TY  - JOUR
A1  - Powell, Daniel J. H.
A1  - Liossi, Christina
A1  - Schlotz, Wolff
A1  - Moss-Morris, Rona
T1  - Tracking daily fatigue fluctuations in multiple sclerosis : ecological momentary assessment provides unique insights
T2  - Journal of behavioral medicine
N2  - Studies investigating the prevalence, cause, and consequence of multiple sclerosis (MS) fatigue typically use single measures that implicitly assume symptom-stability over time, neglecting information about if, when, and why severity fluctuates. We aimed to examine the extent of moment-to-moment and day-to-day variability in fatigue in relapsing-remitting MS and healthy individuals, and identify daily life determinants of fluctuations. Over 4 weekdays, 76 participants (38 relapsing-remitting MS; 38 controls) recruited from multiple sites provided real-time self-reports six times daily (n = 1661 observations analyzed) measuring fatigue severity, stressors, mood, and physical exertion, and daily self-reports of sleep quality. Fatigue fluctuations were evident in both groups. Fatigue was highest in relapsing-remitting MS, typically peaking in late-afternoon. In controls, fatigue started lower and increased steadily until bedtime. Real-time stressors and negative mood were associated with increased fatigue, and positive mood with decreased fatigue in both groups. Increased fatigue was related to physical exertion in relapsing-remitting MS, and poorer sleep quality in controls. In relapsing-remitting MS, fatigue fluctuates substantially over time. Many daily life determinants of fluctuations are similar in relapsing-remitting MS and healthy individuals (stressors, mood) but physical exertion seems more relevant in relapsing-remitting MS and sleep quality most relevant in healthy individuals.
KW  - Multiple sclerosis
KW  - Fatigue
KW  - Ecological momentary assessment
KW  - Ambulatory assessment
KW  - Psychological stress
KW  - Affect
Y1  - 2017
UR  - http://publikationen.ub.uni-frankfurt.de/frontdoor/index/index/docId/46815
UR  - https://nbn-resolving.org/urn:nbn:de:hebis:30:3-468157
SN  - 1573-3521
SN  - 0160-7715
N1  - © The Author(s) 2017. Open Access: This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
VL  - 40
IS  - 5
SP  - 772
EP  - 783
PB  - Springer Science + Business Media B.V.
CY  - Dordrecht [u. a.]
ER  -