Operationalising cognitive fatigability in multiple sclerosis: a Gordian knot that can be cut?

Background: Researchers have attempted to operationalise objective measures of cognitive fatigability in multiple sclerosis (MS) to overcome the perceived subjectivity of patient-reported outcomes of fatigue (PROs). Measures of cognitive fatigability examine decrements in performance during sustaine...

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Main Authors: Harrison, A. M., das Nair, Roshan, Moss-Morris, Rona
Format: Article
Published: Sage 2016
Subjects:
Online Access:https://eprints.nottingham.ac.uk/39213/
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author Harrison, A. M.
das Nair, Roshan
Moss-Morris, Rona
author_facet Harrison, A. M.
das Nair, Roshan
Moss-Morris, Rona
author_sort Harrison, A. M.
building Nottingham Research Data Repository
collection Online Access
description Background: Researchers have attempted to operationalise objective measures of cognitive fatigability in multiple sclerosis (MS) to overcome the perceived subjectivity of patient-reported outcomes of fatigue (PROs). Measures of cognitive fatigability examine decrements in performance during sustained neurocognitive tasks. Objective: This personal viewpoint briefly summarises available evidence for measures of cognitive fatigability in MS and considers their overall utility. Results: Studies suggest there may be a construct that is distinct from self-reported fatigue, reflecting a new potential intervention target. However, assessments vary and findings across and within measures are inconsistent. Few measures have been guided by a coherent theory, and those identified are likely to be influenced by other confounds, such as cognitive impairment caused more directly by disease processes, depression and assessment biases. Conclusion: Future research may benefit from (a) developing a guiding theory of cognitive fatigability, (b) examining ecological and construct validity of existing assessments and (c) exploring whether the more promising cognitive fatigability measures are correlated with impaired functioning after accounting for possible confounds. Given the issues raised, we caution that our purposes as researchers may be better served by continuing our search for a more objective cognitive fatigability construct that runs in parallel with improving, rather than devaluing, current PROs.
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spelling nottingham-392132020-05-04T18:19:21Z https://eprints.nottingham.ac.uk/39213/ Operationalising cognitive fatigability in multiple sclerosis: a Gordian knot that can be cut? Harrison, A. M. das Nair, Roshan Moss-Morris, Rona Background: Researchers have attempted to operationalise objective measures of cognitive fatigability in multiple sclerosis (MS) to overcome the perceived subjectivity of patient-reported outcomes of fatigue (PROs). Measures of cognitive fatigability examine decrements in performance during sustained neurocognitive tasks. Objective: This personal viewpoint briefly summarises available evidence for measures of cognitive fatigability in MS and considers their overall utility. Results: Studies suggest there may be a construct that is distinct from self-reported fatigue, reflecting a new potential intervention target. However, assessments vary and findings across and within measures are inconsistent. Few measures have been guided by a coherent theory, and those identified are likely to be influenced by other confounds, such as cognitive impairment caused more directly by disease processes, depression and assessment biases. Conclusion: Future research may benefit from (a) developing a guiding theory of cognitive fatigability, (b) examining ecological and construct validity of existing assessments and (c) exploring whether the more promising cognitive fatigability measures are correlated with impaired functioning after accounting for possible confounds. Given the issues raised, we caution that our purposes as researchers may be better served by continuing our search for a more objective cognitive fatigability construct that runs in parallel with improving, rather than devaluing, current PROs. Sage 2016-11-30 Article PeerReviewed Harrison, A. M., das Nair, Roshan and Moss-Morris, Rona (2016) Operationalising cognitive fatigability in multiple sclerosis: a Gordian knot that can be cut? Multiple Sclerosis Journal . ISSN 1477-0970 Cognitive fatigability Fatigue Multiple Sclerosis http://dx.doi.org/10.1177/1352458516681862 doi:10.1177/1352458516681862 doi:10.1177/1352458516681862
spellingShingle Cognitive fatigability
Fatigue
Multiple Sclerosis
Harrison, A. M.
das Nair, Roshan
Moss-Morris, Rona
Operationalising cognitive fatigability in multiple sclerosis: a Gordian knot that can be cut?
title Operationalising cognitive fatigability in multiple sclerosis: a Gordian knot that can be cut?
title_full Operationalising cognitive fatigability in multiple sclerosis: a Gordian knot that can be cut?
title_fullStr Operationalising cognitive fatigability in multiple sclerosis: a Gordian knot that can be cut?
title_full_unstemmed Operationalising cognitive fatigability in multiple sclerosis: a Gordian knot that can be cut?
title_short Operationalising cognitive fatigability in multiple sclerosis: a Gordian knot that can be cut?
title_sort operationalising cognitive fatigability in multiple sclerosis: a gordian knot that can be cut?
topic Cognitive fatigability
Fatigue
Multiple Sclerosis
url https://eprints.nottingham.ac.uk/39213/
https://eprints.nottingham.ac.uk/39213/
https://eprints.nottingham.ac.uk/39213/