Adolescent and parent factors related to fatigue in paediatric multiple sclerosis and chronic fatigue syndrome: A comparative study.
Carroll, Susan, Chalder, Trudie, Hemingway, Cheryl et al. · European journal of paediatric neurology : EJPN : official journal of the European Paediatric Neurology Society · 2019 · DOI
Quick Summary
This study compared teenagers with multiple sclerosis (MS) who experienced fatigue, teenagers with ME/CFS, and healthy teenagers to understand what factors contribute to severe fatigue. Researchers found that teenagers with MS who were fatigued and teenagers with ME/CFS had very similar patterns of fatigue and unhelpful thinking patterns about their symptoms, but teenagers with ME/CFS had normal brain function while those with MS had some cognitive difficulties. The study suggests that psychological approaches used successfully in ME/CFS might also help teenagers with MS who experience fatigue.
Why It Matters
This study identifies psychological and behavioural factors shared between ME/CFS and a subset of MS patients with fatigue, suggesting that evidence-based psychological interventions already developed for ME/CFS could potentially be adapted for adolescents with MS-related fatigue. Understanding these modifiable factors is critical because fatigue severely disables adolescents and effective treatments remain lacking.
Observed Findings
50% of adolescents with caMS reported clinically significant fatigue
Fatigued caMS and adolescents with CFS showed equivalent fatigue severity and similar cognitive-behavioural responses to symptoms
Both caMS groups (fatigued and non-fatigued) demonstrated impaired neurocognitive functioning, whereas CFS and healthy controls had normal cognition
Parents of fatigued adolescents across both illness groups showed elevated psychological distress
All parents of adolescents with illness had more unhelpful cognitions than parents of healthy controls
Inferred Conclusions
Cognitive-behavioural factors in adolescents and their parents represent potentially modifiable intervention targets for fatigued caMS, informed by successful psychological approaches in pediatric CFS
Fatigue in caMS appears to have similar psychosocial mechanisms to CFS despite different underlying neurological pathologies
Cognitive difficulties in caMS require separate targeted interventions from fatigue management
Remaining Questions
Would psychological interventions developed for ME/CFS be equally effective when adapted for adolescents with MS-related fatigue?
What causes the neurocognitive impairment in both caMS groups, and does it relate mechanistically to fatigue severity?
What This Study Does Not Prove
This study does not prove that psychological factors cause fatigue in either condition—it only shows associations. The cross-sectional design means we cannot determine whether unhelpful thinking patterns develop as a result of fatigue or contribute to it. Additionally, findings in adolescents may not directly generalize to adult ME/CFS populations.