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Cognitive Fatigue in Multiple Sclerosis: An Objective Approach to Diagnosis and Treatment by Transcranial Electrical Stimulation

1
Department of Neurology, Otto-von-Guericke University Magdeburg, Leipziger Street 44, Magdeburg 39120, Germany
2
Department of Neurophysiology and Pathophysiology, University Medical Center Hamburg-Eppendorf, Martinistraße 52, Hamburg 20246, Germany
3
Center for Behavioral Brain Sciences, Magdeburg 39106, Germany
*
Author to whom correspondence should be addressed.
Both authors contributed equally to this work.
Brain Sci. 2019, 9(5), 100; https://doi.org/10.3390/brainsci9050100
Received: 22 March 2019 / Revised: 29 April 2019 / Accepted: 30 April 2019 / Published: 2 May 2019
(This article belongs to the Special Issue Fatigue in Multiple Sclerosis: Current Concepts and Future Challenges)
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Abstract

Cognitive fatigue is one of the most frequent symptoms in multiple sclerosis (MS), associated with significant impairment in daily functioning and quality of life. Despite its clinical significance, progress in understanding and treating fatigue is still limited. This limitation is already caused by an inconsistent and heterogeneous terminology and assessment of fatigue. In this review, we integrate previous literature on fatigue and propose a unified schema aiming to clarify the fatigue taxonomy. With special focus on cognitive fatigue, we survey the significance of objective behavioral and electrophysiological fatigue parameters and discuss the controversial literature on the relationship between subjective and objective fatigue assessment. As MS-related cognitive fatigue drastically affects quality of life, the development of efficient therapeutic approaches for overcoming cognitive fatigue is of high clinical relevance. In this regard, the reliable and valid assessment of the individual fatigue level by objective parameters is essential for systematic treatment evaluation and optimization. Transcranial electrical stimulation (tES) may offer a unique opportunity to manipulate maladaptive neural activity underlying MS fatigue. Therefore, we discuss evidence for the therapeutic potential of tES on cognitive fatigue in people with MS. View Full-Text
Keywords: cognitive fatigue; multiple sclerosis; objective measurement; fatigability; tDCS; tACS cognitive fatigue; multiple sclerosis; objective measurement; fatigability; tDCS; tACS
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Linnhoff, S.; Fiene, M.; Heinze, H.-J.; Zaehle, T. Cognitive Fatigue in Multiple Sclerosis: An Objective Approach to Diagnosis and Treatment by Transcranial Electrical Stimulation. Brain Sci. 2019, 9, 100.

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