OBJECTIVE Fatigue in multiple sclerosis (MS) is common, burdensome, and usually assessed by self-report measures. This retrospective data analysis of the twice-daily Alertness test (Test battery of Attentional Performance) examined the extent to which this assessment procedure is associated with MS-related fatigue. METHOD Two-hundred and thirteen German inpatients (136 women) aged 18-69 years with predominantly relapsing MS (72.8%) were included. Based on reaction time (RT) differences between morning tonic alertness (8:30-11:00 a.m.) and afternoon tonic alertness (3:00-4:30 p.m.), patients were divided into an "improver," "maintainer," or "decliner" group. Multinomial logistic regression (MLR) was calculated to predict the likelihood of belonging to one of these performance groups, taking into account cognitive fatigue (Fatigue Scale of Motor and Cognition, FSMCcog), disease severity (Expanded Disability Status Scale, EDSS), depression (Center for Epidemiologic Studies Depression Scale, CES-D), gender, and tonic alertness (a.m.). RESULTS The final MLR model (R2 = .30) included tonic alertness (a.m.) (<.001), FSMCcog (.008), EDSS (.038), CES-D (.161), and gender (.057). Using this model, correct assignment to alertness performance groups was 56.8%. Tonic alertness (p.m.) demonstrated the greatest potential for differentiation among the three performance groups (<.001). CONCLUSIONS These results show a relationship between subjective fatigue and tonic alertness. However, other variables also contribute to this association, suggesting that the RT differences between twice-daily measures of tonic alertness is not related to increased subjective fatigue in a substantial number of pwMS, which diminishes the diagnostic value. Further studies including relevant variables such as sleepiness are urgently needed.

中文翻译：

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多发性硬化症患者每日强直警觉性测量与自我报告疲劳之间的关系——回顾性数据分析。

目的 多发性硬化症 (MS) 中的疲劳很常见、造成负担，通常通过自我报告措施进行评估。这项对每日两次警觉性测试（注意力表现测试组）的回顾性数据分析检查了该评估程序与 MS 相关疲劳的关联程度。方法 纳入 213 名年龄在 18-69 岁、主要是复发性 MS 的德国住院患者（136 名女性）（72.8%）。根据早晨强直警觉性（上午 8:30-11:00）和下午强直警觉性（下午 3:00-4:30）之间的反应时间 (RT) 差异，患者被分为“改善者”、“维持者”和“改善者”。或“衰落”群体。计算多项逻辑回归 (MLR) 以预测属于这些表现组之一的可能性，同时考虑认知疲劳（运动和认知疲劳量表，FSMCcog）、疾病严重程度（扩展残疾状态量表，EDSS）、抑郁（流行病学研究中心抑郁量表，CES-D）、性别和强直警觉性（am）。结果 最终的 MLR 模型 (R2 = .30) 包括强直警觉性 (am) (<.001)、FSMCcog (.008)、EDSS (.038)、CES-D (.161) 和性别 (.057)。使用该模型，警觉性表现组的正确分配率为 56.8%。强直警觉性 (pm) 在三个表现组中表现出最大的区分潜力 (<.001)。结论 这些结果显示了主观疲劳和强直警觉性之间的关系。然而，其他变量也促成了这种关联，表明每天两次强直警觉性测量之间的 RT 差异与大量 pwMS 中主观疲劳的增加无关，这降低了诊断价值。迫切需要进一步研究包括嗜睡等相关变量。