Fatigue in Peripheral Neuropathy

[Guest guest]

Fatigue in Peripheral Neuropathy

(ANN April 17, 2008)

H. Brannagan, Frances M. Di Clemente, De Sousa,

Philadelphia, PA, M. en, NY, NY, Chin,

Sander, Norman Latov, Bridget Carey, New York, NY

OBJECTIVE: To determine the prevalence of fatigue in peripheral

neuropathy (PN), if fatigue affects quality of life (qol), if fatigue

occurs in neuropathy independently of depression and if the

prevalence of fatigue varies in different types of PN.

BACKGROUND: Fatigue is a common symptom and commonly associated with

neurological diseases. Fatigue occurs in inflammatory demyelinating

neuropathies, but has not been characterized in other PN.

DESIGN/METHODS: Patients at the peripheral neuropathy center, after

signing informed consent, completed the RAND 36 qol survey, the PRIME

MD depression scale, the visual analogue score for pain, a modified

neuropathy severity score (NSS) and the fatigue severity score (FSS).

Fatigue was defined as a FSS of >=4 and depression as >=10 on the

PRIME MD scale.

RESULTS: Of 149 enrolled, 92 were included, after excluding patients,

with unavailable clinical data, who did not complete the FSS or

determined not to have neuropathy. Seventy two percent (66 of 92) had

fatigue. If patients with depression, which is commonly associated

with fatigue, are excluded, 65% still had fatigue. Fatigue is seen in

80% with celiac neuropathy, 73% with CIDP, 67% with idiopathic

neuropathy, 83% with multifocal motor neuropathy, 71% of IgM

monoclonal gammopathy associated neuropathies, 33% with

diabetic/impaired glucose tolerance neuropathy, 100% with other

inflammatory neuropathies and 66% with other non-inflammatory

neuropathies. The FSS was weakly correlated with neuropathy severity

as measured by the NSS (r=0.267) and moderately correlated with pain

(r=0.503). Among non-depressed patients, the FSS is moderately

correlated with 3 qol domains (role functioning/physical (r=-0.710),

energy/fatigue (r=-0.738) and social functioning (r=-0.612) and

weakly correlated with other domains (r<-0.5).

CONCLUSIONS/RELEVANCE: Fatigue is commonly seen in patients with

neuropathy, including those without depression. It is seen in

inflammatory and non-inflammatory causes of neuropathy. It does not

strongly correlate with neuropathy severity or pain. Fatigue in PN is

correlated with impaired qol.