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. 2022 Jun 17:13:900792.
doi: 10.3389/fneur.2022.900792. eCollection 2022.

The Seasonal Fluctuation of Fatigue in Multiple Sclerosis

Matthias Grothe  1 , Stefan Gross  2   3 , Marie Süße  1 , Sebastian Strauss  1 , Iris Katharina Penner  4   5   6
Affiliations

The Seasonal Fluctuation of Fatigue in Multiple Sclerosis

Matthias Grothe et al. Front Neurol. .

Abstract

Background: Fatigue is a common symptom in patients with multiple sclerosis. Several studies suggest that outdoor temperature can impact fatigue severity, but a systematic study of seasonal variations is lacking.

Methods: Fatigue was assessed with the Fatigue Scale for Motor and Cognitive Functions (FSMC) in a temperate climatic zone with an average outdoor temperature of 8.8°C. This study included 258 patients with multiple sclerosis from 572 visits temporally distributed over the year. The data were adjusted for age, sex, cognition, depression, disease severity, and follow-up time. Linear regression models were performed to determine whether the temporal course of fatigue was time-independent, linearly time dependent, or non-linearly time dependent.

Results: Fatigue was lowest during January (mean FSMC: 49.84) and highest during August (mean FSMC: 53.88). The regression analysis showed the best fit with a model that included months + months2, which was a non-linear time dependency. Mean FSMC per month correlated significantly with the average monthly temperature (ρ = 0.972; p < 0.001).

Conclusion: In multiple sclerosis, fatigue showed a natural temporal fluctuation. Fatigue was higher during summer compared to winter, with a significant relationship of fatigue with outdoor temperature. This finding should be carefully taken into account when clinically monitoring patients over time to not interpret higher or lower scores independent of seasonal aspects.

Keywords: fatigue; multiple sclerosis; neuropsychological; seasonal; sun.

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Conflict of interest statement

MG received honoraria and travel reimbursements for attending meetings, from Biogen, Celgene, Merck Serono, Novartis, Roche, Sanofi Genzyme, and TEVA. His research is funded by the German Ministry for Education and Research BMBF, Merck Serono, and Novartis. None of these relationships resulted in a conflict of interest. IP has received honoraria for speaking at scientific meetings, serving at scientific advisory boards, and performing consulting activities, from Adamas Pharma, Almirall, Bayer Pharma, Biogen, BMS, Celgene, Desitin, Sanofi-Genzyme, Janssen, Merck, Novartis, Roche, and Teva. She received research support from the German MS Society, Celgene, Novartis, Roche, and Teva. None of these relationships resulted in a conflict of interest. MS received honoraria for attending meetings, from Biogen and Merck Serono. None of these relationships resulted in a conflict of interest. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
The non-linear time-dependency regression NULL model + months + months2 provided the best fit to the fatigue data.
See this image and copyright information in PMC

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