Dataset Information

Fatigue and fluid hydration status in multiple sclerosis: A hypothesis.

ABSTRACT:

Background

Fatigue is a prevalent and functionally disabling symptom for individuals living with multiple sclerosis (MS) which is poorly understood and multifactorial in etiology. Bladder dysfunction is another common MS symptom which limits social engagement and quality of life. To manage bladder issues, individuals with MS tend to limit their fluid intake, which may contribute to a low-hydration (LoH) state and fatigue.

Objective

To evaluate the relationship between patient-reported MS fatigue, bladder dysfunction, and hydration status.

Methods

We performed a prospective cross-sectional study in 50 women with MS. Participants submitted a random urine sample and completed several fatigue-related surveys. Using a urine specific gravity (USG) threshold of 1.015, we classified MS subjects into two groups: high-hydration (HiH) and LoH states.

Results

LoH status was more common in MS subjects with bladder dysfunction. Statistically significant differences in self-reported Fatigue Performance Scale were observed between HiH and LoH subjects (p = 0.022). USG was significantly correlated with fatigue as measured by the MS Fatigue Severity Scale (FSS) score (r = 0.328, p = 0.020).

Conclusion

Hydration status correlates with self-reported fatigue, with lower fatigue scores found in those with HiH status (USG < 1.015).

SUBMITTER: Cincotta MC

PROVIDER: S-EPMC5156578 | biostudies-literature | 2016 Oct

REPOSITORIES: biostudies-literature

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Publications

Fatigue and fluid hydration status in multiple sclerosis: A hypothesis.

Cincotta Molly C MC Engelhard Matthew M MM Stankey Makela M Goldman Myla D MD

Multiple sclerosis (Houndmills, Basingstoke, England) 20160819 11

<h4>Background</h4>Fatigue is a prevalent and functionally disabling symptom for individuals living with multiple sclerosis (MS) which is poorly understood and multifactorial in etiology. Bladder dysfunction is another common MS symptom which limits social engagement and quality of life. To manage bladder issues, individuals with MS tend to limit their fluid intake, which may contribute to a low-hydration (LoH) state and fatigue.<h4>Objective</h4>To evaluate the relationship between patient-repo ...[more]

PMID: 27542703

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Project description:Fatigue is a common and disabling symptom in patients with Multiple Sclerosis (PwMS). Its pathogenesis, however, is still not fully understood. Potential psychological roots, in particular, have received little attention to date. The present study examined the association of childhood adversities, specific trait characteristics, and MS disease characteristics with fatigue symptoms utilizing path analysis. Five hundred and seventy-one PwMS participated in an online survey. Standardized psychometric tools were applied. The Childhood Trauma Questionnaire (CTQ) served to assess childhood adversities. Trait variables were alexithymia (Toronto Alexithymia Scale; TAS-26) and early maladaptive schemas (Young Schema Questionnaire; YSQ). Current pathology comprised depression (Beck's Depression Inventory FastScreen; BDI-FS) and anxiety symptoms (State-Trait Anxiety Inventory; STAI-state), as well as physical disability (Patient determined Disease Steps; PDDS). The Fatigue Scale for Motor and Cognitive Functions (FSMC) was the primary outcome variable measuring fatigue. PwMS displayed high levels of fatigue and depression (mean FSMC score: 72; mean BDI-II score: 18). The final path model revealed that CTQ emotional neglect and emotional abuse remained as the only significant childhood adversity variables associated with fatigue. There were differential associations for the trait variables and current pathology: TAS-26, the YSQ domain impaired autonomy and performance, as well as all current pathology measures had direct effects on fatigue symptoms, accounting for 28.2% of the FSMC variance. Bayesian estimation also revealed indirect effects from the two CTQ subscales on FSMC. The final model fitted the data well, also after a cross-validation check and after replacing the FSMC with the Chalder Fatigue Questionnaire (CFQ). This study suggests an association psychological factors on fatigue in Multiple Sclerosis. Childhood adversities, as well as specific trait characteristics, seem to be associated with current pathology and fatigue symptoms. The article discusses potential implications and limitations.

Project description:BackgroundPrevious studies have identified links between fluid intake, hydration related hormones and cortisol measured at one timepoint but have not considered how hydration may influence cortisol dynamics throughout the day. This study assessed associations between hydration status (copeptin, urinary osmolality, urine volume) and habitual fluid intake with cortisol dynamics.MethodsThe day before (DB) a 6-h laboratory visit, 29 male participants (age, 23±4y; BMI, 25.5 ± 4.3 kg/m2; body fat, 17.3 ± 9.3 %) provided 24-h urine samples and a fasted blood sample for hydration status assessment, recorded their 24-h fluid intake for three days prior, and provided 10 saliva samples to assess cortisol dynamics from DB into the evening of the laboratory visit. Calculated indices of cortisol dynamics included: nocturnal cortisol rise (NCR - salivary cortisol rise from bed to awakening), peak salivary cortisol (peak SCORT - highest cortisol of all samples), cortisol awakening response (ΔCAR - difference between high morning sample and awakening sample), area under the curve with respect to ground (AUCG) and increase (AUCI), and diurnal cortisol slope (DCS - rate of change in cortisol from awakening to bed). The relationships between fluid intake or hydration status and cortisol dynamics were analyzed by separating participants into fluid intake tertile groups and by regressing cortisol dynamics on the continuous variables of total fluid intake (TFI) or hydration biomarkers.ResultsThere were no between-group differences for ΔCAR (p = 0.89), AUCG (p = 0.57), AUCI (p = 0.48), peak SCORT (p = 0.14), NCR (p = 0.95), DCS (p = 0.22), or serum cortisol (p = 0.61). TFI was not associated with log (peak SCORT) (p = 0.49), ΔCAR (p = 0.61), AUCG (p = 0.76), or AUCI (p = 0.56). Copeptin was not associated with log (peak SCORT) (p = 0.99), ΔCAR (p = 0.22), AUCG (p = 0.69) or AUCI (p = 0.18). Urinary hydration markers were not associated with any measures of cortisol dynamics (p > 0.05). These null effects were consistent when controlling for physical activity, sleep, and body fat percentage.ConclusionIn the absence of dehydrating stimuli, measures of fluid intake or hydration status may not be associated with cortisol dynamics in young healthy males.

Dataset Information

Fatigue and fluid hydration status in multiple sclerosis: A hypothesis.

Background

Objective

Methods

Results

Conclusion

Publications

Fatigue and fluid hydration status in multiple sclerosis: A hypothesis.

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