Quality of Life in Multiple Sclerosis Compared to Amyotrophic Lateral Sclerosis: Fatigue and Fast Disease Progression Interferes with the Ability to Psychosocially Adjust
Abstract
1. Introduction
2. Materials and Methods
2.1. Design and Participants
2.2. Quality of Life and Depression as Outcome Measures of PSA
2.3. Fatigue
2.4. Statistical Analysis
3. Results
3.1. Demographics and Clinical Data
3.2. Indicators of Psychosocial Adjustment in MS: CFA
3.3. Predictors of Psychosocial Adjustment in MS: Regression Analyses
3.4. Psychosocial Adjustment Comparison to ALS
4. Discussion
4.1. Psychosocial Adjustment in MS
4.2. Psychosocial Adjustment Compared to ALS
4.3. Limitations
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
Abbreviations
MS | Multiple sclerosis |
ALS | Amyotrophic Lateral Sclerosis |
PSA | Psychosocial adjustment |
QoL | Quality of life |
PQoL | Physical quality of life |
MQoL | Mental quality of life |
SQoL | Subjective quality of life |
EDSS | Expanded Disability Status Scale |
RRMS | Relapsing–remitting multiple sclerosis |
PPMS | Primary progressive multiple sclerosis |
SPMS | Secondary progressive multiple sclerosis |
ALS-FRS-R | ALS Functional Rating Scale—Revised |
ACSA | Anamnestic Comparative Self-Assessment |
SF-12 | Short-Form Survey 12 Questionnaire |
MCS | Mental component score |
PCS | Physical component score |
HADS-D | Hospital Anxiety and Depression Scale—Depression |
ADI-12 | ALS Depression Inventory |
FSMC | Fatigue Scale for Motor and Cognitive Functions |
SD | Standard deviation |
CFA | Confirmatory factor analysis |
CFI | Comparative Fit Index |
SRMR | Standardized Root Mean Square Residual |
RMSEA | Root Mean Square Error of Approximation |
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Characteristics | MS Patients (N = 77) | ALS Patients (N = 30) | Statistics | |||
---|---|---|---|---|---|---|
Mean (SD) | N (%) | Mean (SD) | N (%) | |||
Age (years) | 46.83 (13.64) | 56.60 (11.45) | t(105) = −3.47, p < 0.001 | |||
Female/Male | 45/32 (58.4/41.6) | 10/20 (33.3/66.7) | χ2(1) = 5.45, p = 0.020 | |||
Years of education | 14.50 (2.82) | 14.60 (3.33) | t(105) = −0.16, p = 0.876 | |||
EDSS * | 2.90 (1.84) | |||||
ALS-FRS-R * | 35.97 (9.02) | |||||
Time since onset (years) | 10.34 (9.30) | 1.62 (0.87) | t(104) = 5.11, p < 0.001 | |||
PPMS * | 11 (14.3) | |||||
SPMS * | 16 (20.8) | |||||
RRMS * | 50 (64.9) |
Fit Index | Observed Value | Cut-off Criterion | Interpretation |
---|---|---|---|
χ2 * | 8.29, p = 0.016 | p > 0.05 | poor fit (interpretation based on p-value) |
RMSEA * | 0.202 | <0.05 (good), <0.08 (acceptable) | poor fit (interpretation based on index value) |
SRMR * | 0.059 | <0.08 | good fit (interpretation based on index value) |
CFI * | 0.933 | >0.95 | marginal fit (interpretation based on index value) |
Patient-Reported Outcome Measures | MS Patients (N = 77) | ALS Patients (N = 30) | |
---|---|---|---|
Mean (SD) | N (%) | Mean (SD) | |
HADS-D * | 5.58 (4.21) | ||
ADI-12 * | 24.97 (7.91) | ||
Level of depression (%) | 26.59 (20.05) | 52.01 (16.48) | |
ACSA * | 0.75 (2.01) | −0.40 (2.74) | |
SF-12 MCS * | 45.79 (11.36) | 47.98 (11.41) | |
SF-12 PCS * | 42.64 (10.67) | 33.74 (13.01) | |
FSMC motor * | 30.60 (11.67) | ||
mild (≥22) | 9 (11.7) | ||
moderate (≥27) | 10 (13) | ||
severe (≥32) | 38 (49.4) | ||
FSMC cognition * | 29.05 (12.12) | ||
mild (≥22) | 7 (9.1) | ||
moderate (≥28) | 14 (18.2) | ||
severe (≥34) | 31 (40.3) |
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Balz, L.T.; Uttner, I.; Weishaupt, J.; Ludolph, A.C.; Taranu, D.; Vardakas, I.; Jung, S.; Fangerau, T.; Erhart, D.K.; Senel, M.; et al. Quality of Life in Multiple Sclerosis Compared to Amyotrophic Lateral Sclerosis: Fatigue and Fast Disease Progression Interferes with the Ability to Psychosocially Adjust. Brain Sci. 2025, 15, 745. https://doi.org/10.3390/brainsci15070745
Balz LT, Uttner I, Weishaupt J, Ludolph AC, Taranu D, Vardakas I, Jung S, Fangerau T, Erhart DK, Senel M, et al. Quality of Life in Multiple Sclerosis Compared to Amyotrophic Lateral Sclerosis: Fatigue and Fast Disease Progression Interferes with the Ability to Psychosocially Adjust. Brain Sciences. 2025; 15(7):745. https://doi.org/10.3390/brainsci15070745
Chicago/Turabian StyleBalz, Luisa T., Ingo Uttner, Jochen Weishaupt, Albert C. Ludolph, Daniela Taranu, Ioannis Vardakas, Stefanie Jung, Tanja Fangerau, Deborah K. Erhart, Makbule Senel, and et al. 2025. "Quality of Life in Multiple Sclerosis Compared to Amyotrophic Lateral Sclerosis: Fatigue and Fast Disease Progression Interferes with the Ability to Psychosocially Adjust" Brain Sciences 15, no. 7: 745. https://doi.org/10.3390/brainsci15070745
APA StyleBalz, L. T., Uttner, I., Weishaupt, J., Ludolph, A. C., Taranu, D., Vardakas, I., Jung, S., Fangerau, T., Erhart, D. K., Senel, M., Tumani, H., & Lulé, D. E. (2025). Quality of Life in Multiple Sclerosis Compared to Amyotrophic Lateral Sclerosis: Fatigue and Fast Disease Progression Interferes with the Ability to Psychosocially Adjust. Brain Sciences, 15(7), 745. https://doi.org/10.3390/brainsci15070745