Table 2.
Other predictors of quality of life in multiple sclerosis patients
| Fatigue | Prevalence: 75–85% | ||
| Etiology: | |||
| • | Structural: disruption of frontal-thalamic pathways; bilateral pre- and postcentral gyrus, supplementary motor area, caudate nucleus, putamen, thalamus, paracingulate gyrus, precuneus and insula, as well as alterations of basal ganglia functional connectivity | ||
| • | Endocrine: hypothyroidism; HPA axis dysfunction | ||
| • | Depression: independent vs. symptom of it | ||
| Treatment: | |||
| • | Depressed patients: individual CBT, group psychotherapy and SSRI treatment | ||
| • | Non-depressed patients: amantadine or modafinil (little to moderate efficacy) | ||
| Sexual dysfuncion | Prevalence: 60.7%; higher in women | ||
| Etiology: | |||
| • | Structural: pontine atrophy and insular lesions | ||
| • | Endocrine: HPG axis deregulation | ||
| Related factors: disease progression; intense fatigue; depression; side effects of antidepressants; frustration and anger with sexual performance | |||
| Pain | Prevalence: two thirds of patients | ||
| Etiology: trigeminal or glossopharyngeal neuralgia; transverse myelitis; optic neuritis; sensory impairment | |||
| Resilience | Predictors of depression and anxiety symptoms: resilience, avoidance, emotion-focused coping strategies | ||
| Posttraumatic growth → better coping | |||
| Social support | Predictors QoL: social support; number of young children in the family | ||
HPA: hypothalamus-pituitary-adrenal, CBT: cognitive behavioral therapy, SSRI: selective serotonine reuptake inhibitors, HPG: hypothalamus-pituitary-gonadal, QoL: quality of life