b"wereadministeredforprocessingspeedis directly because of MS. One would expect to (Symbol Digit Modalities Test), fatigue levelsee improvements in the SDMT and processing (Fatigue Severity Scale), and depression (Beck'sspeed as the depression was improved with Depression Inventory). Findings showed thattreatment. This is not to imply that all cognitive cognitive performance at SDMT was notissues in MS are because of depression or fatigue, affected by patients' perceived level of physicalbut we do need to keep an eye out for potentially fatigue, but by depression. The presence ofreversible causes for cognitive challenges. a high BDI score aligns with the physicalStudy review suggests fatigue on cognitive performance. It should bevitamin D may reduce fatigue noted this is a single center with few patientsResearchers in Spain conducted a systematic and based primarily on self-reported data forreview of the current literature to analyze the the tests. Additionally, cognitive fatigue was noteffect of vitamin D on fatigue in people with evaluated, which may affect anxiety-depressiveMS. When researchers pulled the data from ve symptoms and physical fatigue. The article wasstudies together, there were 345 participants, published in BMC psychology.271 females, with ages ranging from 25 to 41 Thrower -Fatigue, depression, and cognitiveyears. Most patients had mild disease severity dysfunction are all common symptoms affectingand were diagnosed with relapsing-remitting those living with MS and may signicantly affectMS. The vitamin D supplementation varied quality of life. We do know these three symptomswidely across the studies from 1 mcg to may interact with each other and even mimic50,000 IU. Also to be considered was the one another. For example, people dealing withfrequency of doses. These varied from once depression may experience anhedonia or a lackdaily to once a week. The most common of desire to do things they would normallymeasurement used in the studies was the nd pleasurable. Fatigue could also lead oneFatigue Severity Scale. The combined study to not want to go out and do things in a waydata showed a reduction in fatigue. However, that could mimic anhedonia. This study looksthere were many variations to the studies so at how these three symptoms interact with anocleardosingamountorfrequency focus on cognition as measured by the Symbolcould be determined with such few studies and Digit Modality Test. The SDMT was selectedmany variables. The ndings were published by an MS task force as the best way to quicklyin the journal Nutrients. screen for changes in cognition. This test primarily measuresprocessingspeed.ChangesinaThrower- Vitamin D deciency is common persons SDMT could represent worsening ofin people living with MS. This vitamin plays cognition and would alert the healthcarea role in not only bone health but, also has provider that a more detailed look may beimmunoregulatory functions. Several studies warranted. The SDMT can be done on paperhave shown a reduction in relapse rates and orelectronically.Itrequiresthepatienttoa reduction in the formation of new MRI lesions match symbols with their corresponding digitswhen low levels of vitamin D are corrected in during a 90-second timed test. With the currentpeople with MS, although there is not a 100 study, researchers found that depression waspercent consensus on this topic. This study linked to worsening of the SDMT. This ndingpooled several studies to look at the effect of points out that not all cognitive dysfunctionvitamin D on fatigue, one of the most common 53 msfocusmagazine.org"