Fatigue and associated clinical, psychological and social factors in paediatric multiple sclerosis: a systematic review

Abstract

Background: This review aimed to investigate and evaluate the evidence for associations between fatigue and clinical, psychological and social factors in children and adolescents with MS. Methods: Empirical studies that examined fatigue in relation to at least one clinical, psychological or social factor in paediatric MS were included. Studies were identified by searching online databases, hand-searching reference lists, and requesting unpublished literature from key authors. Nine studies are presented in a narrative synthesis. Findings: Clinical factors appeared to be largely unrelated to fatigue, whereas associations between fatigue and tests of neurocognitive functioning were mixed. Findings relating to fatigue and psychiatric disorders were also mixed. However, fatigue and depressed mood consistently correlated. A small number of studies indicated an association between fatigue and reduced quality of life and school performance. Discussion: Fatigue is a concerning symptom of paediatric MS, yet the evidence to date does not adequately explain its causes or impact. Future research should endeavour to identify clinical and psychosocial factors associated with fatigue in paediatric MS, so that interventions targeting potentially modifiable factors of fatigue may be developed.