PREVALENCE OF FATIGUE IN MULTIPLE SCLEROSIS PATIENTS TREATED IN THE HC-USP.

Background: Fatigue is one of the most frequent symptoms of Multiple Sclerosis (MS) that impact everyday life of patients. Being aware of fatigue prevalence is important to understand its manifestations and give support to therapeutic interventions that will help in the daily management of this symptom. Objective: Describe the prevalence of fatigue in Relapsing-Remitting MS patients treated at the Clinical Hospital of the University of São Paulo (HC-USP). Methods: Clinic-prospective study with 115 patients from May 2011 to August 2012. Mild to moderate disabled patients were included (0-5 at Expanded Disability Status Score - EDSS), until 45 years of age, without any other associated diseases or outbreaks for at least 6 months, regardless the time of the disease. The Brazilian version of the Fatigue Severity Scale (FSS-BR) and Modified Fatigue Impact Scale (MFIS-BR) were applied. Methods: MRS was performed at 3T using different echo times (TE = 135 ms and 35 ms) and a single-voxel located along the left hippocampus. Data were processed using LCModel and the concentration of metabolites weighted for content of tissue water and correction to the percentage of different tissue types. Brain and hippocampi volumetric analyzes were performed by Freesurfer. Subjects underwent a neuropsychological battery from which a memory retention score (RS) was extracted using Hopkins Verbal Learning and Logical Memory tests. Results: The sample represents 10% of the MS patients of the service, from 17 to 45 years old, with time of diagnosis from 0 to 19 years and EDDS from 0 to 5. The majority were women (73.9%), more than a half of them were engaged in labor-intensive activities (56.6%), and 72.2% were employees, volunteers and students. Regarding education, 69.9% had at least an incomplete college education. Those who were considered fatigued had FSS-BR points ≥ 4 and MFIS-BR points ≥ 38, which resulted in a total of 46 patients (40%)[IC95% : 30.9 - 49.1]). Conclusion: The population is primarily composed of women and perform regular and social activities, which can be related to the high level of education. Fatigue prevalence is lower when compared to a similar study that used FSS-BR with a lower cutoff point. The two scales presented a high level of agreement, reinforcing the fact that the use of combined scales is the best option to evaluate fatigue. This was the first study of the combined use of FSS -- BR and MFIS - BR in Brazil and one of the few to use MFIS-BR [ABSTRACT FROM AUTHOR]