Abstract
Objective
To examine the temporal associations, within day and day to day, between pain, fatigue,
depressed mood, and cognitive function in multiple sclerosis (MS).
Design
Repeated-measures study involving 7 days of ecological momentary assessment (EMA)
of symptoms 5 times a day; multilevel mixed models were used to analyze data.
Setting
Community.
Participants
Ambulatory adults (N=107) with MS.
Interventions
Not applicable.
Main Outcome Measure
EMA of pain, fatigue, depressed mood, and cognitive function rated on a 0 to 10 scale.
Results
Fatigue and pain were linked within day such that higher pain was associated with
higher subsequent fatigue (B=.09, P=.04); likewise, higher fatigue was associated with higher pain in the following time
frame (B=.05, P=.04). Poorer perceived cognitive function preceded increased subsequent pain (B=.08,
P=.007) and fatigue (B=.10, P=.01) within day. Depressed mood was not temporally linked with other symptoms. In
terms of day-to-day effects, a day of higher fatigue related to decreased next day
fatigue (B=−.16, P=.01), and a day of higher depressed mood related to increased depressed mood the
next day (B=.17, P=.01). There were no cross-symptom associations from one day to the next.
Conclusions
Findings provide new insights on how common symptoms in MS relate to each other and
vary within and over days. Pain and fatigue show evidence of a dynamic bidirectional
relation over the course of a day, and worsening of perceived cognitive function preceded
worsening of both pain and fatigue. Most temporal associations between symptoms occur
within the course of a day, with relatively little carryover from one day to the next.
Keywords
List of abbreviations:
EMA (ecological momentary assessment), MS (multiple sclerosis)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: July 17, 2017
Footnotes
Supported by the National Institute of Nursing Research of the National Institutes of Health (award no. R03NR014515); and the National Institute of Arthritis and Musculoskeletal and Skin Diseases (award no. 1K01AR064275).
The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
Disclosures: none.
Identification
Copyright
© 2017 by the American Congress of Rehabilitation Medicine
