Comments on energy conservation treatments for MS-related fatigue and a new proposal Psychological treatments of MS-related fatigue mostly depend on energy conservation programs. We argue that the evidence for energy conservation training is weak – in contrast to some reviews on this topic. The reasons for our concerns are the use of informed passive control groups allowing negative placebo effects, the lack of predefined primary outcome parameter, statistically rather than clinically significant effects, and the use of insensitive fatigue questionnaires. We propose to base psychological interventions not on a view of fatigue as a constant loss of mental energy but as a subjective representation (“feeling”) of an inflammatory state, which draws away attentional capacity.
https://www.jns-journal.com/ar....ticle/S0022-510X(24)