Motor fatigability in multiple sclerosis
Research type
Research Study
Full title
Performance related fatigue and disease progression in multiple sclerosis
IRAS ID
166909
Contact name
Don Mahad
Contact email
ISRCTN Number
ISRCTN00000000
Clinicaltrials.gov Identifier
Duration of Study in the UK
2 years, 11 months, 29 days
Research summary
Multiple sclerosis (MS) is the most frequent non-traumatic cause of permanent neurological disability in young adults, with over 100,000 individuals affected in the UK. The majority of individuals with MS develop a gradual decline in neurological function, termed progressive MS, which is resistant to treatment. A proportion of MS patients who have a physically active lifestyle, report exercise induced fatigue (exercise intolerance or motor fatigability) that gradually becomes more prominent and occurs before their usual daily activities become compromised. Motor fatigability in MS is largely put down to a rise in core body temperature when myelin or the protective fatty sheaths of nerve cells is lost (demyelination), called Uhthoff’s phenomenon. However, why such reversible symptoms becomes more prominent over time in MS is not known. The hypothesis is that the motor fatigability gradually deteriorates over years in a subset of MS patients and this deterioration is predicted by a metabolic compromise (dysfunction of mitochondria, the energy producing organelles of cells) in the regions of the brain responsible for motor activity. The aim of this pilot study is to develop sensitive clinical tools in combination with non-invasive imaging techniques to reliably measure the performance related fatigue in MS patients who already have a physically active lifestyle and monitor it over a two-year period. The clinical tools will include detailed analysis of the gait before, after and during exercise as well as fatigue questionnaires. The imaging techniques will include magnetic resonance spectroscopy and functional magnetic resonance scans. The outcome may determine whether the decline in motor fatigability is predicted by a metabolic disturbance in the motor pathways in MS patients. Furthermore, this study may provide new insight towards the clinical presentation of progressive MS and help develop clinical platforms for future clinical trials in progressive MS.
REC name
South East Scotland REC 02
REC reference
15/SS/0088
Date of REC Opinion
25 Nov 2015
REC opinion
Further Information Favourable Opinion