormalities are frequent symptoms in MS. Our model of MS-related fatigue assumes a shared neural network for cognitive fatigue and autonomic failures, i.e., aberrant vagus nerve activity induced by inflammatory processes. Therefore, they should occur in common.

Objective: To explore the relationship between cognitive fatigue and autonomic symptoms in MS patients, using self-reported questionnaires.

Methods: In 95 MS patients, cognitive fatigue was assessed with the Fatigue Scale for Motor and Cognitive Functions and autonomic abnormalities with the Composite Autonomic Symptom Scale-31 (COMPASS-31). We used exploratory correlational analyses and hierarchical regression analysis, controlling for age, depressive mood, disease status, and disease duration, to analyze the relation between autonomic abnormalities and cognitive fatigue.

Results: The cognitive fatigue score strongly correlated with the COMPASS-31 score ( = 0.47,  < 0.001). Regression analysis revealed that a model, including the COMPASS-31 domains: pupillomotor, orthostatic intolerance, and bladder, best predict the level of cognitive fatigue ( = 0.47,  < 0.001) after forcing the covariates into the model.

Conclusion: In MS patients, cognitive fatigue and autonomic dysfunction share a proportion of variance. This supports our model assuming that fatigue might be explained at least partially by inflammation-induced vagus nerve activity.

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5601401PMC
http://dx.doi.org/10.3389/fneur.2017.00475DOI Listing

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