Managing MS-Related Fatigue with Therapeutic, Lifestyle, and Behavioral Interventions

Announcer:
You’re listening to On the Frontlines of Multiple Sclerosis on ReachMD. On this episode, Dr. Glenn Wylie will share strategies for managing fatigue in patients with multiple sclerosis. Not only is Dr. Wylie the Director of the Rocco Ortenzio Neuroimaging Center at Kessler Foundation, but he’s also a Professor at Rutgers - New Jersey Medical School. Here he is now.

Dr. Wylie:
So MS-related fatigue differs from general fatigue, I think, in quantity rather than in quality. Folks with MS have a lot of fatigue—almost everyone experiences really high levels of fatigue because they have MS—but I think that the fatigue that is experienced in MS is similar to and is generated by the same mechanisms as the fatigue that is experienced by the general population. I think that fatigue really is an imbalance between effort and reward, and I think that fatigue is the brain’s way of telling itself that the reward it’s getting for a given action is no longer worth the effort that it has to expend to do that action. And if you have a neurodegenerative disease like MS, then everything that you have to do takes more effort.

So are there any effective management techniques for fatigue based on current research? We’ve been doing some research in this area, and some of the things we’ve been looking at are pharmaceutical interventions and whether disease-modifying therapies reduce fatigue measurably, and we’re finding that they do. They seem to reduce the baseline level of fatigue in folks with MS, so that’s promising. It’s very early in the research process, but it’s promising. 

We’ve also looked at the effect of exercise on fatigue, and that seems to reduce fatigue. Of course, exercise in the short term makes you fatigued; you end up being physically fatigued after you exercise. But in the longer term, it seems to have beneficial effects where, again, it sort of moves the baseline level of fatigue down. And then the other thing we’ve looked at has to do with this idea of effort and reward, and we’ve looked at if you give someone rewards for doing something, does that reduce their fatigue? And that seems to work as well.

Announcer: 
That was Dr. Glenn Wylie talking about the management of fatigue in multiple sclerosis patients. To access this and other episodes in our series, visit On the Frontlines of Multiple Sclerosis on ReachMD.com, where you can Be Part of the Knowledge. Thanks for listening!