Voice and General Fatigue in Multiple Sclerosis: A Comparative Study with Healthy Individuals

Abstract

Objective: The purpose of this study was to compare the levels of vocal fatigue and general fatigue in multiple sclerosis (MS) patients without voice disorders with those of healthy individuals, and to evaluate the relationship between vocal fatigue and general fatigue within the MS group. Material and Methods: The study was conducted using a comparative descriptive design. The sample consisted of 25 individuals diagnosed with MS according to the McDonald criteria and 25 healthy controls matched for age and gender. The mean age of the MS group was 38.12 years (min = 21, max = 62), while the control group had a mean age of 35.79 years (min = 20, max = 56). In the MS group, 88% were female and 12% were male, whereas in the control group 76% were female and 24% were male. Data were collected online using the Descriptive Information Form, the Voice Handicap Index–30 (VHI), the Fatigue Assessment Scale (FAS), and the Vocal Fatigue Index (VFI). Results: The MS group had significantly higher levels of general fatigue compared to the control group (p < 0.001). Similarly, the MS group scored significantly higher on vocal fatigue total (p = 0.001), the fatigue and avoidance subscale (p < 0.001), and the physical discomfort subscale (p = 0.019) than the control group. Conclusion: In this study, it was found that individuals with MS without voice disorders had significantly higher general and voice-related fatigue than healthy individuals. The observation that overall and vocal fatigue levels are higher in MS patients at an independent functioning level, even before the onset of overt dysphonia, suggests that these symptoms may develop from the early stages of the disease. Systematic assessment of voice parameters during the clinical follow-up of patients with MS may contribute to research on the disease and guide the development of early intervention strategies.

Keywords

• Voice
• vocal fatigue
• fatigue
• multiple sclerosis

Supporting Institution

Ankara Medipol University

Project Number

E-85859696-604.01.01-4657

Ethical Statement

Before the research, approval was obtained from the Non-Interventional Clinical Research Ethics Committee of Ankara Medipol University (Decision No: 128, Date: 01.07.2025). Participants were informed about the purpose of the study, the principles of voluntary participation, and the confidentiality of personal data; informed consent forms were obtained electronically from each individual in an online environment. The study process was conducted in accordance with the Declaration of Helsinki.

Thanks

We would like to express our gratitude to the Non-Interventional Clinical Research Ethics Committee of Ankara Medipol University for their contribution to the realization of this study. We also extend our sincere thanks to all individuals who voluntarily participated in the study for their valuable contributions.

Multipl Skleroz Hastalığında Ses ve Genel Yorgunluk: Sağlıklı Bireylerle Karşılaştırmalı Bir İnceleme

Abstract

Amaç: Bu çalışmanın amacı, ses bozukluğu olmayan multipl skleroz (MS) hastalarında ses yorgunluğu ve genel yorgunluk düzeylerini sağlıklı bireylerle karşılaştırmak, MS grubunda ses yorgunluğunun genel yorgunluk ile ilişkisini değerlendirmek amaçlanmıştır. Gereç ve Yöntem: Çalışma, karşılaştırmalı tanımlayıcı desenle yürütülmüştür. Araştırmaya McDonald kriterlerine göre MS tanısı almış 25 birey ve yaş ile cinsiyet açısından benzer özellikler gösteren 25 sağlıklı birey katılmıştır. Katılımcıların yaş ortalaması çalışma grubunda 38,12 (min = 21, maks = 62), kontrol grubunda ise 35,79 (min = 20, maks = 56) olarak bulunmuştur. Çalışma grubunun %88’i kadın, %12’si erkek; kontrol grubunun ise %76’sı kadın, %24’ü erkektir. Veriler; Tanımlayıcı Bilgi Formu, Ses Handikap Endeksi–30 (SHE), Yorgunluk Değerlendirme Ölçeği (FAS-TR) ve Ses Yorgunluğu Ölçeği (SYÖ) aracılığıyla çevrimiçi olarak toplanmıştır. Bulgular: Çalışma grubunda genel yorgunluk düzeyi kontrol grubuna kıyasla anlamlı düzeyde daha yüksek bulunmuştur (p < 0,001). Benzer şekilde, ses yorgunluğu toplam puanı (p = 0,001), yorgunluk ve kaçınma alt boyutu (p < 0,001) ve fiziksel rahatsızlık alt boyutu (p = 0,019) çalışma grubunda kontrol grubuna göre anlamlı düzeyde yüksek bulunmuştur. Sonuç: Bu çalışmada ses bozukluğu olmayan MS tanılı bireylerin genel ve sesle ilişkili yorgunluğun sağlıklı bireylere göre daha belirgin düzeyde yüksek olduğu bulunmuştur. Belirgin bir disfoni ortaya çıkmadan, MS hastalarında bağımsızlık düzeyindeyken genel ve ses yorgunluğunun daha yüksek seviyelerde gözlemlenmesi, bu semptomların hastalığın erken evrelerinden itibaren gelişebileceğini düşündürmüştür. MS hastalarının klinik izlem sürecinde ses alanında sistematik değerlendirmelerin yapılmasının, hastalığa ilişkin araştırmalara katkı sağlayabileceği ve erken müdahale yaklaşımlarının geliştirilmesine yön verebileceği düşünülmektedir.

Keywords

• Ses
• ses yorgunluğu
• genel yorgunluk
• multipl skleroz

Supporting Institution

Ankara Medipol Üniversitesi

Project Number

E-85859696-604.01.01-4657

Ethical Statement

Araştırma öncesinde Ankara Medipol Üniversitesi Girişimsel Olmayan Klinik Araştırmalar Etik Kurulu’ndan onay alınmıştır (Karar No: 128, Tarih: 01.07.2025). Katılımcılara çalışmanın amacı, gönüllü katılım esasları ve kişisel verilerin gizliliği hakkında bilgilendirme yapılmış; her bireyden aydınlatılmış onam formu çevrimiçi ortamda elektronik olarak alınmıştır. Çalışma sürecinde Helsinki Bildirgesine uygun hareket edilmiştir.

Thanks

Çalışmamızın gerçekleştirilmesine katkı sağlayan Ankara Medipol Üniversitesi Girişimsel Olmayan Klinik Araştırmalar Etik Kurulu’na teşekkür ederiz. Ayrıca çalışmaya gönüllü olarak katılan tüm bireylere değerli katkıları için şükranlarımızı sunarız.

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