Neuromuscular factors of fatigue in Multiple Sclerosis

Abstract

Fatigue is one of the main symptoms for individuals with multiple sclerosis (ms) that has significant impact in daily life. this review focuses on central and peripheral factors related to fatigue and suggests strategies for fatigue management in ms. even though the strength level in people with ms is similar to this of healthy people, fatigue phenomena are more pronounced in cases of ms. fatigue symptoms are presented more often in the lower limbs, while factors responsible for the function of the central nervous system and the production-transmission of neural signals towards the periphery seem to play the most important role in fatigue occurrence. however, there is no perfect correlation between diagnostic findings of magnetic resonance imaging and the subjective fatigue feeling of people with ms. scientific data reveal that reduce performance is attributed to deficits on muscular level, both due to metabolic factors or to the contractile properties (excitation-contraction coupling). more systematic research is required to illustrate and understand the particular nature of fatigue in people with ms. apart from pharmacological treatment, there is evidence that physical exercise could not only improve physical fitness, but also induce changes both in neural and muscular level. however, this issue needs further investigation.