The checklist individual strength ( CIS 20‐R) in patients with amyotrophic lateral sclerosis – A longitudinal study

Objectives Fatigue may be underestimated symptom in amyotrophic lateral sclerosis ( ALS ). The self‐administered checklist individual strength ( CIS 20‐R) was used to measure both physical and mental fatigue in ALS . Materials and Methods Fatigue was measured in 51 consecutive patients with ALS using the fatigue severity scale ( FSS ) and the CIS 20‐R (four dimensions: subjective fatigue experience, concentration, motivation, activity). The questionnaire scores were compared with disease and progression parameters [revised ALS functional rating scale ( ALS ‐ FRS ‐R), MRC sum score, slow vital capacity (slow VC )]. Patients had follow‐ups at six and 12 months. Results At baseline (mean age: 57.9 years ± 12.3, mean disease duration: 15.8 months ± 12.7) clinical relevant fatigue was seen in 49% in FSS and 40% in CIS 20‐R. FSS and CIS 20‐R (except the subscale for concentration) were steadily increasing in the course of the disease. CIS 1 (subjective fatigue) but not FSS showed a correlation to the ALS ‐ FRS ‐R and the progression of the ALS ‐ FRS ‐R after 12 months. There was a moderate positive correlation between FSS and CIS 20‐R. Conclusions The CIS 20‐R is a sensitive tool to detect clinically relevant fatigue in early stages of ALS . Both physical and mental (motivation) dimensions of fatigue steadily increase during the course of the disease in ALS .