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===MS fatigue=== The pathophysiology and mechanisms causing MS [[fatigue]] are not well understood.<ref>{{cite journal | vauthors = Manjaly ZM, Harrison NA, Critchley HD, Do CT, Stefanics G, Wenderoth N, Lutterotti A, MΓΌller A, Stephan KE| title = Pathophysiological and cognitive mechanisms of fatigue in multiple sclerosis | journal = Journal of Neurology, Neurosurgery, and Psychiatry | volume = 90 | issue = 6 | pages = 642β651 | date = June 2019 | pmid = 30683707 | pmc = 6581095 | doi = 10.1136/jnnp-2018-320050 }}</ref><ref>{{cite journal | vauthors = Ellison PM, Goodall S, Kennedy N, Dawes H, Clark A, Pomeroy V, Duddy M, Baker MR, Saxton JM|title = Neurostructural and Neurophysiological Correlates of Multiple Sclerosis Physical Fatigue: Systematic Review and Meta-Analysis of Cross-Sectional Studies | journal = Neuropsychology Review | volume = 32 | issue = 3 | pages = 506β519 | date = September 2022 | pmid = 33961198 | pmc = 9381450 | doi = 10.1007/s11065-021-09508-1 }}</ref><ref>{{cite journal | pmc=5102292 | date=2016 | title=Central fatigue in multiple sclerosis: A review of the literature | journal=The Journal of Spinal Cord Medicine | volume=39 | issue=4 | pages=386β399 | doi=10.1080/10790268.2016.1168587 | pmid=27146427 | vauthors = Newland P, Starkweather A, Sorenson M }}</ref> MS fatigue can be affected by body heat,<ref name="Heat and cold sensitivity in multiple sclerosis"/><ref name="Davis-2018"/> and this may differentiate MS fatigue from other primary fatigue.<ref name="Multiple Sclerosis Trust"/><ref name="Christogianni-2018"/><ref name="Christogianni-2022"/> Fatigability (loss of strength) may increase perception of fatigue, but the two measures warrant independent assessment in clinical studies.<ref name="loy">{{cite journal |vauthors=Loy BD, Taylor RL, Fling BW, Horak FB |title=Relationship between perceived fatigue and performance fatigability in people with multiple sclerosis: A systematic review and meta-analysis |journal=Journal of Psychosomatic Research |volume=100 |issue= |pages=1β7 |date=September 2017 |pmid=28789787 |pmc=5875709 |doi=10.1016/j.jpsychores.2017.06.017}}</ref>
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