Bakshi Rohit
Buffalo Neuroimaging Analysis Center, The Jacobs Neurological Institute, University at Buffalo, State University of New York, Buffalo, New York 14203, USA.
Mult Scler. 2003 Jun;9(3):219-27. doi: 10.1191/1352458503ms904oa.
In patients with multiple sclerosis (MS) fatigue is the most common symptom and one of the most disabling features. As many as 40% have described it as the single most disabling symptom--a higher percentage than weakness, spasticity, motor problems, or bowel or bladder problems. The etiology and pathophysiology of MS-related fatigue remain unknown. Studies have failed to demonstrate an association between MS-related fatigue and the level of disability, clinical disease subtype, or gender, although recent data show an association between MS-related fatigue and depression and quality of life. Imaging studies using positron emission tomography suggest that fatigue in MS is related to hypometabolism of specific brain areas, including the frontal and subcortical circuits. The impact of fatigue on patient functioning and quality of life clearly warrants intervention. In addition to nonpharmacologic measures, such as exercise and energy conservation strategies, several pharmacologic agents have been evaluated for their ability to reduce MS-related fatigue, including amantadine, central nervous system stimulants (pemoline), and the novel wake-promoting agent modafinil.
在多发性硬化症（MS）患者中，疲劳是最常见的症状，也是最致残的特征之一。多达40%的患者将其描述为最致残的单一症状，这一比例高于虚弱、痉挛、运动问题或肠道或膀胱问题。与MS相关的疲劳的病因和病理生理学仍不清楚。尽管最近的数据显示与MS相关的疲劳与抑郁和生活质量之间存在关联，但研究未能证明与MS相关的疲劳与残疾程度、临床疾病亚型或性别之间存在关联。使用正电子发射断层扫描的影像学研究表明，MS中的疲劳与特定脑区的代谢减退有关，包括额叶和皮质下回路。疲劳对患者功能和生活质量的影响显然需要干预。除了非药物措施，如运动和能量节约策略外，还评估了几种药物减少与MS相关疲劳的能力，包括金刚烷胺、中枢神经系统兴奋剂（匹莫林）和新型促醒剂莫达非尼。
