Citation

Kluger BM, Krupp LB, Enoka RM. Neurology 2013; 80(4): 409-416.

Affiliation

From the Departments of Neurology and Psychiatry (B.M.K.), University of Colorado Denver, Aurora; Departments of Neurology and Psychology (L.B.K.), Stony Brook University Medicine Stony Brook, Stony Brook, NY; and the Department of Integrative Physiology (R.M.E.), University of Colorado Boulder, Boulder.

Copyright

(Copyright © 2013, Lippincott Williams and Wilkins)

DOI

10.1212/WNL.0b013e31827f07be

PMID

23339207

Abstract

Fatigue is commonly reported in many neurologic illnesses, including multiple sclerosis, Parkinson disease, myasthenia gravis, traumatic brain injury, and stroke. Fatigue contributes substantially to decrements in quality of life and disability in these illnesses. Despite the clear impact of fatigue as a disabling symptom, our understanding of fatigue pathophysiology is limited and current treatment options rarely lead to meaningful improvements in fatigue. Progress continues to be hampered by issues related to terminology and assessment. In this article, we propose a unified taxonomy and a novel assessment approach to addressing distinct aspects of fatigue and fatigability in clinical and research settings. This taxonomy is based on our current knowledge of the pathophysiology and phenomenology of fatigue and fatigability. Application of our approach indicates that the assessment and reporting of fatigue can be clarified and improved by utilizing this taxonomy and creating measures to address distinct aspects of fatigue and fatigability. We review the strengths and weaknesses of several common measures of fatigue and suggest, based on our model, that many research questions may be better addressed by using multiple measures. We also provide examples of how to apply and validate the taxonomy and suggest directions for future research.

Language: en