TY - JOUR T1 - A randomised double-blind placebo-controlled feasibility trial of flavonoid-rich cocoa for fatigue in people with relapsing and remitting multiple sclerosis JF - Journal of Neurology, Neurosurgery & Psychiatry JO - J Neurol Neurosurg Psychiatry SP - 507 LP - 513 DO - 10.1136/jnnp-2018-319496 VL - 90 IS - 5 AU - Shelly Coe AU - Jo Cossington AU - Johnny Collett AU - Andrew Soundy AU - Hooshang Izadi AU - Martin Ovington AU - Luke Durkin AU - Maja Kirsten AU - Miriam Clegg AU - Ana Cavey AU - Derick T Wade AU - Jacqueline Palace AU - Gabriele C DeLuca AU - Kim Chapman AU - Jane-Marie Harrison AU - Elizabeth Buckingham AU - Helen Dawes Y1 - 2019/05/01 UR - http://jnnp.bmj.com/content/90/5/507.abstract N2 - The impact of flavonoids on fatigue has not been investigated in relapsing and remitting multiple sclerosis (RRMS).Objective To determine the feasibility and estimate the potential effect of flavonoid-rich cocoa on fatigue and fatigability in RRMS.Methods A randomised double-blind placebo-controlled feasibility study in people recently diagnosed with RRMS and fatigue, throughout the Thames Valley, UK (ISRCTN69897291). During a 6-week intervention participants consumed a high or low flavonoid cocoa beverage daily. Fatigue and fatigability were measured at three visits (weeks 0, 3 and 6). Feasibility and fidelity were assessed through recruitment and retention, adherence and a process evaluation.Results 40 people with multiple sclerosis (10 men, 30 women, age 44±10 years) were randomised and allocated to high (n=19) or low (n=21) flavonoid groups and included in analysis. Missing data were <20% and adherence to intervention of allocated individuals was >75%. There was a small effect on fatigue (Neuro-QoL: effect size (ES) 0.04, 95% CI −0.40 to 0.48) and a moderate effect on fatigability (6 min walk test: ES 0.45, 95% CI −0.18 to 1.07). There were seven adverse events (four control, three intervention), only one of which was possibly related and it was resolved.Conclusion A flavonoid beverage demonstrates the potential to improve fatigue and fatigability in RRMS. ER -