Studies
| Study Title: | Factors Describing Cognitive Fatigue in Neurological Conditions |
| Rationale: | The clinical treatment of cognitive fatigue is difficult regardless of condition, mainly because a basic understanding of the variables contributing to it are not well defined. The proposed project seeks to better understand cognitive fatigue experienced by people with neurological disorders, including MS and stroke. Specifically, this study seeks to answer the following questions: (a) what are the factors associated with CF among people with neurological disorders, and (b) how does CF affect the quality of life of these individuals? To ground this work, a model of cognitive fatigue is currently under development in my lab using concept analysis. Through this proposed study, we will test this model among people with MS and stroke. If the model is supported, the knowledge gained will inform future research as well as clinical evaluations of cognitive fatigue among people with neurological disorders. Novel insights into how and why cognitive fatigue manifests may also ultimately lead to improved clinical treatment strategies for cognitive fatigue. |
| Study Description: | The clinical treatment of cognitive fatigue is difficult regardless of condition, mainly because a basic understanding of the variables contributing to it are not well defined. The proposed project seeks to better understand cognitive fatigue experienced by people with neurological disorders, including MS and stroke. Specifically, this study seeks to answer the following questions: (a) what are the factors associated with CF among people with neurological disorders, and (b) how does CF affect the quality of life of these individuals? To ground this work, a model of cognitive fatigue is currently under development in my lab using concept analysis. Through this proposed study, we will test this model among people with MS and stroke. If the model is supported, the knowledge gained will inform future research as well as clinical evaluations of cognitive fatigue among people with neurological disorders. Novel insights into how and why cognitive fatigue manifests may also ultimately lead to improved clinical treatment strategies for cognitive fatigue.
General fatigue has been shown to be associated with other common symptoms of neurological conditions, including cognitive impairment, depression, anxiety, and sleep disturbances. However, the factors contributing to cognitive fatigue in neurological disorders are not yet known. Recent studies used MRI technology to understand the underlying pathogenesis of cognitive fatigue, however, these studies are mostly focused on people with MS and there is little or no information about other neurological diseases such as stroke. Therefore, treating cognitive fatigue clinically remains difficult regardless of condition, particularly because cognitive fatigue is not well defined and there is a lack of understanding of the variables contributing to it. While the study of cognitive fatigue is becoming more predominant in the neurology literature, no research to date has examined the interrelatedness of CF and other associated characteristics of the disease and compare these factors among different neurological conditions. This study will attempt to expand upon the methodology employed by Strober and Arnett [and Berard et al to objectively measure cognitive fatigue and will include quality of life in our model of CF, and compare the associated factors of CF among different neurological conditions. To ground this work, a model of cognitive fatigue has been recently developed in my lab using the concept analysis approach. The purpose of this study is to test this model among people with MS and stroke using Structural Equation Modeling (SEM) and to determine whether the parameters leading to cognitive fatigue apply to these populations. We will gather data on demographic information, depression, anxiety, sleep quality, cognitive fatigue, self-efficacy, and quality of life. Novel insights into how and why cognitive fatigue manifests may inform future research, and ultimately lead to improved clinical treatment strategies for cognitive fatigue that can result in improved quality of life.This Cross-sectional study will test a model of cognitive fatigue for people living with neurological conditions including Multiple Sclerosis (MS) and Stroke. The goal of this study is to test the relationship between different factors identified in the literature - such as depression, sleep disorder, and self-efficacy - and cognitive fatigue in order to validate the model of cognitive fatigue developed previously by our team. To test the model, we will use Structural Equation Modeling (SEM)to analyze the data collected from a sample of participants who meet the eligibility criteria. A total of 150 individuals (75 individuals with MS, and 75 individuals with stroke) will be recruited through the Dalhousie MS Research Unit, Dr. Gubitz's neurology clinic, rehabilitation clinics, advertisement on the website of Atlantic Division of MS Society of Canada, and Heart and Stroke Foundation of Nova Scotia. Approved advertising posters will be shared with study recruitment centers to be distributed based on their protocols. Interested individuals will be invited to contact the study office, based at Dalhousie University, using our research lab email address (cfatigue@dal.ca) or phone number (902-402-7867). Once a prospective participant contacts the research team, the study information will be sent to them by email. The assigned research assistant will schedule a a virtual meeting to overview the study, obtain verbal consent and assess the eligibility of participants. All virtual meetings will be held on BBCollaborate. Once the eligibility of participants is confirmed and after the provision of verbal consents, participants will be invited to another meeting (virtual) to complete the study questionnaires including demographics, self-report measures of cognitive fatigue, depression, anxiety, sleep quality, self-efficacy, and quality of life, and Paced Auditory Serial Addition Test (PASAT) to measure objective fatigue online. Data in this study will be collected using Opinio software, an online survey tool stored on Dalhousie servers. Participants will be in a virtual meeting (on BBCollaborate) with a research assistant while they are completing the online testings. Two main types of data will be collected in this study: Basic health and demographic Data- All eligible participants will complete an online survey to provide information about age, sex, education, employment status, type of MS/diagnosis, years since diagnosis, medications, other medical conditions, and receiving any fatigue management program or treatment. Data from standardized measures- The variables used in this study are cognitive fatigue, sleep quality, depression, anxiety, health-related quality of life, and self-efficacy measuring by the Modified Fatigue Impact Scale (MFIS), Paced Auditory Serial Addition Test (PASAT), Pittsburgh Sleep Quality Index (PSQI), the Patient Health Questionnaire – 9 (PHQ-9), the Hospital Anxiety and Depression Scale (HADS), the RAND-36, and General Self-Efficacy Scale (GSE) respectively. |
| Starting Dates: | 2021-11-22 |
| Ending Dates: | 2025-03-31 |
| Who can participate: | Participants in this study will be adults (>18) with MS and stroke who report that they are experiencing cognitive fatigue. All participants must be fluent in English; have access to internet and an electronic device ; be able to complete the study independently; present with no other neurological, medical, or psychiatric conditions that may have impaired cognition. Individuals with learning disabilities, hand, arm or visual impairments that significantly limit their ability to use electronic devices, history of seizures or unexplained syncope will be excluded. |
| Location of Trial: | Dalhousie University |
| Trial Investigator: | Dr. Sorayya Askari (Health Professions\Occupational Therapy) |
| Contact Information: | cfatigue@dal.ca call (902)448-3129 |
| Trial Funding: | NSHA Research Fund, Dalhousie Faculty of Health research development grant, and Dalhousie Belong Fellowship |